The COVID-19 pandemic has projected humanity into an unprecedented era characterized by feelings of helplessness and loss of control. While it is too early to robustly understand the impact of the virus on long-term psychological outcomes, healthcare professionals have already noted a marked increase in anxiety due to the uncertainty brought about by COVID-19.

However, we have little understanding of how employees’ COVID-19 health anxiety (CovH anxiety) — feelings of fear and apprehension about having or contracting COVID-19 — has spilled over to affect their work and home-related behaviours. In recent research co-authored with Nitya Chawla from Texas A&M University, we tested a model indicating how CovH anxiety impacts work, home and health outcomes. In this article, we will summarize our findings.

CovH anxiety’s impact on work, home and health outcomes

Grounded in the literature on health anxiety, the concept of CovH anxiety holds that threatening events — such as a global pandemic — trigger high levels of anxiety. Research indicates that feelings of anxiety trigger defense mechanisms in the form of a fight or flight response that is aimed at escaping the threat: the fight response is triggered when a threat is deemed surmountable, while the flight response is triggered when it is believed that the threat is difficult to overcome. The COVID-19 pandemic has been likely to prompt a flight response, given that it presented an immediate threat, it was unclear how long it would persist and there were a multitude of unanswered questions regarding its impact.

Research indicates that situations that elicit threat motivate people to reduce the expression of their emotions through emotion suppression — a form of coping that is used to regulate emotions after they have been generated. Professor McCarthy and I expected that the affective reaction to the pandemic (i.e., CovH anxiety) would trigger coping in the form of emotion suppression.

Withdrawal strategies have been observed among
individuals with clinical levels of anxiety.

Research across several disciplines supported this hypothesis. Emotion regulation research has found a positive relationship between measures of stress, anxiety, aggression and negative affect (emotion) on the one hand, and suppression-based emotion regulation on the other. Other studies indicate that anxiety and negative emotions lead to subsequent emotion suppression.

Furthermore, in clinical psychology, withdrawal strategies have been commonly observed among individuals with clinical levels of anxiety, and there is evidence that breast cancer patients with high levels of negative emotions use coping strategies focused on disengagement.

When individuals engage in emotion suppression, they are stifling the experience of their emotions and denying them an outlet. Not surprisingly, this type of regulation has been found to be maladaptive, particularly when people are faced with challenging situations. Rather than aiding the individual in coping, emotion suppression tends to exacerbate distress and lead to lower physical and psychological well-being.

We theorized that emotion suppression is detrimental to need fulfillment in three key work-related areas: competence, relatedness and autonomy. A healthy fulfillment of these needs leads to a number of positive professional, social and health-related outcomes. Let’s take a closer look at our hypotheses in each area:

1) Competence

The depleting nature of emotion suppression is driven by the increased cognitive load resulting from trying to deal with the underlying emotions being suppressed. We posited that this impairs constructive thought processeses, problem solving, memory and information recall, resulting in a reduction in individuals’ efficacy beliefs about performing a variety of tasks.

2) Relatedness

We felt that emotion suppression would also impact individuals’ relatedness needs by inhibiting social functioning and positive interpersonal experiences. For example, the use of emotion suppression has been linked to diminished recall of social information, lower communication effectiveness and social functioning, and reduced rapport between interaction partners. Suppression is also related to increased social avoidance behaviours, negative partner perceptions and increased hostility.

3) Autonomy

Finally, we felt that emotion suppression would lead to a decreased sense of autonomy. Emotion suppression is an inhibitory state in which people do not display their inner feelings, suggesting that suppression does not reflect autonomous behavior. Supporting this logic, scholars have proposed that emotion suppression impairs people’s sense of autonomy as they are unable to express genuine emotions and thus experience a loss of control.

In line with past work, we expected decreased psychological need fulfillment to be critical not just in influencing individuals’ work effectiveness but their home experiences and health outcomes, as well. With respect to the work domain, a lack of need fulfillment is likely to impede job effectiveness, particularly with regards to competence needs. Feelings of competence entail succeeding at optimally challenging tasks and being able to attain desired outcomes.

For employees working during the pandemic, goal progress has been an important indicator of work success because formal performance metrics may have been unclear during this unprecedented time. Goal progress reflects employee perceptions of whether they have been able to meet work goals. The more competent a person feels, the more likely they will strive to meet their goals. Thus, need fulfillment should facilitate goal progress.

When an individual’s work needs are being met,
they are less likely to engage in family conflict.

During the early stages of the pandemic, people were largely cut off from members of their social network outside of their immediate households. As such, the primary outlet for social engagement for many people was their own family. ‘Family engagement’ reflects the extent to which individuals’ direct attention to, and are absorbed in, their family, and it represented a critical outcome for people during the pandemic.

Past research indicates that psychological need fulfillment can increase relationship commitment and warmth toward partners. Moreover, need fulfillment has been related to reduced hostile behaviours in family relationships. It facilitates more open, understanding and less aggressive responses during family conflicts.

When individuals’ needs are being met, they are also less likely to alienate themselves from family or engage in family conflict. Thus, we expected psychological need fulfilment to be positively related to employees’ family engagement. Finally, we built on past research demonstrating that need fulfillment plays a critical role in influencing individuals’ health by examining psychosomatic complaints as a core outcome, which is an important physical indicator of wellbeing. According to researchers, the satisfaction of autonomy needs is energizing and promotes health and well-being, while lack of need satisfaction contributes to pathology and ill-being.

Problem-focused strategies are attempts to moderate the negative effects of a significant stressor. In the midst of the pandemic, handwashing was one of the most common forms of problem-focused coping. Given that proper handwashing kills the virus, it provides individuals with a mechanism to cope with the threat of COVID-19. This is important because anxiety typically triggers a loss of control, which can be alleviated by engaging in proactive forms of coping — such as handwashing — aimed at minimizing the threat. As a result, we posited that handwashing frequency may buffer the impact of CovH anxiety.

To summarize, we predicted the following: That psychological need fulfillment is associated with (a) greater goal progress at work (b) greater family engagement and (c) lower somatic health complaints.

Our research

To test the impact of CovH anxiety on employees, we began recruiting study participants during the week that social distancing measures were first implemented in Canada. In an effort to obtain employees from a diverse range of industries, we posted advertisements on several social networking sites, including LinkedIn, Facebook and Twitter. To qualify for the study, participants had to be employed and work at least 20 hrs per week.

Within the advertisement was a link to a survey, which included a measure of CovH anxiety. The remaining three surveys were each sent approximately one week apart in an effort to reduce concerns tied to common method biases. Participants received a link to each survey via e-mail on Friday at noon and had until the following Monday at noon to complete it. At Time 2, participants rated their emotion suppression and handwashing habits. At Time 3, they completed the measure of psychological need fulfillment. At Time 4, we assessed participants’ behaviours across the work and home domains, as well as psychosomatic health complaints.

Our final sample consisted of 503 participants. They were predominantly female (63.2 per cent), Caucasian (74.6 per cent) and full-time employees (89.7 per cent). On average, participants were 36.8 years old and employed in their current organization for 6.3 years.

Finding 1

We predicted that CovH anxiety would positively relate to emotion suppression, and we found a significant positive effect of CovH anxiety on suppression. Importantly, this effect held even after controlling for trait anxiety, suggesting anxiety relating to a specific situation (COVID-19) has unique effects on suppression.

Finding 2

We also proposed that emotion suppression negatively relates to psychological need fulfillment, and our results provided support for this hypothesis. We found a negative effect of emotion suppression on psychological need fulfillment.

Finding 3

Consistent with our third hypothesis, psychological need fulfillment was positively associated with goal progress and family engagement but negatively related to somatic health complaints.

Finding 4

Our fourth hypothesis theorized that CovH anxiety would have serial indirect effects on the behavioural criteria via emotion suppression and need fulfillment. CovH anxiety had a negative indirect effect on goal progress and family engagement via suppression and need fulfillment. In
contrast, it had a positive indirect effect on somatic health complaints.

Finding 5

Our final hypothesis proposed a moderating effect of handwashing frequency on the relationship between CovH anxiety and emotion suppression. We found a significant interaction effect of CovH anxiety and handwashing frequency on emotion suppression. The relationship between CovH anxiety and emotion suppression was significant and positive when handwashing frequency was lower, but not when the frequency was higher.

Key takeaways

Individuals with greater CovH anxiety suffered from reduced work effectiveness (i.e., lower goal progress), lower family engagement and greater somatic health complaints due to their lack of psychological need fulfillment as a result of suppressed emotions. In addition, proactive coping mechanisms — such as handwashing frequency — buffered individuals from suppressing their emotions. 

In closing

Our study speaks powerfully to the experiences of employees during the COVID-19 crisis. CovH anxiety has had significant implications for work effectiveness, family engagement and personal health.

Our work also demonstrates that in the face of an unprecedented threat, problem-focused coping in the form of a simple behavior such as handwashing can help mitigate the impact of the situation-specific anxiety. We are not suggesting that handwashing is a universal coping mechanism that will work across a variety of threat situations. Rather, we highlight the importance of engaging in appropriate coping behaviours relevant to the situation individuals are dealing with.

While there is still much to be understood about the impact of the pandemic on employees and organizations, our research offers critical insights into people’s experiences during the initial phases of this crisis and is a step towards understanding the work-, home and health-related implications of this unprecedented situation.

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This article first appeared in the Fall 2021 issue of Rotman Management magazine. Published in January, May and September, each issue features thought-provoking insights and problem-solving tools from leading global researchers and management practitioners. Subscribe today