The Impact of COVID-19 Probability and Cost Estimates on Worry and Health Behavior Compliance in Young Adults

The novel coronavirus COVID-19 pandemic is associated with elevated rates of anxiety and relatively lower compliance with public health guidelines in younger adults. To develop strategies for reducing anxiety and increasing adherence with health guidelines, it is important to understand the factors that contribute to anxiety and health compliance in the context of COVID-19. Earlier research has shown that greater perceived probability of negative events and their costs are associated with increased anxiety and compliance with health behaviors, but it is unclear what role they play in a novel pandemic surrounded by uncertainty. In the present study we measured 1) perceived probability as the self-reported probability of being infected and experiencing serious symptoms due to COVID-19 and 2) perceived cost as financial, real-world, physical, social and emotional consequences of being infected with COVID-19. Worry was assessed using the Penn State Worry Questionnaire (PWSQ) and health compliance was measured as endorsement of the World Health Organization (WHO) health directives for COVID-19. Our results showed that greater perceived costs of contracting the COVID-19 virus were associated with greater worry and compliance with health behaviors, even when controlling for probability estimates. Interestingly, neither self-reported worry nor its interaction with cost estimates was associated with increased engagement in health behaviors. Our results provide important insight into decision making mechanisms involved in both increased anxiety and health compliance in COVID-19 and have implications for developing psychoeducational and psychotherapeutic strategies to target both domains.