Participants and procedure
This study was conducted as part of the Irish arm of the COVID-19 Psychological Research Consortium (C19PRC) Study - an ongoing, longitudinal project assessing the psychosocial impact of the COVID-19 pandemic across multiple nations (21). To date, five waves of data have been collected. Data from Wave 2 of the C19PRC Study, collected April 30th to May 19th, 2020 during Ireland’s first nationwide lockdown, was used in this study.
The survey company Qualtrics was employed to recruit participants from traditional, actively managed, double-opt-in research panels via email, SMS, or in-app notifications. Participants were invited to follow a link where they were provided with a description of the study and, if willing to participate, asked to provide informed consent. Participants (N = 1,032) had to be aged 18 years or older, resident in the Republic of Ireland, could read and write in English, and were selected using quota sampling methods to generate a sample representative of the adult general population of Ireland in terms of sex, age, and geographical distributions as per the most recent (2016) census (22). All measures were completed online, with a median completion time of 23.58 minutes. Participants received financial reimbursement from Qualtrics for their time. Sociodemographic characteristics of the sample are presented in Table 1.
Table 1. Sociodemographic and Pandemic-Related Characteristics of the Sample (N = 1,032).
|
%
|
Mean
|
SD
|
Sex
|
|
|
|
Female
|
51.9
|
|
|
Male
|
47.8
|
|
|
‘Other’
|
0.3
|
|
|
Age
|
|
44.86
|
15.74
|
Irish Nationality
|
71.6
|
|
|
Grew up in Ireland
|
79.1
|
|
|
Living location
|
|
|
|
City
|
20.3
|
|
|
Suburb
|
21.4
|
|
|
Town
|
28.5
|
|
|
Rural
|
29.8
|
|
|
Irish Ethnicity
|
75.0
|
|
|
In a committed relationship
|
70.7
|
|
|
Number of children in the household
|
|
1.70
|
1.02
|
Number of adults in the household including oneself
|
|
2.44
|
1.09
|
Living alone
|
12.8
|
|
|
Attended university or third-level education
|
71.0
|
|
|
Employment status
|
|
|
|
Full-time (self)/employed
|
42.9
|
|
|
Part-time (self)/employed
|
18.2
|
|
|
Retired
|
16.6
|
|
|
Unemployed
|
22.4
|
|
|
2019 income
|
|
|
|
€0-€19,999
|
22.0
|
|
|
€20,000-€29,999
|
20.2
|
|
|
€30,000-€39,999
|
19.9
|
|
|
€40,000-€49,999
|
13.0
|
|
|
€50,000+
|
25.0
|
|
|
Diagnosis of a chronic illness
|
|
|
|
Self
|
24.1
|
|
|
Family member
|
34.0
|
|
|
COVID-19 status
|
|
|
|
Suspected or confirmed infection - self
|
1.2
|
|
|
Suspected or confirmed infection - loved one
|
3.5
|
|
|
Someone close to you died of COVID-19
|
4.2
|
|
|
Changes to homelife due to COVID-19 pandemic
|
|
|
|
Increased child caring responsibilities
|
19.7
|
|
|
Increased housework responsibilities
|
32.9
|
|
|
Increased care of elderly relatives
|
16.9
|
|
|
Increased feeling of being unsafe in the home
|
7.9
|
|
|
Inceased occurrence of intimate partner violence
|
4.1
|
|
|
Anxiety related to the COVID-19 pandemic (0 to 100 scale)
|
|
61.10
|
26.60
|
Perceived risk of COVID-19 infection (0 to 100 scale)
|
|
37.62
|
24.42
|
Finacial worries due to COVID-19 (1 to 10 scale)
|
|
5.37
|
2.92
|
Income change due to COVID-19 (-100% to +100% scale)
|
|
-9.74
|
28.61
|
Note: SD = Standard deviation.
Measures
Depression and anxiety
MDD: The Patient Health Questionnaire-9 (23) (PHQ-9) measures the nine symptoms of MDD, as described in the DSM-5 (24). Participants indicated how often they have been bothered by each symptom over the last two weeks using a four-point Likert scale that ranges from ‘Not at all’ (0) to ‘Nearly every day’ (3). Scores > 10 have adequate sensitivity (.85) and specificity (.89) in identifying those who meet diagnostic criteria. The psychometric properties of the PHQ-9 scores are widely supported (25), and the internal reliability in the current sample was excellent (α = .91).
GAD: The Generalized Anxiety Disorder 7-item Scale (26) (GAD-7) asks participants to indicate how often they have been bothered by each symptom over the last two weeks using a four-point Likert scale (0 = ‘Not at all’, to 3 = ‘Nearly every day’). Scores > 10 have adequate sensitivity (.89) and specificity (.82) in identifying persons who meet diagnostic criteria for GAD. The GAD-7 has been shown to produce reliable and valid scores in community studies (27), and the internal reliability in the current sample was excellent (α = .94).
Sociodemographic and COVID-19 pandemic-related variables
Twenty-three sociodemographic and COVID-19 pandemic-related variables were used in this study (see Table 1).
Psychological variables
Personality traits: The Big-Five Inventory (28) (BFI) measures the traits of openness, conscientiousness, extraversion, agreeableness, and neuroticism. Each trait was measured by two items using a five-point Likert scale that ranges from ‘strongly disagree’ (1) to ‘strongly agree’ (5). Higher scores reflect higher levels of each personality trait, and the BFI has produces scale scores with good reliability and validity (28). Internal reliability estimates are not reported given coefficient alpha is inappropriate for demonstrating internal consistency where only two items are used (29).
Internal locus of control: The three-item ‘Internal’ subscale of the Locus of Control Scale (30) was used to assess the extent to which people believe that they have control over the things that occur in their life (e.g., ‘My life is determined by my own actions’). The three questions use a seven-point Likert scale ranging from ‘strongly disagree’ (1) to ‘strongly agree’ (7). Higher scores reflect higher levels of internal locus of control. The internal reliability of the scale scores in this sample was acceptable (α = .77).
Identification with others: The Identification with all Humanity Scale (31) (IWAHS) is a nine-item scale where people respond to three statements with reference to three groups: people in my community, people from Ireland, and all humans everywhere. The response scale ranged from ‘not at all’ (1) to ‘very much’ (5), where higher scores reflect greater identification with others. The internal reliability of the scale scores in this sample was excellent (α = .93).
Religious beliefs: Respondents indicated their agreement to eight statements from the Monotheist and Atheist Beliefs Scale (32). Response options ranged from ‘strongly disagree’ (1) to ‘strongly agree’ (5). Atheism oriented statements (e.g., ‘Moral judgments should be based on respect for humanity rather than religious doctrine’) were reverse scored and summed with monotheist items to produce a total score, where higher scores reflect religious belief orientation. The psychometric properties of the scale have been previously supported (32), and the internal reliability in the current sample was good (α = .81).
Intolerance of uncertainty: The Intolerance of Uncertainty scale (33) (US) includes 12 items answered using a five-point Likert scale ranging from ‘not at all characteristics of me’ (1) to ‘entirely characteristic of me’ (5). Higher scores reflect increased levels of intolerance of uncertainty. The psychometric properties of the IUS scale is widely supported (33). The internal reliability of the IUS scores in the current sample was good (α = .88).
Loneliness: The three-item Loneliness Scale (34) was designed for use in large-scale population surveys. Respondents are asked to indicate how often they feel that they lack companionship; left out; and isolated from others. Responses are scored using a three-point scale including ‘hardly ever’ (1), ‘sometimes’ (2), and ‘often’ (3). Higher scores reflect higher levels of loneliness. The internal reliability of the scale scores in this sample was good (α = .87).
Somatic problems: The Patient Health Questionnaire-15 (35) (PHQ-15) a self-report measure that asks participants how often they have been bothered by a list of 15 commonly reported physical complaints over the last two weeks. We excluded the ‘menstrual problems’ item due to its sex-specific nature that would preclude analysis of the entire sample. The response options are ‘Not bothered at all’ (0), ‘Bothered a little’ (1), and ‘Bothered a lot’ (2). A total scale score of the 14 items was computed with higher scores reflecting greater somatic problems. The internal reliability of the scale in this sample was good (α = .83).
Sleep Quality: The Sleep Condition Indicator (36) (SCI) is an eight-item measure of different types of sleep problems including sleep continuity, sleep satisfaction, severity of sleep problems, and daytime functioning. Items are scored on a four-point Likert scale with scores ranging from 0-32. Higher scores reflect better sleep quality. The SCI scale has been shown to produce reliable and valid scores (36), and the internal reliability in this sample was good (α = .88).
Data analysis
The analytic strategy included three linked phases. First, differences between the proportion of men and women who screened positive for MDD and GAD, respectively, were assessed using binary logistic regression analysis. Odds ratios (OR) with 95% confidence intervals were calculated to quantify the magnitude of these differences. Second, differences between men and women on all sociodemographic, pandemic, and psychological variables were assessed using chi-square tests of independence (for categorical variables) and independent samples t-tests (for continuous variables). Phi coefficients and Cohen’s d values were calculated to quantify the magnitude of differences for the categorical and continuous variables, and interpreted according to their respected conventions (37). Finally, sex and all sex-varying variables were added to a binary logistic regression model as predictors of screening positive for MDD and GAD, respectively. Adjusted odds ratios (AOR) with 95% confidence intervals were calculated. There was minimal missing data (0.3%), and this was managed using listwise deletion.