(PS2-38) Risk Perception Contributes to Daily Worry During the COVID-19 Pandemic: An Ecological Momentary Assessment Study

Worry is a critical transdiagnostic process involved in the development and maintenance of various affective disorders. Worry and other forms of cognitive avoidance are predictive of many negative outcomes including increased anxiety, negative affect, and physiological arousal. Theoretical models posit that risk perception, including inflated estimates of risk probability and risk severity, is one mechanism that may contribute to increased worry and anticipatory distress, particularly when facing an uncertain stressor. While it is thought that the process whereby risk perception impacts worry unfolds on a day to day basis, little research has explored this relationship directly. Research leveraging intensive longitudinal data, such as ecological momentary assessment (EMA), is needed to better understand how daily shifts in risk perception may contribute to daily worry, and vice versa. The current study was conducted in Spring 2020, during the early phase of the COVID-19 pandemic, which serves as a unique case study highlighting an uncertain stressor that was associated with both risk perception and high levels of worry.  

Participants (N = 143) were undergraduate students who completed a daily EMA paradigm which included surveys three times per day for up to four weeks. In the morning, participants completed measures of their perceived infection likelihood and perceived infection severity related to COVID-19. Participants then rated their worry about COVID-19 in the afternoon, approximately four hours later. We ran a multilevel linear regression model to test whether earlier risk perception processes predicted later worry, controlling for the previous day’s worry. Person-average perceived infection likelihood (β = .29, p < .001) and person-average infection severity (β = .15, p < .001) both significantly predicted worry, indicating that individuals with higher average perceived infection likelihood and average perceived infection severity reported higher average worry about COVID-19. Importantly, there was also a significant effect of within-person infection likelihood (β = .07, p < .001) and infection severity (β = .05, p < .001). On days where individuals reported higher levels of perceived infection likelihood and infection severity, they also reported higher levels of worry about COVID-19. This study is one of the first investigations of how risk perception processes may contribute to worry and other forms of cognitive avoidance on a daily basis. Biased estimates of threat probability and severity appear to play an important role in increasing daily worry related to an ongoing stressor and may be a critical component in the development of affective symptoms. Clinically, our findings suggest that treatments targeting risk perception processes may be important for reducing worry during stressful events.