key: cord-0943500-jpmcic3x authors: Sasaki, Natsu; Kuroda, Reiko; Tsuno, Kanami; Kawakami, Norito title: Exposure to media and fear and worry about COVID‐19 date: 2020-06-26 journal: Psychiatry Clin Neurosci DOI: 10.1111/pcn.13095 sha: dab8be2f2731414b9d077302e67f8fff2309c221 doc_id: 943500 cord_uid: jpmcic3x nan Too much exposure to media has been known to be associated with greater fear and worry and poor mental health in a health crisis (1, 2) . Repeated media exposure was reported to have a negative impact on mental health after the New York Terrorist Attack on September 11, 2001 (3), Ebola outbreak (4) , and the Great East Japan Earthquake and Tsunami (5) . The use of social media as a resource of information was associated with greater fear and worry about adverse health effects of possible radiation exposure after the Fukushima Nuclear Power Plant Accident (6) . It has been argued that the same pattern may be observed in the outbreak of the new coronavirus disease 2019 (COVID-19) (2) , and it is recommended to limit the access to media in its frequency and to a reliable information source to keep better mental health (7) . A study from Wuhan, China reported that social media exposure (such as Weibo, WeChat) was associated with depression and anxiety during the COVID-19 outbreak (8) . However, evidence is still limited in the current outbreak of COVID-19. Here, we report additional evidence based on a secondary analysis of data collected from a sample of employees in Japan in the middle of March, 2020, in the early phase of the COVID-19 outbreak in Japan. Authors conducted a cross-sectional online survey to examine the relationship between the type of media use and fear and worry of COVID-19 by using the sample from the cohort of full-time employees in February 2019 (n=4,120). Participants were explained that their anonymity was preserved and gave online informed consent. This study was approved by The Research Ethics Committee of The University of Tokyo (No. 10856-(2)). Participants (n=1,420) completed an online self-report questionnaire on March 19-22, 2020. Participants included managers (8.8%), white collar workers (62.8%), and blue color workers (28.4%); those who engaged in the medical and welfare sector consisted of 13.5%. Detail information is available elsewhere (9) . Type of media as information source about COVID-19 was asked by using a list of 14 sources (television, radio, newspaper, web media, any SNS [YouTube, Twitter, Facebook, and other SNS], governmental or organizational website, chat with family or friends, workplace, medical This article is protected by copyright. All rights reserved. organization or staff, academic papers, and others) with each item rated "Yes" (=1) or "No" (=0). Fear and worry over COVID-19 were measured by asking one item ("Do you feel anxiety over COVID-19?") on a 6-point Likert-type scale (ranging from 1 "Not at all" to 6 "Feel strongly"). The frequencies of media use were: television (89.9%), radio (11.3%), newspaper (27.7%), web media (66.1%), any SNS (17.5%), governmental or organizational site (15.6%), chat with family or friends (30.1%), workplace (27.7%), medical organization or staff (9.5%), academic papers (1.1%), and others (0.1%). A linear regression analysis revealed that the use of television (β=0.133, p=0.0000005) and web media (β=0.113, p=0.000031) as information source of COVID-19 significantly and positively correlated with fear and worry over COVID-19, after adjusting sex, age, marital status, having at least one child, and occupational type. None of the other media use did not significantly correlate with fear and worry over COVID-19. Our survey was limited in many ways -the cross-sectional study design, non-representative sample of employees, and lack of information about duration nor frequency of the media use. However, our findings suggest that television and web media as an information source of COVID-19 are associate with greater fear and worry over the disease in the general working population in Japan. Television broadcasts news and provides information of COVID-19 almost all the day. Web media can be accessible anytime in day and night. People may have access to these medias very frequently. Media exposure with visual images, such as TV viewing, is known to be related to psychological distress and posttraumatic stress disorder (5, 10), though there were few studies showed such association with print or audio media. Social media also sometimes provided disinformation or false (8) that may exaggerate anxiety about COVID-19. Too much access to these medias may lead people to overestimate the risk of COVID-19, then increase fear and worry about the disease. Based on our findings, together with a previous one in China (8) , we believe that recommending people living under the COVID-19 breakout to limit the frequency and amount of access to television and web media to obtain information about COVID-19 would be effective in preventing Understanding the mental health effects of indirect exposure to mass trauma through the media The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure Mental-and physical-health effects of acute exposure to media images of the September 11, 2001, attacks and the Iraq War Distress, worry, and functioning following a global health crisis: A national study of Americans' responses to Ebola Peritraumatic distress, watching television, and posttraumatic stress symptoms among rescue workers after the Great East Japan earthquake Relationship Between Use of Media and Radiation Anxiety Among the Residents of Fukushima 5.5 Years After the Nuclear Power Plant Accident Caring for Patients' Mental Well-Being During Coronavirus and Other Emerging Infectious Diseases: A Guide for Clinicians Mental health problems and social media exposure during COVID-19 outbreak Workplace responses to COVID-19 Psychological reactions to terrorist attacks: findings from the National Study of Americans' Reactions to This article is protected by copyright. All rights reserved. mental health problems in the workplace. We of course realize an inevitable role of the media in a health crisis to convey correct, essential, and useful information. The important thing is that people should be aware of a psychological risk of too much exposure to the media and control the access by themselves in a health crisis such as the COVID-19 breakout.This article is protected by copyright. All rights reserved. Conflict of Interest Disclosures: None reported. This article is protected by copyright. All rights reserved.