The impact of COVID-19 pandemic on quality of life is widely underscored. This study aimed to investigate the role of cognitive, affective, and behavioral factors on quality of life, as well as their mediating effect in the relationship of perceived risk of infection and control beliefs with quality of life. The sample consisted of 1730 adults. A battery of established and self-devised scales was administered online. It was found that higher levels of perceived risk of infection and negative emotionality predicted worse quality of life, while reflective functioning independently contributed to better well-being. Furthermore, a greater sense of personal control predicted better quality of life, but this effect was partially mediated by positive reappraisal, wishful thinking, avoidance, and trust. Specifically, higher level of control beliefs predicted better quality of life through higher levels of positive reappraisal and trust along with less use of wishful thinking and avoidance. Adherence to preventive measures was unrelated to quality of life. It is concluded that psychological factors and adaptive coping strategies should be prioritized in designing interventions and policies against COVID-19 pandemic.
KeywordsCOVID-19Quality of LifePerceived Risk of InfectionInfection Control BeliefsReflective FunctioningTrustEmotionalityCoping Strategies
Alqahtani, F. D., Hassan, S. U. N., Alsaif, B., & Zrieq, R. (2021). Assessment of the Quality of Life during COVID-19 Pandemic: A Cross-Sectional Survey from the Kingdom of Saudi Arabia. International Journal of Environmental Research and Public Health, 18, 847. https://doi.org/10.3390/ijerph18030847
Ballou, S., Gray, S., & Palsson, O. S. (2020). Validation of the Pandemic Emotional Impact Scale. Brain, Behavior, and Immunity—Health, 9, Article ID: 100161. https://doi.org/10.1016/j.bbih.2020.100161
Blake, H., Knight, H., Jia, R., Corner, J., Morling, J. R., Denning, C., Ball, J. K., Bolton, K., Figeuredo, G., Morris, D., Tighe, P., Villalon, A., Ayling, K., & Vedhara, K. (2021). Students’ Views towards SARS-CoV-2 Mass Asymptomatic Testing, Social Distancing and Self-Isolation in a University Setting during the COVID-19 Pandemic: A Qualitative Study. https://doi.org/10.20944/preprints202101.0399.v1
Bluhm, L. H. (1987). Trust, Terrorism, and Technology. Journal of Business Ethics, 6, 333-342. https://doi.org/10.1007/BF00382889
Borelli, J. L., Brugnera, A., Zarbo, C., Rabboni, M., Bondi, E., Tasca, G. A., & Compare, A. (2019). Attachment Comes of Age: Adolescents’ Narrative Coherence and Reflective Functioning Predict Well-Being in Emerging Adulthood. Attachment & Human Development, 21, 332-351. https://doi.org/10.1080/14616734.2018.1479870
Brailovskaia, J., & Margraf, J. (2020). Predicting Adaptive and Maladaptive Responses to the Coronavirus (COVID-19) Outbreak: A Prospective Longitudinal Study. International Journal of Clinical and Health Psychology, 20, 183-191. https://doi.org/10.1016/j.ijchp.2020.06.002
Carr, D., & Pudrovska, T. (2012). Divorce and Widowhood in Later Life. In R. Blieszner, & V. H. Bedford (Eds.), Handbook of Families and Aging (pp. 489-513). Praeger/ABC-CLIO. https://psycnet.apa.org/record/2012-21777-020
Christopoulos, A., Pavlopoulos, V., Poulios, A., Karadimitri, K., Lagos, E., Stavrakaki, M., Stefanakou, E., Alexopoulou, E., Bekiari, A., Ktena, M., Panaritis, C., Risvas, C., & Tsiorda, M. (2021). Direct and Indirect Pathways from Reflective Functioning to Conspiracy Thinking in the COVID-19 Pandemic. Manuscript submitted for publication.
Coroiu, A., Moran, C., Campbell, T., & Geller, A. C. (2020). Barriers and Facilitators of Adherence to Social Distancing Recommendations during COVID-19 among a Large International Sample of Adults. PLoS ONE, 15, e0239795. https://doi.org/10.1371/journal.pone.0239795
Costantini, G., Di Sarno, M., Preti, E., Richetin, J., & Perugini, M. (2021). Would You Rather Be Safe or Free? Motivational and Behavioral Aspects in COVID-19 Mitigation. Frontiers in Psychology, 12, Article ID: 635406. https://doi.org/10.3389/fpsyg.2021.635406
Ebrahimi, O. V., Hoffart, A., & Johnson, S. U. (2020). The Mental Health Impact of Non-Pharmacological Interventions Aimed at Impeding Viral Transmission during the COVID-19 Pandemic in a General Adult Population and the Factors Associated with Adherence to These Mitigation Strategies. Clinical Psychological Science. https://doi.org/10.31234/osf.io/kjzsp
Epifanio, M. S., Andrei, F., Mancini, G., Agostini, F., Piombo, M. A., Spicuzza, V., Riolo, M., Lavanco, G., Trombini, E., & La Grutta, S. (2021). The Impact of COVID-19 Pandemic and Lockdown Measures on Quality of Life among Italian General Population. Journal of Clinical Medicine, 10, 289. https://doi.org/10.3390/jcm10020289
Esposito, G., Passeggia, R., Pepicelli, G., Cannata, A., Parlato, F., & Freda, M. F. (2020). Mentalizing the University Experience: An Exploratory Study on the Relationship between University Students’ Reflective Functioning, Psychological Well-Being and Academic Performance. Mediterranean Journal of Clinical Psychology, 8, 1-21.
Ferreira, L. N., Pereira, L. N., da Fé Brás, M., & Ilchuk, K. (2021). Quality of Life under the COVID-19 Quarantine. Quality of Life Research, 30, 1389-1405. https://doi.org/10.1007/s11136-020-02724-x
Fetzer, T., Witte, M., Hensel, L., Jachimowicz, J. M., Haushofer, J., Ivchenko, A., Caria, S., Reutskaja, E., Roth, C., Fiorin, S., Gomez, M., Kraft-Todd, G., Goetz, F., & Yoeli, E. (2020). Measuring Worldwide COVID-19 Attitudes and Beliefs. Working Paper. https://files.osf.io/v1/resources/3sn2k/providers/osfstorage/5ea0300e35f4bf0057201b28?action=download&direct&version=4
Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). Dynamics of a Stressful Encounter: Cognitive Appraisal, Coping, and Encounter Outcomes. Journal of Personality and Social Psychology, 50, 992-1003. https://doi.org/10.1037/0022-3514.50.5.992
Fonagy, P., Luyten, P., Moulton-Perkins, A., Lee, Y.-W., Warren, F., Howard, S., Ghinai, R., Fearon, P., & Lowyck, B. (2016). Development and Validation of a Self-Report Measure of Mentalizing: The Reflective Functioning Questionnaire. PLoS ONE, 11, e0158678. https://doi.org/10.1371/journal.pone.0158678
Garbóczy, S., Szemán-Nagy, A., Ahmad, M. S., Harsányi, S., Ocsenás, D., Rekenyi, V., Al-Tammemi, A. B., & Kolozsvári, L. R. (2021). Health Anxiety, Perceived Stress, and Coping Styles in the Shadow of the COVID-19. BMC Psychology, 9, Article No. 53. https://doi.org/10.1186/s40359-021-00560-3
Ginieri-Coccossis, M., Triantafillou, E., Tomaras, V., Soldatos, C., Mavreas, V., & Christodoulou, G. (2012). Psychometric Properties of WHOQOL-BREF in Clinical and Health Greek Populations: Incorporating New Culture-Relevant Items. Psychiatriki (Psychiatry), 23, 130-142. https://pubmed.ncbi.nlm.nih.gov/22796911
Girardi, D., De Carlo, A., Dal Corso, L., Di Sipio, A., & Falco, A. (2021, April 24-26). Risk of COVID-19 Infection at Work and Psycho-Physical Strain: The Moderating Role of Negative Affectivity. Psychological Applications and Trends, 312-316. https://doi.org/10.36315/2021inpact064
Griva, F., Pomini, V., Gournellis, R., Doumos, G., Thomakos, P., & Vaslamatzis, G. (2020). Psychometric Properties and Factor Structure of the Greek Version of Reflective Functioning Questionnaire. Psychiatriki (Psychiatry), 31, 216-224. https://doi.org/10.22365/jpsych.2020.313.216
Groth, N., Schnyder, N., Kaess, M., Markovic, A., Rietschel, L., Moser, S., Michel, C., Schultze-Lutter, F., & Schmidt, S. (2019). Coping as a Mediator between Locus of Control, Competence Beliefs, and Mental Health: A Systematic Review and Structural Equation Modelling Meta-Analysis. Behaviour Research and Therapy, 121, Article ID: 103442. https://doi.org/10.1016/j.brat.2019.103442
Gurvich, C., Thomas, N., Thomas, E. H., Hudaib, A.-R., Sood, L., Fabiatos, K., Sutton, K., Isaacs, A., Arunogiri, S., Sharp, G., & Kulkarni, J. (2020). Coping Styles and Mental Health in Response to Societal Changes during the COVID-19 Pandemic. International Journal of Social Psychiatry, 67, 540-549. https://doi.org/10.1177/0020764020961790
Helliwell, J. F., Huang, H., Wang, S., & Norton, M. (2021). Happiness, Trust and Deaths under COVID-19. In World Happiness Report 2021 (Chap. 2). https://worldhappiness.report/
Horesh, D., Kapel Lev-Ari, R., & Hasson-Ohayon, I. (2020). Risk Factors for Psychological Distress during the COVID‐19 Pandemic in Israel: Loneliness, Age, Gender, and Health Status Play an Important Role. British Journal of Health Psychology, 25, 925-933. https://doi.org/10.1111/bjhp.12455
Karademas, E. C. (2007). Positive and Negative Aspects of Well-Being: Common and Specific Predictors. Personality and Individual Differences, 43, 277-287. https://doi.org/10.1016/j.paid.2006.11.031
Kharshiing, K. D., Kashyap, D., Gupta, K., Khursheed, M., Shahnawaz, M. G., Khan, N. H., Uniyal, R., & Rehman, U. (2021). Quality of Life in the COVID-19 Pandemic in India: Exploring the Role of Individual and Group Variables. Community Mental Health Journal, 57, 70-78. https://doi.org/10.1007/s10597-020-00712-6
Krok, D., & Zarzycka, B. (2020). Risk Perception of COVID-19, Meaning-Based Resources and Psychological Well-Being amongst Healthcare Personnel: The Mediating Role of Coping. Journal of Clinical Medicine, 9, 3225. https://doi.org/10.3390/jcm9103225
Lamarche, V. M. (2020). Socially Connected and COVID-19 Prepared: The Influence of Sociorelational Safety on Perceived Importance of COVID-19 Precautions and Trust in Government Responses. Social Psychological Bulletin, 15, e4409. https://doi.org/10.32872/spb.4409
Lazarus, R., & Folkman, S. (1984). Stress, Appraisal, and Coping. Spring Publisher Company.
Lee, D. J., So, W. Y., & Lee, S. M. (2021). The Relationship between Korean Adolescents’ Sports Participation, Internal Health Locus of Control, and Wellness during COVID-19. International Journal of Environmental Research and Public Health, 18, 2950. https://doi.org/10.3390/ijerph18062950
Li, J. B., Yang, A., Dou, K., Wang, L. X., Zhang, M. C., & Lin, X. Q. (2020). Chinese Public’s Knowledge, Perceived Severity, and Perceived Controllability of COVID-19 and Their Associations with Emotional and Behavioural Reactions, Social Participation, and Precautionary Behaviour: A National Survey. BMC Public Health, 20, Article No. 1589. https://doi.org/10.1186/s12889-020-09695-1
Luyten, P., & Fonagy, P. (2018). The Stress-Reward-Mentalizing Model of Depression: An Integrative Developmental Cascade Approach to Child and Adolescent Depressive Disorder Based on the Research Domain Criteria (RDoC) Approach. Clinical Psychology Review, 64, 87-98. https://doi.org/10.1016/j.cpr.2017.09.008
Luyten, P., Campbell, C., Allison, E., & Fonagy, P. (2020). The Mentalizing Approach to Psychopathology: State of the Art and Future Directions. Annual Review of Clinical Psychology, 16, 297-325. https://doi.org/10.1146/annurev-clinpsy-071919-015355
Martinelli, N., Gil, S., Belletier, C., Chevalère, J., Dezecache, G., Huguet, P., & Droit-Volet, S. (2021). Time and Emotion during Lockdown and the Covid-19 Epidemic: Determinants of Our Experience of Time? Frontiers in Psychology, 11, Article ID: 616169. https://doi.org/10.3389/fpsyg.2020.616169
McCabe, M. (2006). A Longitudinal Study of Coping Strategies and Quality of Life among People with Multiple Sclerosis. Journal of Clinical Psychology in Medical Settings, 13, 367-377. https://doi.org/10.1007/s10880-006-9042-7
McFadden, P., Ross, J., Moriarty, J., Mallett, J., Schroder, H., Ravalier, J., Manthorpe, J., Currie, D., Harron, J., & Gillen, P. (2021). The Role of Coping in the Wellbeing and Work-Related Quality of life of UK Health and Social Care Workers during COVID-19. International Journal of Environmental Research and Public Health, 18, 815. https://doi.org/10.3390/ijerph18020815
Mikulincer, M., & Shaver, P. R. (2007). Attachment in Adulthood: Structure, Dynamics, and Change. Guilford Press.
Nolte, T., Guiney, J., Fonagy, P., Mayes, L. C., & Luyten, P. (2011). Interpersonal Stress Regulation and the Development of Anxiety Disorders: Attachment-Based Developmental Framework. Frontiers in Behavioral Neuroscience, 5, 55. https://doi.org/10.3389/fnbeh.2011.00055
Nordgren, L. F., Van Der Pligt, J., & Van Harreveld, F. (2007). Unpacking Perceived Control in Risk Perception: The Mediating Role of Anticipated Regret. Journal of Behavioral Decision Making, 20, 533-544. https://doi.org/10.1002/bdm.565
Panayiotou, G., Panteli, M., & Leonidou, C. (2021). Coping with the Invisible Enemy: The Role of Emotion Regulation and Awareness in Quality of Life during the COVID-19 Pandemic. Journal of Contextual Behavioral Science, 19, 17-27. https://doi.org/10.1016/j.jcbs.2020.11.002
Pavlopoulos, V., Christopoulos, A., Poulios, A., Alexopoulou, E., Bekiari, A., Ktena, M., Panaritis, C., Risvas, C., Tsiorda, M., Karadimitri, K., Lagos, E., Stavrakaki, M., & Stefanakou, E. (2021). The Good, the Bad and the Ugly: Predicting Adherence to Quarantine and Endorsement of Scientifically Informed Policies in the COVID-19 Pandemic. Manuscript submitted for publication.
Pieh, C., Budimir, S., & Probst, T. (2020). The Effect of Age, Gender, Income, Work, and Physical Activity on Mental Health during Coronavirus Disease (COVID-19) Lockdown in Austria. Journal of Psychosomatic Research, 136, Article ID: 110186. https://doi.org/10.1016/j.jpsychores.2020.110186
Prati, G., Pietrantoni, L., & Zani, B. (2011). A Social-Cognitive Model of Pandemic Influenza H1N1 Risk Perception and Recommended Behaviors in Italy: A Social-Cognitive Model of Pandemic Influenza H1N1. Risk Analysis, 31, 645-656. https://doi.org/10.1111/j.1539-6924.2010.01529.x
Reinders Folmer, C., Brownlee, M., Fine, A., Kooistra, E. B., Kuiper, M. E., Olthuis, E., De Bruijn, A. L., & Van Rooij, B. (2020). Social Distancing in America: Understanding Long-Term Adherence to Covid-19 Mitigation Recommendations. Amsterdam Law School Research Paper (2020-62). https://psyarxiv.com/457em/download/?format=pdf https://doi.org/10.31234/osf.io/457em
Robinson, P., Skårderud, F., & Sommerfeldt, B. (2019). Eating Disorders and Mentalizing. In P. Robinson, F. Skårderud, & B. Sommerfeldt (Eds.), Hunger: Mentalization-Based Treatments for Eating Disorders (pp. 35-49). Springer. https://doi.org/10.1007/978-3-319-95121-8_3
Rohrmann, B. (2008, June). Risk Perception, Risk Attitude, Risk Communication, Risk Management: A Conceptual Appraisal. Paper Presented in the 15th International Emergency Management Society Annual Conference (Vol. 2008).
Rossi, R., Socci, V., Talevi, D., Mensi, S., Niolu, C., Pacitti, F., Di Marco, A., Rossi, A., Siracusano, A., & Di Lorenzo, G. (2020). COVID-19 Pandemic and Lockdown Measures Impact on Mental Health among the General Population in Italy. Frontiers in Psychiatry, 11, 790. https://doi.org/10.3389/fpsyt.2020.00790
Rundmo, T., & Iversen, H. (2004). Risk Perception and Driving Behaviour among Adolescents in Two Norwegian Counties before and after a Traffic Safety Campaign. Safety Science, 42, 1-21. https://doi.org/10.1016/S0925-7535(02)00047-4
Sarli, L., Artioli, G., de Luca, E., Moretti, C., Camacho, V. C., Di Niro, V., Deiana, L., & Monaco, F. (2021). Nurses’ Perceived Quality of Educational Life during the Covid-19 Induced Rapid Transition to Online Learning in Post-Graduate Courses: A Qualitative Study. Creative Education, 12, 1247-1261. https://doi.org/10.4236/ce.2021.126094
Schwarzer, N. H., Nolte, T., Fonagy, P., Griem, J., Kieschke, U., & Gingelmaier, S. (2021). The Relationship between Global Distress, Mentalizing and Well-Being in a German Teacher Sample. Current Psychology, 1-10. https://doi.org/10.1007/s12144-021-01467-3
Shamblaw, A. L., Rumas, R. L., & Best, M. W. (2021). Coping during the COVID-19 Pandemic: Relations with Mental Health and Quality of Life. Canadian Psychology/ Psychologie Canadienne, 62, 92-100. https://doi.org/10.1037/cap0000263
Shamloo, M. B. B., Nasiri, M., Maneiy, M., Kiarsi, M., & Madmoli, Y. (2020). Correlation between Ways of Coping and Quality of Life in Iranian Husbands of Women with Breast Cancer. International Journal of Palliative Nursing, 26, 84-90. https://doi.org/10.12968/ijpn.2020.26.2.84
Solomou, I., & Constantinidou, F. (2020). Prevalence and Predictors of Anxiety and Depression Symptoms during the COVID-19 Pandemic and Compliance with Precautionary Measures: Age and Sex Matter. International Journal of Environmental Research and Public Health, 17, 4924. https://doi.org/10.3390/ijerph17144924
Šrol, J., Mikušková, E. B., & Cavojova, V. (2020). When We Are Worried, What Are We Thinking? Anxiety, Lack of Control, and Conspiracy Beliefs amidst the COVID-19 Pandemic. Applied Cognitive Psychology, 35, 720-729. https://doi.org/10.1002/acp.3798
Van Ballegooijen, H., Goossens, L., Bruin, R. H., Michels, R., & Krol, M. (2021). Concerns, Quality of Life, Access to Care and Productivity of the General Population during the First 8 Weeks of the Coronavirus Lockdown in Belgium and the Netherlands. BMC Health Services Research, 21, Article No. 227. https://doi.org/10.1186/s12913-021-06240-7
Weir, K. (2020). Grief and COVID-19: Mourning Our Bygone Lives. American Psychological Association. https://www.apa.org/news/apa/2020/04/grief-covid-19
White, R. G., & Van Der Boor, C. (2020). Impact of the COVID-19 Pandemic and Initial Period of Lockdown on the Mental Health and Well-Being of Adults in the UK. BJPsych Open, 6, e90. https://doi.org/10.1192/bjo.2020.79
World Health Organization. Division of Mental Health and Prevention of Substance Abuse (1997). WHOQOL: Measuring Quality of Life. WHO. https://apps.who.int/iris/handle/10665/63482
Wright, L., Steptoe, A., & Fancourt, D. (2021). Predictors of Self-Reported Adherence to COVID-19 Guidelines. A Longitudinal Observational Study of 51,600 UK Adults. The Lancet Regional Health-Europe, 4, Article ID: 100061. https://doi.org/10.1016/j.lanepe.2021.100061