In the two years of the COVID-19 pandemic, researchers around the world have been investigating not only how the virus affects the body, but also its impact on psychological well-being 

A new study at Bar-Ilan University (BIU) in Ramat Gan (near Tel Aviv) has found a link between physiological data collected before the onset of the pandemic and heightened COVID-related fears, particularly among individuals with average-to-larger nuclear families. The researchers also found that these worries were higher in women compared to men and in people whose income dropped during the pandemic.

The study was published in Stress: International Journal on the Biology of Stress under the title “Pre-pandemic electrodermal activity predicts current COVID-related fears: household size during lockdown as a moderating factor.” 

Prof. Ilanit Gordon, of BIU’s psychology department and the Gonda (Goldschmied) Multidisciplinary Brain Research Center, together with Prof. Danny Horesh, of the psychology department and members of Gordon’s lab including Alon Tomashin, Nir Milstein, Oded Mayo and Adi Korisky conducted the study. 

The authors noted that “bearing in mind the extant research regarding the mental health effects of COVID −19, there is a major gap in knowledge we aimed to address in the current study. Most psychological COVID-19 studies to date have not assessed pre-pandemic physiological markers. In a global health crisis intrinsically comprising both mental and physical health risk factors, the absence of psychophysiological prospective research on [the pandemic]is a scientific gap that should be critically bridged. Further, although the current health crisis involves unique, perhaps even unprecedented, social circumstances – social distancing, lockdowns and home quarantines on a massive scale – there is very limited knowledge regarding the modulating role of these social circumstances on the relationship between physiological function and mental distress.”

A total of 185 adults (71% of them women) who participated in the study answered a questionnaire that included three questions about their fears and worries relating to different aspects of the pandemic – unknowingly carrying the virus, infecting others with the virus and family members contracting the virus. The survey took place during the first lockdown in Israel in mid-2020 (today, Israel is expecting to be over the hump of the fifth wave by the end of January). 

In 2017-2018, months before the collection of the COVID survey, the same group of adults took part in one of two in-lab experiments as undergraduate students. In those experiments, electrodermal activity (EDA) at rest, measuring the activity of sweat glands in the palm, were collected. Resting EDA is a physiological signal that reflects heightened responsiveness to the environment or to internal events. If we are very vigilant to changes in the environment, stressed or overly concerned, there are subsequent changes in sweat gland activity as well. 

EDA data and questionnaire responses were assessed to determine participants’ mental well-being and ability to control their fears during the pandemic. The results revealed a positive association between higher resting EDA and the COVID fears.

“The fact that EDA was measured two to three years prior to the pandemic adds another layer of complexity, as it shows the effects of one’s physiological makeup on one’s emotional reactions during a later crisis,” declared Gordon, who led the study. 

Pre-pandemic EDA measures were also evaluated together with household size to predict participants’ fears about COVID-19. Importantly, the EDA-fears association was influenced by the number of individuals who lived with the respondent during COVID-19. Fears were greater among those who were in lockdown with a relatively large number of people than those in lockdown in smaller households.

Women showed greater levels of worry compared to men, a result in line with numerous studies, including one conducted by Horesh in 2015 that indicated women report higher levels of stress, anxiety and post-traumatic symptoms. According to the researchers, one explanation for these gender differences that could be particularly relevant to the pandemic is that women were often found to show an increased tendency to monitor stressful situations, possibly leading to increased threat perception and subsequent distress.

Finally, an association was also found between a major deterioration in one’s financial status during COVID-19 and one’s level of worry. Twenty percent of the participants reported a substantial reduction in income, and the financial state of 41% of them decreased, to some degree, due to the pandemic. While the massive economic impact of the pandemic may have severe mental health implications, the findings of the study show that financial difficulties are also associated with health-related fears, thus extending beyond one’s livelihood and income.  

The study contributes to very-limited number of studies up to now on this subject and examines pre-COVID physiological measurements as prospective predictors of psychological distress during a pandemic. It highlights the importance of identifying at-risk populations, such as those who are theoretically more aroused and those who have limited financial resources, for whom mental health interventions may be offered. 

The research also emphasizes that the integration of physiological, social and psychological measures is crucial for better assessment and diagnosis in mental health settings – a process using a variety of methods that may be particularly relevant for a health pandemic that has massive effects on both body and mind.