Corona doubt and scepticism: repression and denial as psychological defence mechanisms to process distress?

Abstract

After more than a year of pandemic, SARS-CoV-2 (Severe acute respiratory syndrome coronavirus type 2) remains a relevant health care and society issue. Movements doubting the dangerousness or the existence of the virus have emerged and became a challenge to social cohesion. About 3487 individuals (434 Corona doubters and 3053 non-doubters) have participated in an online survey (predominat age group: 35–45 years). Particularly, COVID-19-related anxiety, generalized anxiety (Generalizied Anxiety Disorder Screener, GAD-7), depression (Patient Health Questionnaire, PHQ-2) and functional/adherent safety behaviour were assessed. COVID-19 doubters describe less functional safety behaviour. Fear of the virus is evident, similar to non-doubters. Generalized anxiety and depression were significantly higher in doubters. Repression and denial as psychological defence mechanisms could be the unconscious psychological strategy for coping with the distress variables. The results point out that public strategies may only be successful in managing opinions and beliefs if they address fears and worries.

To the Editor

Still, after more than a year, SARS-CoV-2 holds the world in suspense. COVID-19 is particularly dangerous for older people and people with pre-existing somatic conditions.¹ Vaccination campaigns are faltering. Non-pharmaceutical interventions (NPIs), such as restrictions on work life, social life and everyday activities, are still the only option. At the same time, movements doubting the dangerousness or even the existence of the virus have emerged. Doubters are convinced that containment measures are inadequate, unnecessary or even arbitrary. Worldwide, doubters organize demonstrations against restrictions, often without respecting hygiene rules. This poses a threat to social cohesion and may negatively impact the motivation to get vaccinated. So far, no knowledge about the psychological burden of this group exists.² During the beginning of the second lockdown in November 2020, a total of 434 Corona doubters (75.6% female) and 3053 non-doubters (81.4% female) participated in an online survey in which the predominant age group was 35–45 years. COVID-19-related anxiety,³ generalized anxiety (Generalizied Anxiety Disorder Screener, GAD-7),⁴ depression (Patient Health Questionnaire, PHQ-2),⁵ functional/adherent safety behaviour (ASB) (e.g. keeping distance and wearing masks), subjective level of information regarding COVID-19, trust in governmental interventions and the subjective risk perception of getting infected or becoming seriously ill were surveyed.

COVID-19 doubters have less trust in governmental actions, feel less informed and describe less functional safety behaviour. Unexpectedly, COVID-19-related anxiety was equally pronounced in doubters and non-doubters (see Fig. 1). The fact that generalized anxiety and depression were significantly higher in doubters might be of public health relevance in terms of handling the pandemic: as expected, doubters have less confidence in government mitigation measures and are less likely to comply with these mandates. Fear of the virus is evident, similar to non-doubters, although this appears to be processed through a lower, subjective risk perception of falling (seriously) ill. The comparatively higher generalization of anxiety and the increased depression in doubters may be the result of an experienced loss of control in Corona times, which is interconnected with a lower subjective level of information. Repression and denial as psychological defence mechanisms could be the unconscious psychological strategy for coping with these distress variables. The results highlight that public strategies may only be successful in managing opinions and beliefs if they also address fears and worries. Unmasking and excluding individuals and groups with beliefs different to evidence could lead to uninhibited and amplified emotions.

Fig. 1.

Differences between doubters (n = 434) and non-doubters (n = 3053). Bars represent means and error bars 95% confidence intervals (CIs). Annotations above the bars show effect sizes in Cohen’s d with 95% CIs. (a) The means and CIs of the PHQ-2 scale. It consists of two four-point Likert-scaled items. Scores range from 0 to 6. Doubters show an increased depression symptom score (t(537.6) = 4.19, P < 0.0001). (b) The means and CIs of the GAD-7, which consists of seven items on a four-point Likert scale (range of total score: 0–21). Doubters show increased levels of generalized anxiety compared to non-doubters (t(550.18) = 2.90, P = 0.004). (c) The means and CIs of the COVID-19-Anxiety scale (C-19-A). It consists of 10 five-point Likert-scaled items with the total score ranging from 0 to 40. Doubters and non-doubters show an equal level of COVID-19-Anxiety (t(521.18) = −0.69, P = 0.49. In (d), means and CIs of the ASB scale are depicted. The scale consists of four items on a seven-point Likert scale. Here, the overall mean of the Likert scales is illustrated. Doubters show lower levels of safety behaviour than non-doubters (t(495.26) = −13.97, P < 0.0001). Results were obtained using Welch’s t-tests. Linear regression models that included the covariates gender, age, education, community size and presence of mental disease yielded equivalent results.

Martin Teufel, Chair

Adam Schweda, Data Scientist

Hannah Kohler, Clinician Scientist

Venja Musche, Junior Researcher

Madeleine Hetkamp, Junior Researcher

Benjamin Weismüller, Researcher

Sheila Moradian, Junior Researcher

Eva-Maria Skoda, Head of Research

Alexander Bäuerle, Deputy Head of Research

Conflict of interest statement

We have no competing interests.