How Perceived Partner Responsiveness Moderates the Relationship between Metacognitive Beliefs about Health Anxiety and COVID-19 Anxiety?

Abstract

While previous studies have explored the links between COVID-19 anxiety and metacognitive beliefs, scant attention has been given to the relationship between metacognitive beliefs about health anxiety and COVID-19 anxiety, and the potential influencers of this relationship. Existing research underscores the importance of perceiving understanding, validation, and sensitivity from romantic partners in managing stress and anxiety effectively. The aim of this study is to examine the relationships between metacognitive beliefs about health anxiety and COVID-19 anxiety as well as the perceived partner responsiveness. Another objective is to assess the potential moderating effect of perceived partner responsiveness. Our research involved 210 individuals, aged 18 to 65, engaged in romantic relationships between November 2020 and May 2021. Participants completed the Perceived Partner Responsiveness Scale, Coronavirus Anxiety Scale, and Metacognition Questionnaire-Health Anxiety Scale. Our findings reveal a positive association between metacognitive beliefs regarding uncontrollable thoughts, COVID-19 and general anxiety symptoms. Contrary to expectations, heightened perceived partner responsiveness exacerbated the impact of uncontrollable thought beliefs on coronavirus anxiety. Nevertheless, this effect does not manifest in general anxiety symptoms. This moderating role of perceived partner responsiveness differs from existing literature, emphasizing the need for further research into metacognition, anxiety, and relationship dynamics.

Keywords

• perceived partner responsiveness
• health anxiety
• metacognitive beliefs

References

1. Ahorsu, D. K., Lin, C. Y., Imani, V., Saffari, M., Griffiths, M. D., & Pakpour, A. H. (2020). The fear of COVID-19 scale: development and initial validation. International Journal of Mental Health and Addiction, 1-9.
2. Ay, T., & Hizli Sayar, F. G. (2022). Association between Metacognitive Beliefs and COVID-19 phobia in a community population: a cross-sectional study. Current Psychology, 1-11.
3. Bailey, R., & Wells, A. (2015). Development and initial validation of a measure of metacognitive beliefs in health anxiety: The MCQ-HA. Psychiatry Research, 230(3), 871-877.
4. Bailey, R., & Wells, A. (2016). Is metacognition a causal moderator of the relationship between catastrophic misinterpretation and health anxiety? A prospective study. Behaviour Research and Therapy, 78, 43-50.
5. Balzarini, R. N., Muise, A., Zoppolat, G., Di Bartolomeo, A., Rodrigues, D. L., Alonso-Ferres, M., ... & Slatcher, R. B. (2023). Love in the time of COVID: Perceived partner responsiveness buffers people from lower relationship quality associated with COVID-related stressors. Social Psychological and Personality Science, 14(3), 342-355.
6. Beck, A. T., Epstein, N., Brown, G., ve Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893.
7. Bomyea, J., Ramsawh, H., Ball, T. M., Taylor, C. T., Paulus, M. P., Lang, A. J., & Stein, M. B. (2015). Intolerance of uncertainty as a mediator of reductions in worry in a cognitive behavioral treatment program for generalized anxiety disorder. Journal of Anxiety Disorders, 33, 90–94. doi:10.1016/j.janxdis.2015.05.004
8. Bueno-Notivol, J., Gracia-García, P., Olaya, B., Lasheras, I., López-Antón, R., & Santabárbara, J. (2021). Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. International journal of clinical and health psychology, 21(1), 100196.

9. Buunk, B. P., Janssen, P. P., & Vanyperen, N. W. (1989). Stress and Afïïliation Reconsidered: the Effects of Social Support in Stressful and Non-stressful Work. Social Behaviour, 4, 155-171.
10. Carleton, R. N. (2016). Into the unknown: A review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders, 39, 30–43. doi:10.1016/j.janxdis.2016.02.007
11. Cassidy, J., & Shaver, P. R. (Eds.). (1999). Handbook of attachment: Theory, research, and clinical applications. New York: Guilford.
12. Collins, N. L., & Feeney, B. C. (2000). A safe haven: an attachment theory perspective on support seeking and caregiving in intimate relationships. Journal of Personality and Social Psychology, 78(6), 1053.
13. Doane, L. D., Mineka, S., Zinbarg, R. E., Craske, M., Griffith, J. W., & Adam, E. K. (2013). Are flatter diurnal cortisol rhythms associated with major depression and anxiety disorders in late adolescence? The role of life stress and daily negative emotion. Development and Psychopathology, 25(3), 629-642.
14. Eşkisu, M., Çam, Z., & Boysan, M. (2023). Health-Related Cognitions and Metacognitions Indirectly Contribute to the Relationships Between Impulsivity, Fear of COVID-19, and Cyberchondria. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 1-23.
15. Evren, C., Evren, B., Dalbudak, E., Topcu, M., ve Kutlu, N. (2020). Measuring anxiety related to COVID-19: A Turkish validation study of the Coronavirus Anxiety Scale. Death Studies, 1-7.
16. Feeney B. C., & Collins N. L. (2015). Thriving through relationships. Current Opinion in Psychology, 1, 22–28.
17. Han, L., Zhan, Y., Li, W., Xu, Y., Xu, Y., & Zhao, J. (2021). Associations between the perceived severity of the COVID-19 pandemic, cyberchondria, depression, anxiety, stress, and lockdown experience: cross-sectional survey study. JMIR Public Health and Surveillance, 7(9), e31052.
18. Hashemi, S. G. S., Hosseinnezhad, S., Dini, S., Griffiths, M. D., Lin, C. Y., & Pakpour, A. H. (2020). The mediating effect of the cyberchondria and anxiety sensitivity in the association between problematic internet use, metacognition beliefs, and fear of COVID-19 among Iranian online population. Heliyon, 6(10).
19. Huang, Y., Wang, Y., Zeng, L., Yang, J., Song, X., Rao, W., ... & Zhang, X. (2020). Prevalence and correlation of anxiety, insomnia and somatic symptoms in a Chinese population during the COVID-19 epidemic. Frontiers in psychiatry, 11, 568329.
20. Kaur, A., Butow, P., & Thewes, B. (2011). Do metacognitions predict attentional bias in health anxiety?. Cognitive Therapy and Research, 35, 575-580.
21. Kıran, S. (2020). Sağlık anksiyetesini yordayan bilişsel ve üstbilişsel faktörler. Unpublished master’s thesis. Dokuz Eylül University, İzmir.
22. Lakhan, R., Agrawal, A., & Sharma, M. (2020). Prevalence of depression, anxiety, and stress during COVID-19 pandemic. Journal of neurosciences in rural practice, 11(04), 519-525.
23. Lee, S. A. (2020). Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death studies, 44(7), 393-401.
24. Maisel, N. C., & Gable, S. L. (2009). The paradox of received social support: The importance of responsiveness. Psychological Science, 20(8), 928-932.
25. McCauley, M., Minsky, S., & Viswanath, K. (2013). The H1N1 pandemic: Media frames, stigmatization and coping. BMC Public Health, 13(1), 1116. doi:10.1186/1471-2458-13-1116.
26. Melli, G., Bailey, R., Carraresi, C., & Poli, A. (2018). Metacognitive beliefs as a predictor of health anxiety in a self‐reporting Italian clinical sample. Clinical Psychology & Psychotherapy, 25(2), 263-271.
27. Mikulincer, M., & Shaver, P. R. (2007). Attachment, group–related processes, and psychotherapy. International Journal of Group Psychotherapy, 57(2), 233-245.
28. Mohammadkhani, S., Akbari, M., Shahbahrami, M., Seydavi, M., & Kolubinski, D. C. (2023). Metacognitions about health in relation to coronavirus anxiety: The mediating role of cognitive attentional syndrome and distress tolerance. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 41(1), 222-236.
29. Oglesby, M. E., Raines, A. M., Short, N. A., Capron, D. W., & Schmidt, N. B. (2016). Interpretation bias for uncertain threat: A replication and extension. Journal of Behavior Therapy and Experimental Psychiatry, 51, 35–42. doi:10.1016/ j.jbtep.2015.12.006.
30. Panayiotou, G., & Karekla, M. (2013). Perceived social support helps, but does not buffer the negative impact of anxiety disorders on quality of life and perceived stress. Social Psychiatry and Psychiatric Epidemiology, 48(2), 283–294. doi:10.1007/s00127-012-0533-6.
31. Reis, H. T. (2003). A self-report measure of perceived partner responsiveness. (Unpublished data), University of Rochester, Rochester, NY.
32. Reis, H. T., & Clark, M. S. (2013). Responsiveness. In J. A. Simpson & L. Campbell (Eds.), The Oxford handbook of close relationships (pp. 400–423). Oxford University Press.
33. Ruan, Y., Reis, H. T., Clark, M. S., Hirsch, J. L., & Bink, B. D. (2020). Can I tell you how I feel? Perceived partner responsiveness encourages emotional expression. Emotion, 20(3), 329.
34. Satici, B., Gocet-Tekin, E., Deniz, M. E., & Satici, S. A. (2021). Adaptation of the Fear of COVID-19 Scale: Its association with psychological distress and life satisfaction in Turkey. International journal of mental health and addiction, 19, 1980-1988.
35. Selçuk, E., Zayas, V., & Hazan, C. (2010). Beyond satisfaction: The role of attachment in marital functioning. Journal of Family Theory & Review, 2(4), 258-279.
36. Sher L. (2020). COVID-19, anxiety, sleep disturbances and suicide. Sleep medicine, 70, 124. https://doi.org/10.1016/j.sleep.2020.04.019
37. Slatcher R. B., Selçuk E., Ong A. D. (2015). Perceived partner responsiveness predicts diurnal cortisol profiles 10 years later. Psychological Science, 26, 972–982.
38. Shrout, P. E., Herman, C. M., & Bolger, N. (2006). The costs and benefits of practical and emotional support on adjustment: A daily diary study of couples experiencing acute stress. Personal Relationships, 13(1), 115-134. Simpson, J. A., Rholes, W. S., & Nelligan, J. S. (1992). Support seeking and support giving within couples in an anxiety-provoking situation: The role of attachment styles. Journal of Personality and Social Psychology, 62(3), 434.
39. Soares, L. S., Rodrigues, A. C., de Paula, J. J., Thorell, L. B., & de Miranda, D. M. (2021). Partner responsiveness moderates the relation between COVID-19-related stressors and changes in mood during the pandemic. Current Psychology, 1-8.
40. Taşfiliz, D., Çetiner, E. S., & Selçuk, E. (2020). Yakın ilişkilerde algılanan duyarlılığın yaş farklılıkları ve psikolojik esenlik ile ilişkisi. Türk Psikoloji Dergisi, 35(86), 19-39.
41. Ulusoy, M., Şahin, N. H., ve Erkmen, H. (1998). The Beck anxiety inventory: psychometric properties. Journal of Cognitive Psychotherapy, 12(2), 163-72.
42. Wells, A. (2000). Emotional Disorders and Metacognition. Innovative Cognitive Therapy. Chichester: Wiley
43. Wells, A., & Matthews, G. (1996). Modeling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34(11-12), 881-888.
44. Yook, K., Kim, K. H., Suh, S. Y., & Lee, K. S. (2010). Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 24(6), 623–628. doi:10.1016/j. janxdis.2010.04.003