SARS and Its Effects: Coping with the Threat

Esther Greenglass,Anita DeLongis & Dayna Lee-

Baggley

Paper presented at ICP, Bejing, August 8- 13, 2004

 

 

Grateful acknowledgement toGeorge D. Bishop, National

University of Singapore & the SARS Psychosocial

Research Consortium  

Coping with SARS

• In dealing with stress, some strategies include preventive coping, taking precautions, relationship focused coping, seeking social support and avoidance

• The relationship between anxiety and these strategies is examined here

Method

• Data were collected using an Internet-based survey based on 229 respondents from Europe, Asia, Australia, New Zealand, Canada, and the USA and was conducted from May 2003 to January 2004

• This study focused primarily on the stressful aspects of the perception of SARS and coping strategies employed

Demographics• Gender 159 Female 65 Male 5 missing• Age

Age Frequency• Under 20 69• 20-39 100• 40-59 49• 60+ 5• Missing 6

Demographics (cont.d)• Education

Years Frequency• <6 years 10• 7-12 28• 13-16 94• 16+ 94• Missing 3

Perceived SARS Threat

• A 5-item measure• Extent to which SARS is seen as a

direct threat to one’s health• Sample item: “SARS is threatening

my health”• Response: 1 not at all to 4 a great

deal• Alpha = .71

Preventive Coping

• A 3-item measure that assesses behaviors designed to lessen the risk of getting SARS in the future

• Sample item: “I do what I can so that I will not get SARS”

• Response: 1 not at all true 4 completely true

• Alpha = .77

To avoid getting SARS, I have personally: (tick those that apply)

Avoidance Behavior• Travel to SARS affected

area• Eating in restaurants• Shaking hands• Travel in taxis• Travel in subways or

commuter trains• Eating in food courts• Large gatherings of

people• Particular types of people• Travel by plane• Work/school

Taking Precautions• Worn a mask• Washed my hands more

often• Taken more care about

cleanliness• Used disinfectants• Eaten a balanced diet• Exercised regularly• Taken an herbal

supplement• Made sure I got sufficient

sleep

Score= sum of behaviors checked

Seeking Social Support• A 2-item measure that assesses

seeking information and emotional support to deal with concerns about SARS

• Sample Item: “Talked to someone to find out more about SARS”

• Response: 1 not at all 5 a great deal

• Alpha =.83

Relationship Focused Coping

• A 4- item measure that assesses extent to which the individual helps others deal with SARS

• Sample item: “Tried to understand the other person’s concerns about SARS”

• Response: 1 not at all 4 a great deal

• Alpha = .91

Avoidance of People• A 10-item measure• Sum of behaviors to avoid certain

people including those who appear unwell,a health care worker, and a person who might be from an area infected with SARS, for example

• Sample item: “How likely are you to avoid a person who is coughing?”

• Response: 1 very unlikely to 5 very likely

• Alpha = .91

State Anxiety

• Anxiety related to SARS• A 17-item measure• Adapted from the State-Trait Anxiety

Inventory (STAI) A-State Anxiety measure (Spielberger et al., 1970)

• Sample item: “I am worried about possible misfortune regarding SARS”

• Response: 1 not at all 4 very much so• Alpha = .94

Depression• A 10-item measure* designed to measure • Sample item: “I feel sad”• Response: 1 rarely or none of the time 4 most or all of the time• Alpha=.88

*Center for Epidemiological Studies Depression Scale

Relative Risk of Getting SARS vs Catching a Cold*

• A 2-item measure• The relative risk of me or someone my

age and sex getting SARS compared to the risk of catching a cold

• Sample item: “Compared to my risk of catching a cold, the risk of my getting SARS is”

• Response: 1 very low to 5 very high• Alpha = .82

* adapted from Renner & Schwarzer, 2003

Relative Risk of Getting SARS vs Getting West Nile

Virus*• A 2-item measure• The relative risk of me or someone my

age and sex getting SARS compared to the risk of getting West Nile Virus

• Sample item: “Compared to my risk of getting West Nile virus, the risk of my getting SARS is”

• Response: 1 very low to 5 very high• Alpha = .92

*adapted from Renner & Schwarzer, 2003

Relative Risk of Getting SARS vs Getting AIDS*

• A 2-item measure• The relative risk of me or someone my

age and sex getting SARS compared to the risk of getting AIDS

• Sample item: “Compared to my risk of getting AIDS, the risk of my getting SARS is”

• Response: 1 very low to 5 very high• Alpha = .82

*adapted from Renner & Schwarzer, 2003

Correlations Between SARS Threat, Anxiety, Risk of Getting SARS

Compared to the Risk of Catching a Cold, Getting AIDS and Getting West

Nile Virus State Anxiety Cold RiskAIDS RiskWest Nile Virus

Risk

**p < .01 ***p < .001

59***

51***

31***

29**

Correlations between Anxiety, Avoidance of People, Avoidance Behavior, Taking

Precautions, & Risk of Getting SARS vs. Risk of Catching a Cold, Getting AIDS & Getting

West Nile Virus

Avoidance of PeopleCold RiskAIDS RiskWest Nile VirusAvoidance BehaviorTaking Precautions

**p < .01 ***p < .001

52***

52***

39***

33**

32**

30**

Theoretical Model Relating SARS Threat, Preventive Coping, Avoidance of People,

Anxiety and Depression

SARS Threat

PreventCoping

Avoid ofPeople

State Anxiety

Depression

Structural Model Relating SARS Threat, Preventive Coping, Avoidance of People,

Anxiety and Depression

SARS Threat

PreventCoping

Avoid ofPeople

State Anxiety

Depression

.49***

.39***

.52***.27***

.47***

.12*

-.25**

.18**

Model Chi-Square

df p GFI AGFI NFI CFI RMSEA PCLOSE 

Initial model 

25.835 4 .000 .962 .856 .919 .929 .155 .001

Revised Model 1a

 

11.298 3 .010 .981 .903 .965 .973 .110 .057

Revised Model 1b

 

3.958 2 .138 .993 .949 .988 .994 .066 .291

Goodness of Fit Indices for Models

a

a Identical to the initial model except that a path from preventive coping to depression was addedb Identical to the revised model 1a except that a correlation between preventive coping and avoiding people perceived to be at high risk of SARS was added

Conclusions • Greater threat due to SARS leads to

increases in preventive coping and avoidance of people associated with SARS

• Preventive coping includes avoidance of people

• Preventive coping and avoidance of people lead to greater anxiety

• Anxiety leads to depression• Depression decreases with greater

preventive coping