In collaboration with Payame Noor University and Iranian Health Psychology Association

Document Type : Scientific Research

Authors

1 Assistant Professor, Department of Psychology, Faculty of Education and Psycholoyg, Alzahra University, Tehran, Iran

2 B.A., Department of Psychology, Alzahra University, Tehran, Iran.

3 Associate Professor, Payame Noor University, Tehran, Iran.

4 M.A., Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran.

Abstract

Objective: The Covid-19 virus changes over time and is still present in the world. Therefore, the rate of acceptance of the vaccine and the factors affecting it should be investigated. The aim of this study was to determine the mediating role of personality traits in the relationship between the acceptance rate of corona vaccine and anxiety, depression and stress during the covid-19 pandemic. Method: The current research was descriptive-correlation and structural equation modeling. The statistical population included all adults aged 18 to 60 in Tehran, of which 388 (81 men and 257 women) were selected by the simple random method. To collect data, Hexaco short questionnaire, depression, anxiety and stress questionnaire and the knowledge, attitude, application and concerns questionnaire of the Covid-19 vaccine were used. Then the data were analyzed with SPSS (version 24) and AMOSE (version 24) software. Results: The findings showed that anxiety, depression, and stress have an inverse and significant effect on vaccine resistance or acceptance (β=0.15 and P=0.013). This finding was different from the results of some other researches. It was expected that the acceptance rate of the vaccine would increase with the increase of fear, anxiety and stress. However, in our study it decreased. On the other hand, the results of this research showed that anxiety, depression and stress have a positive and significant effect on personality traits (β=0.41 and P<0.001). Also, the resistance or acceptance of the Covid-19 vaccine was related to anxiety, depression, and stress, and this relationship was significant and inverse and consistent with the results of other studies. Another finding of this research indicated the existence of a relationship between personality traits and vaccine resistance or acceptance (β=0.13 and P=0.021), the results of which were not consistent with some other studies. Conclusion: Generally, the results indicate that the variable of personality traits can play a mediating role (P=0.038) in relation to anxiety, depression, stress resistance or vaccine acceptance. In fact, some personality traits such as extroversion, agreeableness, openness to experience and conscientiousness had less anxiety and stress. Therefore, they managed themselves better during the Covid-19 crisis. On the other hand, people who had higher anxiety and stress were more biased towards information in crisis situations and resisted accepting the Covid-19 vaccine. However, resistance to accepting the Covid-19 vaccine was different in different people. In fact, according to this research, people who had higher stress, anxiety and depression usually had to resist accepting the Covid-19 vaccine. But if they were part of agreeable and negative excitable personality traits, they would show willingness to receive the Covid-19 vaccine. On the other hand, extroverts, who were expected to be willing to accept the Covid-19 vaccine, resisted accepting it.

Keywords

Main Subjects

Acar-Burkay, S. & Cristian, D. (2022). Cognitive underpinnings of COVID-19 vaccine hesitancy. Social Science & Medicine, 301, 114911. https://doi.org/10.1016/j.socscimed.2022.114911
Ahorsu, DK. Imani, V. Lin, CY. Timpka, T. Brostrom, A. Updegraff, J. A. Pakpour, A. H. (2020). Associations between fear of COVID-19, mental health, and preventive behaviours across pregnant women and husbands: An actor-partner interdependence modelling. International Journal of Mental Health and Addiction. Advance online publication.https://doi.org/10.1007/s11469-020-00340-x.
Ahorsu, D. K. Lin, C. Y. Imani, V. Saffari, M. Griffiths, M. D. & Pakpour, A. H. (2020). The fear of COVID-19 scale: development and initial validation. International journal of mental health and addiction, 1-9.
Al-Mohrej, O. A. Al-Shirian, S. D. Al-Otaibi, S. K. Tamim, H. M. Masuadi, E. M. & Fakhoury, H. M. (2016). Is the Saudi public aware of Middle East respiratory syndrome?. Journal of infection and public health, 9(3): 259-266.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., textrev.). https://doi.org/10.1176/appi.books.9780890425787.
Amit Aharon, A. Nehama, H. Rishpon, S. & Baron-Epel, O. (2018). A path analysis model suggesting the association between health locus of control and compliance with childhood vaccinations. Human vaccines & immunotherapeutics, 14(7): 1618-1625.
Anderson, R. M. Vegvari, C. Truscott, J. Collyer, B. S. (2020). Challenges in Creating herd immunity to SARS-CoV-2 infection by mass Vaccination. The Lancet, 396, 1614-6.
Aschwanden, D. Strickhouser, J. E. Sesker, A. A. Lee,  J. H. Luchetti, M. Stephan, Y. Sutin, A. R. & Terracciano, A. (2020). Psychological and Behavioural Responses to Coronavirus Disease 2019: The Role of Personality. Eur J Pers. 35(1): per.2281.https://doi.Org/10.1002/per.2281
Baker, M. N. & Merkley, E. (2023). 2Dynamic role of personality in explaining COVID-19 vaccine hesitancy and refusal. Frontiers in Psychology, 1-8. 10.3389/fpsyg.2023.1163570.
Barth, J. Schumacher, M. & Herral-Lingen, C. (2004). Depression as risk factor for mortality in patients with coronary heart disease: a meta-analysis. Phychosom Med. 66(6): 13-802.
Basharpoor, S. taherifard, M. & mohamadi, G. (2019). Psychometric Properties of Persian Version of Brief HEXACO Inventory in University Students. Quarterly of Educational Measurement, 9(36): 65-89. doi: 10.22054/jem.2017.4956.1158. (in Persian)
Bendau, A. Plag, J. Petzold, M. B. Ströhle, A. (2021). COVID-19 vaccine hesitancy and related fears and anxiety. International immunopharmacology, 97, 107724-107729.
Besharat Gharamaleki, R. Khanjani, Z. & Babapour, J. (2013)  Comparison of Five Big Personality Factors in Depressive Disorder Patients and Obsessive –Compulsive Disorders with normal individuals. Knowledge & Research in Applied Psychology, 14(1): 110-117. ( in Persian)     
Carra, G. (2022). Were anxiety, depression and psychological distress associated with local mortality rates during COVID-19 outbreak in Italy? Findings from the COMET study. Journal of Psychiatric Research, 152, 242-249.https://doi.org/10.1016/j.jpsychires.2022.06.018.
Cheng, V. Wong, S. Chuang, V. So, S. Chen, J. Sridhar, S. & et al. (2020). The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. Journal of Infection. https://doi.org/10.1016/j.jinf.2020.04.024.
Cook, T. El-Boghdadly, K. McGuire, B. McNarry, A. F. Patel, A. & Higgs, A. (2020).  Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anaesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists. Anaesthesia. 75, 785- 799.
Coustasse, A. Kimble, C. & Maxik, K. (2021). COVID-19 and Vaccine Hesitancy: A Challenge the United States Must Overcome. The Journal of Ambulatory Care Management, 44, 71-75.
Damnjanović, K. Graeber, J. Ilić, S. Lam, W. Y. Lep, Ž. Morales, S. Pulkkinen, T. & Vingerhoets, L. (2018). Parental Decision-Making on Childhood Vaccination. Frontiers in psychology9, 735.https://doi.org/10.3389/fpsyg.2018.00735.
De Vries, R. E. & van Kampen, D. (2010). The HEXACO and 5DPT models of personality: A comparison and their relationships with psychopathy, egoism, pretentiousness, immorality, and Machiavellianism. Journal of Personality Disorders, 24(2): 244-257.
De Vries, R. E. (2013). The 24-item brief HEXACO inventory (BHI). Journal of Research in Personality, 47(6): 871-880.
Ebstrup, J. F. Eplov, L. F. Pisinger, C. Jørgensen, T. (2011). Association between the Five Factor personality traits and perceived stress: is the effect mediated by general self-efficacy? Anxiety, Stress & Coping, 24(4): 407 -419.
Enkel, S. L. Attwell, K. Snelling, T. L. & Christian, H. E. (2018). 'Hesitant compliers': Qualitative analysis of concerned fully-vaccinating parents. Vaccine, 36(44): 6459–6463.https://doi.org/10.1016/j.vaccine.2017.09.088.
Esmaeilpour, K. H. Babapour Kheirodin, J. & Ebrahimi Sarindizaj, Z. (2013). The relationship between HEXACO personality dimensions and type D personality. J Research Health, 3(3): 405-411.
Fontanet, A. & Cauchemez, S. (2020). COVID-19 herd immunity: where Are we? Nature Reviews Immunology. 20, 583- 84.
Frank, M. G. Fonken, L. K. Dolzani, S. D. Annis, J. L. Siebler, P. H. Schmidt, D. Watkins, L. R. Maier, S. F. & Lowry, C. A. (2018). Mvaccae treatment induces an anti-inflammatory milieu in the CNS: attenuation of stress-induced microglial priming, alarmins, and anxiety-like behavior. Brain, Behavior, and Immunity. 73, 352-363.
Ghorbani, V. Jandaghiyan, M. Jokar, S. Zanjani, Z. (2021). The Prediction of Depression, Anxiety, and Stress during the COVID-19 Outbreak Based on Personality Traits in the Residents of Kashan City from March to April 2020: A Descriptive Study. JRUMS, 20 (5): 503-518.URL: http://journal.rums.ac.ir/article-1-5916-en.html. (in Persian)     
Giorgio, E. D. Riso, D. D. Mioni, G. & Cellini, N. (2020). The interplay Between mothers’ and children behavioral and psychological factors during COVID‑19: An Italian Study. Eur Child Adolesc Psychiatry. Aug 31,1-12. https://doi.org/10.1007/s00787-020-01631-3.
Habibzadeh, P. & Stoneman, E. K. (2020). The novel coronavirus: a bird’s eye view. Int J Occup Environ Med (The IJOEM), 11. 1921, 65-71.
Iwasa, H. Masui, Y. Gondo, Y. Yoshida, Y. Inagaki, H. Kawaai, C. Kim, H. Yoshida, H. & Suzuki, T. (2009). Personality and participation in mass health checkups among Japanese community-dwelling elderly. J. Psychosom. Res. 66, 155–159.
Jafari harandi, M. & arefi, M. (2022). Efficacy of Unified Trans-Diagnostic Treatment on the Health Anxiety and Emotional Self-Regulation in the Women with the Covid-19 Pandemic Anxiety. Health Psychology, 11(42): 7-22. doi: 10.30473/hpj.2022.59114.5229. (in Persian)
Jiao, W. Y. Wang, L. N. Liu, J. Fang, S. F. Jiao, F. Y. Pettoello-Mantovani, M. & Somekh, E. (2020). Behavioral and Emotional Disorders in Children during the COVID-19 Epidemic. J Pediatr. 221, 264-266.e1. doi: 10.1016/j.Jpeds.2020.03.013. Epub PMID: 32248989; PMCID: PMC7127630.
Karlsson, L. C. Soveri, A. Lewandowsky, S. Karlsson, L. Karlsson, H. Nolvi, S. & Antfolk, J. (2021). Fearing the disease or the vaccine: The case of COVID-19. Personality and Individual Differences. doi:10.1016/j.paid.2020.110590
Kessler, R. C. & Bromet, E. J. (2013). The epidemiology of depression across cultures. Annual Review of Public Health. 34, 119-38. [DOI:10.1146/annurev-publhealth-031912-114409] [PMID] [PMCID]
Khan, M. U. Shah, S. Ahmad, A. & Fatokun, O. (2014). Knowledge and attitude of healthcare workers about middle east respiratory syndrome in multispecialty hospitals of Qassim, Saudi Arabia. BMC public health, 14(1): 1-7.
Kheirabadi, Z. Soltanabadi, S. Jamshid Mofid, P. Gavahi, S. Ghasemi, M. Alimehdi, M. (2021). Predicting COVID-19 Vaccine Acceptance and Hesitation Based on Psychological Resilience and Positive and Negative Affect. J Mar Med, 3(4): 5-12.http://jmarmed.ir/article-1-279-en.html.   (in Persian) 
Kotov, R. Gamez, W. Schmidt, F. & Watson, D. (2010). Linking big Personality traits to anxiety, depressive and substance use disorders. A meta-analysis. Psychological Bullet. 136(5): 768-821. Doi: 10.1037/a0020327.
Kube, T. Rief, W. Gollwitzer, M. Gärtner, T. & Glombiewski, J. A. (2019). Why dysfunctional expectations in depression persist–Results from two experimental studies investigating cognitive immunization. Psychological Medicine, 49(9): 1532-1544.
Kyselova, A. A. Kravtsova, E. S. Mishchenko, D. O. & Chernishova, E. R. (2018). [The relationship between mindfulness meditation and depression (Ukrainian)]. Український журнал медицини, біології та спорту. 4(326): 304. https://jmbs.com.ua/pdf/5/1/jmbs0-2020-5-1.pdf#page=304
La, V. P. Pham, T. H. Ho, M. T. Nguyen, M. H. P. Nguyen, K. L. Vuong, T. T. Nguyen, H. K. T. Tran, T. Khuc, Q. Ho, M. T. & Vuong, Q. H. (2020). Policy Response, Social Media and Science Journalism for the Sustainability of the Public Health System Amid the COVID-19 Outbreak: The Vietnam Lessons. Sustainability, 12(7): 2931. https://doi.org/10.3390/su12072931.
Lazarus, J. V. Ratzan, S. C. Palayew, A. Gostin, L. O. Larson, H. J. Rabin, K. &  et al. (2021). A globa survey of potential acceptance of a COVID-19 vaccine. Nature medicine. 27(2): 225-228.
Lee, K. & Ashton, M. C. (2004). Psychometric properties of the HEXACO personality inventory. Multivariate Behavioral Research, 39(2): 329– 358.
Lee, S. A. (2020). Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety, Death Studies, 44(7): 393-401, DOI: 10.1080/07481187.2020.1748481.
Lee, S. A. Mathis, A. A. Jobe, M.C. Pappalardo, E. A. (2020). Clinically significant fear and anxiety of Covid_19.  A psychometric examination of the coronaviruse anxiety scale psychiatry Research 290, 112-113. https://doi.org/10.101/j.psychres.2020.113112.
Lin, C. Y. (2020). Social reaction toward the 2019 novel coronavirus (COVID-19 [Editorial]. Social Health and Behavior, 3(1): 1–2. https://doi.org/10.4103/shb.Shb_11_20
Lin, F. Y. & Wang, C. H. (2020). Personality and individual attitudes toward vaccination: a nationally representative survey in the United States. BMC Public Health, 20, 1759. https://doi.org/10.1186/s12889-020-09840-w.
Liu Y, Yan LM, Wan L, Xiang TX, Le A, Liu JM, Peiris M, Poon LLM, & Zhang W. (2020). Viral dynamics in mild and severe cases of COVID-19. The Lancet. Infectious diseases, 20(6): 656–657. https://doi.org/10.1016/S1473-3099(20)30232-2.
Lovibond, S. H. & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales. Sydney: Psychology Foundation.
McHale, P. Keenan, A. & Ghebrehewet, S. (2016). Reasons for measles cases not being vaccinated with MMR: investigation into parents' and carers' views following a large measles outbreak. Epidemiology & Infection, 144(4): 870-875.
Mertensa, G. Gerritsen, L. Duijndam, S. Salemink, S. & Engelhard, I. M. (2020). Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020. Journal of Anxiety Disorders,102258, 1-8. https://doi.org/10.1016/j.janxdis.2020.102258.
Mirdrikvand, F. (2023). Structural Model of Pain Perception in Patients With Refractory Joint Pain Based on Personality Traits and Early Maladaptive Schemas: The Moderating Role of Social Support. Health Psychology, 12(46): 41-62. doi: 10.30473/hpj.2023.63629.5516. (in Persian)
Mo, P. K. h. Luo, S. Wang, S. Zhao, J. Zhang, G. Li, L. Li, L. Xie, L. & Lau, J. T. F. (2021). Intention to Receive the COVID-19 Vaccination in China: Application of the Diffusion of Innovations Theory and the Moderating Role of Openness to Experience. 9, 129. https://doi.org/10.3390/ vaccines9020129.
Mohagheghi, H. Farhadi, M. Yaghoobi, A. Mahdavi, A. (2021). Anxiety in the realm of personality: The role of attitudes. Rooyesh,10 (2): 15-24.URL: http://frooyesh.ir/article-1-2526-en.html. (in Persian)   
Mohammad Zamani, Z. Hammatyar, V. Sharifzadeh, M. & Haj Abutalebi, N. (2020). Investigating the relationship between resilience, hexaco personality traits and psychological distress with anxiety caused by corona disease in residents of Tehran.The Journal of New Advances in Behavioral Sciences, 54(6): 307-324. URL: http://ijndibs.com/article-۱-۶۰۳-fa.html. (in Persian)
Murakami, H. Kobayashi, M. Hachiya, M. Khan, Z. S. Hassan, S. Q. & Sakurada, S. (2014). Refusal of oral polio vaccine in northwestern Pakistan: a qualitative and quantitative study. Vaccine, 32(12): 1382-1387.
Murphy, J. Vallières, F. Bentall, R. P. Shevlin, M. McBride, O. Hartman, T. K. McKay, R. Bennett, K. Mason, L. Gibson-Miller, J. Levita, L. Martinez, A. P. Stocks, T. V. A. Karatzias, T. & Hyland, P. (2021). Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nature communications, 12(1): 29. https://doi.org/10.1038/s41467-020-20226-9.
Nazlı, Ş. B. Yığman, F. Sevindik, M. Deniz Özturan, D.  .(2022) Psychological factors affecting COVID-19 vaccine hesitancy. Irish Journal of Medical Science, 191(1): 71-80.
Pandhi, N. Schumacher, J. R. Thorpe, C. T. & Smith, M. A. (2016). Cross-sectional study examining whether the extent of first-contact access to primary care differentially benefits those with certain personalities to receive preventive services. BMJ Open, 6, e009738.
Patty, N. J. Van Dijk, H. M. Wallenburg, I. Bal, R. Helmerhorst, T. J. Van Exel, J. & Cramm, J. M. (2017). To vaccinate or not to vaccinate? Perspectives on HPV vaccination among girls, boys, and parents in the Netherlands: A Q-methodological study. BMC public health, 17(1): 1-12.
Pau, A. & Rowland, M. L. (2007). Emotional Intelligence and Perceived Stress in Dental Undergraduates: A Multinational Survey, Journal of Dental Education. 17, 39-57.
Peak, C. M, Kahn, R, Grad, Y. H. Childs, L. M. Li, R. Lipsitch, M. & Buckee, C. O. (2020). Individual quarantine versus active monitoring of contacts for the mitigation of COVID-19: a modelling study. The Lancet. Infectious diseases, 20(9): 1025–1033. https://doi.org/10.1016/S1473-3099(20)30361-3.
Peckham, A. McHugh, R. & Otto, M. (2013). A meta-analysis of the magnitude of biased attention in depression. Depression and Anxiety, 30(4): 407–407.https://doi.org/10.1002/da.22092.
Perlis, R. H. Ognyanova, K. Santillana, M. Lin, J. Druckman, J. Lazer, D. &  et al. (2021). Association of major depressive symptoms with endorsement of COVID-19 vaccine misinformation among US adults. JAMA network open, 5(1), e2145697
Qiu, J. Shen, B. Zhao, M. Wang, Z. Xie, B. & Xu, Y. (2020).  A natinwide survey of psychological distrees among Chinese people in the COVID_19 epidemic: Implications and policy recomendatoins General psychiatry, 33(2): e100213.
Rehman, U. (2021). Depression, Anxiety and Stress Among Indians in Times of Covid‑19 Lockdown. Community Mental Health Journal,57, 42-48.https://doi.org/10.1007/s10597-020-00664-x.
Sahebi, A. Asghari, M. J. & Salari. R. S. (2005). Validation of Depression Anxiety and Stress Scale (DASS-21) for an Iranian Population. Journal of Developmental Psychology,1(4): 36-54. (in Persian)    
Schoch-Spana, M. & et al. (2021). The public's role in COVID-19 vaccination: Human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States. Vaccine, 39(40): 6004–6012. https://doi.org/10.1016/j.vaccine.2020.10.059.
Solimani, Z. Mahmoodi, H. Rezapour, M. & Amiri, H. (2022). The Typology of Knowledge, Attitude, Practices, and Concerns toward COVID-19 Vaccine and its Association with Vaccine Injection in Medical Sciences Students. Research square, 1-13.https://doi.org/10.21203/rs.3.rs-2100761/v1.
Su, Z. Wen, J. McDonnell, D. Goh, E. Li, X. Šegalo, S. Ahmad, J. Cheshmehzangi, A. & Xiang, Y. T. (2021). Vaccines are not yet a silver bullet: The imperative of continued communication about the importance of COVID-19 safety measures. Brain, behavior, & immunity - health12, 100204.https://doi.org/10.1016/j.bbih.2021.100204
Taylor, S. Landry, C. A. paluszek, M. M.  Fergus, T. A. Mckay, D. Asmundosn, G. J. G. (2020). Development and initial validation of the Covid Strees Scales. Journal of Anxiety Disorders, 72, 102232.
Thu, T. P. B. Ngoc, P. N. H. Hai, N. M. & Tuan, L. A. (2020). Effect of the social distancing measures on the spread of COVID-19 in 10 highly infected countries. The Science of the Total Environment, 742, 140430.
Vujicic, M. M. & Rendelovic, D. J. (2017). Personality traits as peredictors of depression, anxiety, and stress with secondary school students of final years. Orginal scientific paper, 217-237. 10.5937/ZRFFP47-14984.
Wang, C. Pan, R. Wan, X. Tan, Y. Xu, L. Ho, C. S. & Ho, R. C. (2020). Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. International journal of environmental research and public health, 17(5): 1729. https://doi.org/10.3390/ijerph17051729
Wang, G. Zhang, Y. Zhao, J. Zhang, J. & Jiang, F. (2020).  Mitigate The effects of home confinement on children during the COVID-19 outbreak. Lancet, 395(10228): 945-947. https://doi.org/10/1016/ S0140-6736 (20) 30547 –X
Wang, Y. Di, Y. Ye, J. & Wei, W. (2021). Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychology, Health & Medicine, 26(1): 13-22.
Wray, N. R. & et al. (2018). Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium. Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression. Nature genetics, 50(5): 668–681. https://doi.org/10.1038/s41588-018-0090-3
Yildirim, H. Işik, K. & Aylaz, R. (2021). The effect of anxiety levels of elderly people in quarantine on depression during covid-19 pandemic. Social Work in Pulic Health, 36(2): 194-204.
Yuan, J. Dong, M. Ling, Wong, I. O. Cowing, B. J. Tak Lam, W. W. Ni, M. Y. & Liao, Q. (2022). Can psychological distress account for the associations between COVID-19 vaccination acceptance and socio-economic vulnerability? Appl Psychol Health Well-Being,1583-1602. 10.1111/aphw.12452.
Zabihi hesari, N. K. Ramazani, Z. (2017). Relationship between five Factors of personality and state and trait anxiety in girl students of Boarding schools. Rooyesh, 5 (4) :191-208. URL: http://frooyesh.ir/article-1-388-(in Persian)
 Zhang, L. & Liu, Y. (2020). Potential interventions for novel coronavirus in China: A systematic review. J Med Virol, 92(5): 479-490. 10.1002/jmv.25707.