背景:不容忍不确定性(IU)被广泛接受为一系列心理健康问题的诊断脆弱性因素。它被认为是与对不同压力生活状况的一系列反应相关的变境脆弱性因素。这项系统评价和荟萃分析的目的是研究IU与对COVID-19大流行的特定心理反应之间的关系,以及从IU研究和其他关于COVID-19的研究中得出的这种关系的调节因素。
方法:所包括的研究如下:(i)在同行评审的期刊或论文/论文中发表的英语文章;(ii)报告COVID-19的特定心理影响;(c)报告IU;(iii)病例对照研究,前瞻性队列研究,大量人群的实验研究和横断面研究,以及(iv)报告感兴趣变量之间的相关系数。排除对诊断为神经和/或器质性损害的参与者的研究。搜索的数据库是谷歌学者,PubMed,ScienceDirect,和ProQuest,直到2022年12月31日。使用用于调查工具的偏差风险(ROBUST,Nudelman等人。,2020)。使用一项研究去除法进行敏感性分析,并检查了学生的残差和库克的距离。使用随机效应模型。
结果:我们在来自22个国家的85项研究中检查了IU与COVID-19相关心理影响之间的关系(N=69,997;64.95%为女性;平均样本年龄,32.90±9.70)。没有发表偏倚的证据。我们发现IU和COVID-19相关的心理影响之间存在中等正相关(N=69,562,r=0.35,k=89,95%CI[0.32,0.37]),这与所使用的IU测量值无关,也与是否仅与病毒有关或与大流行的更广泛方面有关来测量心理影响无关。这也与严重程度无关,出版年份,样品类型和尺寸,学习质量,年龄和焦虑的样本水平,抑郁症状,压力,心理健康和社会支持。然而,观察到的关联在国家和国家收入水平(低收入人群中更强)和性别(男性人群中更强)之间差异显著,并且对于可靠性更高和项目更多的措施而言,但在暴露于COVID-19的人更多的样本中更低。
结论:研究结果支持IU是与认知,大流行期间的行为和痛苦反应。限制包括仅英语来源,依赖于使用新系统编码的广泛测量值和研究中的可变偏倚风险。这些影响被认为与在全球范围内经历的主要情境压力源的心理后果的管理有关,但是国家和社会经济层面的变化也对区域或社区层面的不同或局部压力源产生影响。
BACKGROUND: Intolerance of uncertainty (IU) is widely accepted as a transdiagnostic vulnerability factor for a range of mental health problems. It is considered a transsituational vulnerability factor associated with a range of responses to different stressful life situations. The aim of this systematic review and meta-analysis is to examine the association between IU and specific psychological responses to the COVID-19 pandemic and the moderators of this relationship drawn from IU research and other studies on COVID-19.
METHODS: The studies included were as follows: (i) English-language articles published in peer-reviewed journals or thesis/dissertations; (ii) reporting specific psychological impacts of COVID-19; (c) reporting IU; (iii) case-control studies, prospective cohort studies, experimental studies and cross-sectional studies of large populations and (iv) reporting correlation coefficients between the variables of interest. Studies on participants with a diagnosis of neurological and/or organic impairment were excluded. The databases searched were Google Scholar, PubMed, ScienceDirect, and ProQuest, up until 31 December 2022. The risk of bias was assessed using the Risk of Bias Utilized for Surveys Tool (ROBUST, Nudelman et al., 2020). Sensitivity analysis was conducted using the one-study remove method, and studentized residuals and Cook\'s distance were examined. A random effects model was used.
RESULTS: We examined the association between IU and COVID-19-related psychological impacts across 85 studies from 22 countries (N = 69,997; 64.95% female; mean sample age, 32.90 ± 9.70). There was no evidence of publication bias. We found a medium and positive association between IU and COVID-19-related psychological impacts (N = 69,562, r = 0.35, k = 89, 95% CI [0.32, 0.37]), which was independent of the IU measure used or whether the psychological impact was measured in relation to the virus alone or broader aspects of the pandemic. It was also independent of severity, publication year, sample type and size, study quality, age and sample levels of anxiety, depressive symptoms, stress, mental well-being and social support. However, the observed association varied significantly between countries and country income levels (stronger among low-incomes) and across genders (stronger among males) and was stronger for measures with greater reliability and more items, but lower among samples with more people who had been exposed to COVID-19.
CONCLUSIONS: The findings support that IU is a higher order transsituational vulnerability factor related to cognitive, behavioural and distress responses during the pandemic. Limitations include English-language-only sources, reliance on a wide range of measures that were coded using a novel system and variable risk of bias across studies. The implications are considered in relation to the management of psychological consequences of major situational stressors experienced at a global scale, but the variations at a national and socioeconomic level also have implications for different or localized stressors at a regional or community level.