An investigation of patterns of association between anxiety symptom clusters and mask-wearing during the COVID-19 pandemic in Canada.

Abstract

Several measures have been implemented to reduce the spread of the COVID-19, with mask-wearing among the most widely used measures. Yet, the barriers to mask-wearing are unclear. This study examined whether different types of anxiety symptom clusters (i.e., symptoms of claustrophobia, physical anxiety sensitivity, and social anxiety sensitivity) are associated with mask-wearing tendencies during the COVID-19 pandemic and investigated how anxiety symptom clusters relate to mask-wearing discomfort and selfisolation distress. A total of 556 Canadian adults were recruited online between January and February of 2021. The study was administered online via Qualtrics. Participants completed questionnaires measuring symptoms of claustrophobia, anxiety sensitivity, and isolation distress, along with a measure of maskwearing behaviours. Linear regression analyses revealed that elevated anxiety symptoms across all symptom clusters predicted more physical and emotional discomfort related to mask-wearing, as well as reduced likelihood of leaving the home due to mask-related discomfort. Leaving home less often due to mask-related discomfort was significantly associated with more self-isolation distress and poorer coping overall. Differential patterns of mask-wearing behaviours across anxiety symptom clusters were not detected. These findings suggest that anxiety symptoms (i.e., including claustrophobia, physical anxiety sensitivity, and social anxiety sensitivity) are positively associated with mask-related distress. This, in turn, may lead people to avoid leaving their home and consequently experience increased self-isolation distress. Furthermore, these findings suggest that people with heightened anxiety symptoms tend to experience more discomfort with mask-wearing, which may perpetuate a cycle of avoidance and poorer coping overall. Public Significance StatementThe findings suggest that anxiety symptoms may interfere with engagement in this important public health measure, informing policy-makers of at-risk groups in the population. Moreover, those who experience higher mask-related anxiety are more likely to stay at home, leading to increased self-isolation and isolation-related distress.