key: cord-0831411-liu9fo89
authors: Yıldırım, Murat; Güler, Abdurrahim
title: Positivity mechanism explains how COVID-19 perceived risk increases death distress and reduces happiness
date: 2020-08-20
journal: Pers Individ Dif
DOI: 10.1016/j.paid.2020.110347
sha: 624db1c3b0d01060b89179c55d71e5e0535c21a8
doc_id: 831411
cord_uid: liu9fo89

The novel coronavirus (COVID-19) pandemic has produced an unprecedented impact on all aspects of life, including mental outcomes like death distress. This study examined the mediating effect of positivity on the association between COVID-19 related perceived risk, death distress, and happiness. Participants were 3109 Turkish adults (Mean (age) = 38.64 ± 10.40) who completed online measures of perceived risk, positivity, death distress, and happiness during the pandemic. Results showed that perceived risk had a significant direct effect on positivity, death distress, and happiness. Positivity had a significant direct effect on death distress and happiness. Mediation analysis indicated that positivity mediated the effect of perceived risk on death distress and happiness. Results suggest that positivity is an important aspect of developing strength-based preventions and interventions aiming to reduce psychological distress and improve happiness.

unease, and discontent of dying. Death depression refers to occurrence of negative emotions such as sadness, loneliness, hopelessness associated with one's own death, death of significant others, and general meaning of death. Death obsession reflects rumination, persistent ideas, or repetitive thoughts centred on death of own and significant others (Abdel-Khalek, 1998; Mohammadzadeh, Ashouri, Vahedi, & Asgharipour, 2018) . Despite being correlated, the three dimensions are empirically distinct concepts (Lester, 2003) . People with high levels of death distress tend to experience more mental health problems or psychopathology such as distress/impairment, depression, anxiety, and stress (Bodner, Shrira, Bergman & Cohen-Fridel, 2015; Menzies, Sharpe, & Dar-Nimrod, 2019) , which may trigger risk of death or engagement in suicidal behaviours. Death distress is also associated with obsession (Abdel-Khalek, 2004) , religiosity (Mohammadzadeh & Oraki, 2018) , satisfaction and resilience (Wen, 2010) .

The negative emotions emerged during COVID-19, which can result in suicidal behaviours, can be preventable (Mamun & Griffiths, 2020) . Psychological resources and strengths can help individuals to cope with stressors effectively. As such, positivity can act as an important psychological strength that can protect temporal and permanent COVID-19 related tragedies. Positivity is conceptualised as a dispositional self-evaluative tendency to view one's life, and future with a positive outlook while restrains negativity (Caprara et al., Studies showed that positivity is significantly associated with life satisfaction, selfesteem, optimism, depressive symptoms (Caprara et al., 2012) , happiness (Lauriola & Iani, 2015) , quality of interpersonal relationships (Laguna, Alessandri, & Caprara, 2017) , and resilience (Milioni et al., 2016) . Evidence also suggests that people with resources, capacities, and psychological strengths such positive emotions (e.g., happiness), positive individuals' traits (e.g., positivity), and social environmental factors (e.g., social support) may help to maintain positive mental health (Yıldırım & Arslan, 2020) . Trait-like variables have significant effects on happiness, well-being, and positive mental health (Sheldon & Lyubomirsky, 2004) . Due to the trait-like nature of positivity, it can act as an effective mediator toward the examination of death distress and happiness, particularly within the context of COVID-19.

Empirical studies have examined the impacts of COVID-19 related risk factors in contributing to psychological distress during the pandemic (Arslan, Yıldırım, Tanhan, Buluş & Allen, 2020 ), yet little attention has been paid to the underlying mechanism that reduces psychological distress and increases happiness. Previous research has shown that psychological resource capacities like hope, optimism, and self-esteem can reduce death anxiety (Barnett, Anderson & Marsden, 2018; Hiyoshi, Becker, Oishi & Fukuyama, 2017; Soleimani et al., 2020; ) . However, to date, there is no direct evidence testing the impact of positivity in the relationship between COVID-19 risk perception and death distress. Positivity is an individual characteristic that may assist to sustain individuals' happiness and mental health due to its protective role (Caprara et al., 2012) . Thus, it is also plausible that positivity may create the motivational resources to help people cope with the challenges of pandemic and consequently protect their mental health. Terror Management Theory (TMT; Greenberg, Pyszczynski & Solomon, 1986) can help us to understand the cognitive, emotional, and J o u r n a l P r e -p r o o f Journal Pre-proof behavioural responses to COVID-19. The theory assumes that people have a dual-process system that acts as a protective function against people's awareness of vulnerability and inevitable mortality. According to the TMT, death anxiety underlies much of the human behaviours, but people with high psychological resource capacities will experience less anxiety against death-related scenes.

Given the profound adverse effects of COVID-19 on mental health outcomes such as death distress, it is critical to understand the underlying mechanism of COVID-19 related psychological factors like perceived risk, death distress, and happiness. Therefore, this study aimed to examine the mediating role of positivity on the relationship between COVID-19 related perceived risk, death distress, and happiness. The hypotheses are as follows: (1) perceived risk would have a significant effect on positivity, death distress, and happiness; (2) positivity would have a significant effect on death distress and happiness; (3) positivity mediates the association between perceived risk, death distress and happiness.

The sample included 3,109 Turkish adults drawn from general public. Their ages ranged between 18 and 70 with a mean age of 38.64 (SD =10.40). They were proportionally distributed by gender (49.98% males). The majority of participants (64.68%) were married, university graduate (39.76%), belonging to average perceived socioeconomic status (68.51%), without any chronic disease (72.40%), living with three or four people (53.30%), and living in the city centre (81.76%).

This study was conducted during the COVID-19 pandemic throughout April 2020. A message contained the study link was distributed online to all potential participants. Before beginning to partake in the study, participants were given information explaining the aims of the study, the voluntary nature of involvement, potential benefits, risks, and data confidentiality at the first page of the survey. After providing informed consent, they were allowed to proceed. The study protocol was approved through institutional ethical committee.

related to personal risk (Yıldırım & Güler, 2020) . The scale includes 8 items and two dimensions (cognitive and emotional). Each item is rated on a Likert-type scale between 1 (negligible) and 5 (very large). Sample items include -What is the likelihood that you would acquire the COVID-19?‖ (cognitive) and -How worried are you about contracting the COVID-19?‖ (emotional). Higher scores reflect greater risk related to COVID-19. Yıldırım and Güler (2020) reported that the CPRS has a two-factor structure (shown through exploratory and confirmatory factor analyses), good convergent validity with COVID-19 severity, self-efficacy, and mental health and high internal consistency reliability. 

Journal Pre-proof Death Distress Scale (DDS). The DDS is a 9-item measure of death distress with three components: anxiety, depression, and obsessive thoughts (Dadfar, & Lester, 2020) .

Items are rated on a Likert-type scale from 1 (never) to 5 (always). Sample items are -I am not at all afraid to die‖ (anxiety), -Hearing the word death makes me sad‖ (depression‖, and -I can't get the notion of death out of my mind‖ (obsession). The scores of each component are obtained by summing the response to each of the items on the respective component.

Higher scores indicate higher levels of death distress. As the DDS has not been validated in Turkish yet, this study investigated the psychometric properties of the DSS to enhance its utility for use in research and practice (see results section). (2019) reported sound psychometric properties for the scale in Turkish language.

Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to examine the factor structure of the CPRS and DDS. Participants were randomly split into two subsamples of roughly equal size. Subsample 1 (n=1565) was used for EFA and Subsample 2 (n=1544) for CFA, which was conducted using SPSS-AMOS (v.24). CFA results were evaluated using multiple indices: Chi-Square/degree of freedom ratio (χ2/df), the goodness of fit index (GFI), adjusted goodness of fit (AGFI), comparative fit index (CFI), incremental fit index (IFI), Tucker-Lewis fit index (TLI), root mean squared error of J o u r n a l P r e -p r o o f Journal Pre-proof approximation (RMSEA), and standardized root mean square residual (SRMR) were used to assess the fit of the model to data (Tabachnick & Fidell, 2007) . The statistics that represent a -good‖ fit are demonstrated by GFI, AGFI, CFI, IFI and TLI ≥ .95, RMSEA ≤ .08, SRMR ≤ .05, and χ2/df < 3 (Hu & Bentler, 1999; Kline, 2005) . Pearson's correlation was run to explore the relationships between the variables. The SPSS macro PROCESS (Hayes, 2013) was used to perform mediation analyses. The bootstrapping method with 5000 resamples to estimate the 95% confidence intervals (CI) was subsequently conducted to demonstrate the significance of indirect effects.

Using Subsample 1 (n=1565), we conducted EFA with principal axis factoring and promax rotation to identify the underlying factor structure of the DDS. Kaiser-Meyer-Olkin value was .78 and the Barlett's test of sphericity was also significant, χ2 ( df=36 ) =8011,92, p < .001. The analysis demonstrated a three-factor solution with eigenvalue of 3.79, 2.09, and 1.20, which explained 42.08% (death obsession), 23.17% (death depression), and 13.28% (death anxiety) of the total variance, respectively. The factor loadings for the nine items ranged between .49 and .96. Internal consistency reliabilities were computed as .77 for death anxiety, .88 for death depression, and .91 for death obsession. Additional statistics are reported in Table 1. CFA was used to examine whether the proposed three-factor model of the DDS could be replicated in Subsample 2 (n=1544). Other than χ2/df, which showed a moderate fit 

Descriptive statistics, internal consistencies, and correlation matrix are presented in 

Following the exploration of the preliminary results, we tested the mediating role of the positivity in the relationships between coronavirus risk and death anxiety, death depression, death obsession, and happiness. The results of mediation analyses are reported in Table 3 and Table 4 . Firstly, the results showed that coronavirus risk had a significant negative direct effect on positivity, but not on death anxiety. Positivity had a significant negative direct effect on death anxiety. Positivity fully mediated the effect of coronavirus risk on death anxiety. Coronavirus risk and positivity together accounted for 1% of the total variance in death anxiety. Secondly, the direct effect of coronavirus risk on death depression was positive and significant. Coronavirus risk led to decreased positivity which in turn led to decreased death depression. Collectively, coronavirus risk and positivity accounted for 11% of the total variance in death depression. Thirdly, the direct effect of coronavirus risk on death obsession was positive and significant. The indirect effect of coronavirus risk on death J o u r n a l P r e -p r o o f obsession through positivity was negative and significant. Coronavirus risk and positivity together accounted for 10% of the total variance in death obsession. Finally, the direct effect of coronavirus risk on happiness was negative and significant. Positivity functioned as a partial mediator between coronavirus risk and happiness. Coronavirus risk led to decreased positivity which in turn led to increased happiness. Coronavirus risk and positivity accounted for 38% of the total variance in happiness.

This study investigated the role of positivity as a potential mechanism for linking between COVID-19 related perceived risk, death distress, and happiness. As predicted, perceived risk was associated with positivity, death distress, and happiness. More importantly, the results suggested that the effect of perceived risk on death distress and happiness was mediated by positivity.

Our findings that COVID-19 related perceived risk had a significant direct effect on positivity, death distress, and happiness supported our first hypothesis. This result is consistent with previous studies that explored the relationship between perceived risk and mental health outcomes occurred during the COVID-19 pandemic (e.g., Ahorsu et al., 2020; Xiao, 2020; Zhang, Wang, Rauch & Wei, 2020) . This result suggests that excessive levels of COVID-19 related perceived risk can have a negative effect on psychological health by increasing experience of death distress, decreasing happiness and positive outlook about self, life, and future. Positivity was positively associated with happiness and negatively associated with death distress supporting the second hypothesis of this study. Previous studies demonstrated that higher level of positivity is related with increased satisfaction with life, happiness, optimism, resilience, and decreased depressive symptoms (Caprara et al., 2012; Lauriola & Iani, 2015; Milioni et al., 2016) . This suggests J o u r n a l P r e -p r o o f Journal Pre-proof that individuals with higher levels of positivity report higher levels of happiness and lower levels of psychological distress. Being positive can energize one's potential, relationships, worldview, and mental energies (Fredrickson, 2009 ).

The main finding of this study is that positivity mediates the link between COVID-19 related perceived risk, death distress, and happiness, confirming our third hypothesis. This result suggests that the underlying mechanism between perceived risk, death distress, and happiness can be explained in part by positivity. However, it is important to note that this study used a large sample suggesting that power can be very high in terms of producing significant results. For example, coronavirus risk and positivity together explained 1% of the total variance in death anxiety. Even though the proportion of explained variance is small for this model, it is significantly different from 0, showing that the hypothesised model has a significant explanatory power. According to Cohen's (1988) Concerning adaptation of the DDS into Turkish language, the results showed that the DDS is a reliable and valid measurement tool assessing death distress among Turkish public.

The construct validity of the DDS confirms a three-factor structure representing anxiety, depression, and obsession with good internal consistency reliability. The DDS also had adequate correlation with other employed study variables. This result is in accordance with the original study (Dadfar, & Lester, 2020) . Previous studies showed that three dimensions of death distress had none/low to high correlation with each other and explained different proportion of variance in an outcome variable among samples with different cultural backgrounds (e.g. Abdel-Khalek, 2004 , Lester, 2003 .

Individual and cultural differences may influence the relationships between the dimensions of death distress and their relationships with other variables. Individual attitudes toward deaths can be formed by culture, and therefore these dimensions differ from each other across culture .

As researchers become increasingly interested in the mechanisms that underlie death distress and happiness (Iverach, Menzies, & Menzies, 2014; Yildirim, 2019 ). Positivity appears to be a key factor that can contribute to this investigation. In this study, we tested a model that facilitates to explain how COVID-19 perceived risk can reduce positivity, The findings of this study should be considered in light of several limitations. First, there are different forms of COVID-19 related risk such as unknown risk and dread risk, but the present study only focused on the personal risk at general level. Future studies may explore whether the mediating effect of positivity would vary as the forms of risk perception change. Second, as participants in the current study were recruited online, it is necessary to be cautious in respect to generalization of these findings to those who are unable to access the internet. Third, the current study is based on a cross-sectional research which could not verify the causal relationship between COVID-19 perceived risk, death distress, and happiness.

Subsequent studies may attempt to adopt longitudinal designs with control for possible confounders to elucidate the relationship between COVID-19 perceived risk, death distress, and happiness alongside their underlying mechanism. 

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We thank to all participants who voluntarily contributed to this study.

The authors declared no conflicts of interest with