Paris School of Economics (PSE), Paris, France.
Centre National de la Recherche Scientifique (CNRS), Paris, France.
PLoS One. 2024 Jun 25;19(6):e0305833. doi: 10.1371/journal.pone.0305833. eCollection 2024.
This paper investigates the association between several mental health indicators (depression, anxiety, stress, and loneliness) and the overall tendency to follow official recommendations regarding self-protection against COVID-19 (i.e., overall compliance). We employ panel data from the COME-HERE survey, collected over four waves, on 7,766 individuals (22,878 observations) from France, Germany, Italy, Spain, and Sweden. Employing a flexible specification that allows the association to be non-monotonic, we find a U-shaped relationship, in which transitions to low and high levels of mental health are associated with higher overall compliance, while transitions to medium levels of mental health are associated with less overall compliance. Moreover, anxiety, stress, and loneliness levels at baseline (i.e., at wave 1) also have a U-shaped effect on overall compliance later (i.e., recommendations are followed best by those with lowest and highest levels of anxiety, stress, and loneliness at baseline, while following the recommendations is lowest for those with moderate levels of these variables). These U shapes, which are robust to several specifications, may explain some of the ambiguous results reported in the previous literature. Additionally, we observe a U-shaped association between the mental health indicators and a number of specific health behaviours (including washing hands and mask wearing). Importantly, most of these specific behaviours play a role in overall compliance. Finally, we uncover the role of gender composition effects in some of the results. While variations in depression and stress are negatively associated with variations in overall compliance for men, the association is positive for women. The U-shaped relation in the full sample (composed of males and females) will reflect first the negative slope for males and then the positive slope for females.
本文探讨了几种心理健康指标（抑郁、焦虑、压力和孤独）与总体遵循 COVID-19 自我保护官方建议的倾向（即总体依从性）之间的关系。我们使用了来自法国、德国、意大利、西班牙和瑞典的 7766 个人（22878 个观测值）的 COME-HERE 调查的面板数据，该调查共进行了四轮。采用允许关联呈非单调关系的灵活规范，我们发现了一种 U 型关系，其中心理健康水平的低水平和高水平转变与总体较高的依从性相关，而心理健康水平的中水平转变与总体较低的依从性相关。此外，基线（即第 1 波）的焦虑、压力和孤独水平也对以后的总体依从性产生 U 型影响（即，最低和最高焦虑、压力和孤独水平的人最遵守建议，而中等水平的人最不遵守建议）。这些 U 型关系在几种规范下都是稳健的，可能解释了先前文献中报道的一些模棱两可的结果。此外，我们还观察到心理健康指标与许多特定健康行为（包括洗手和戴口罩）之间存在 U 型关联。重要的是，这些特定行为中的大多数都对总体依从性起作用。最后，我们揭示了性别构成效应在一些结果中的作用。虽然抑郁和压力的变化与男性的总体依从性变化呈负相关，但对女性而言，这种关联是正相关的。在包含男性和女性的全样本中，U 型关系将首先反映男性的负斜率，然后反映女性的正斜率。
