Participants and procedures
This study used data from the Republic of Ireland arm of the COVID-19 Psychological Research Consortium (C19PRC) 5. Participants were recruited from traditional, actively managed, research internet panels by the survey company Qualtrics using email, SMS, or in-app notifications. Based on inclusion criteria, respondents were 18 years of age or older, resident of the Republic of Ireland, and capable of completing the survey in English. To ensure the sample was nationally representative, as per the 2016 Irish census 6, quota sampling methods were used in terms of sex, age, and geographical distribution. Sample characteristics are presented in Table 1. Ethical approval was granted by the University of Sheffield.
Table 1 Sociodemographic characteristics of the sample (N = 1,032) Measures
Mental health attitudes during COVID-19
For this study, a six-item measure was developed by the research team to assess the public’s attitudes about mental health issues during the COVID-19 pandemic. The six statements are shown in Figure 1. Participants were asked to indicate the extent to which they agreed with each statement on a five-point Likert scale ranging from ‘strongly disagree’ (1) to ‘strongly agree’ (5). To determine the optimal scoring scheme for this measure, a confirmatory factor analysis was undertaken. A one-factor model with weighted least squares mean- and variance-adjusted estimation 7 provided acceptable fit to the sample data (χ2 (9, 1032) = 466.58, p < 0.001; CFI = 0.95; TLI = 0.92; RMSEA = 0.22 (90% CI = 0.21, 0.24); SRMR = 0.04). Although the RMSEA indicated poor fit, this test has been shown to perform poorly in models with small degrees of freedom 8. The six items loaded significantly (p < 0.001) onto the latent attitude variable, and all items had standardized factor loadings greater than 0.80 with the exception of item 3 which had a loading of 0.30. Furthermore, the internal reliability of the six items was good (α = 0.81). Thus, a summed score of the six items was used for analytic purposes, and scores of this attitudinal variable ranged from 6 to 30 with higher scores reflecting more favourable attitudes.
Sociodemographic variables
Eight sociodemographic variables were assessed including age, sex (0 = male, 1 = female), nationality (0 = Irish, 1 = non-Irish), urbanicity (0 = non-city dwelling, 1 = city dwelling), highest educational achievement (0 = post-secondary level, 1 = secondary level or less), religious identification (0 = atheist/agnostic, 1 = any religion), annual income (0 = less than €20,000, 1 = €20,000–29,999, 2 = €30,000–39,999, 3 = €40,000–49,999, 4 = €50,000 or more), current or past mental health treatment (0 = no, 1 = yes), and voted in the 2020 general election (0 = yes, 1 = no).
Psychological variables
Internalizing distress
A summed score of symptoms of posttraumatic stress disorder, major depression, and generalized anxiety was used to represent internalizing distress. The six-item International Trauma Questionnaire (ITQ) 9, the Patient Health Questionnaire-9 (PHQ-9) 10, and the Generalized Anxiety Disorder 7-item Scale (GAD-7) 11 were used to measure the respective indicators of internalizing distress. Scores range from 0 to 72 with higher scores reflecting higher levels of distress. The internal reliability of the scale scores (i.e. the 22 items from the measures) was excellent (α = 0.96).
Identification with others
The nine-item Identification with all Humanity Scale (IWAHS) 12 asks participants to indicate how much they identify with people in their community, from Ireland, and all humans everywhere. The response scale ranged from ‘not at all’ (1) to ‘very much’ (5), and higher scores reflect greater identification with others. The internal reliability of the IWAHS scores in this sample was excellent (α = 0.93).
Personality traits
The Big-Five Inventory (BFI) 13 measures the five personality traits of openness, conscientiousness, extraversion, agreeableness, and neuroticism with two items on a five-point Likert scale ranging from ‘strongly disagree’ (1) to ‘strongly agree’ (5). Higher scores reflect higher levels of each trait. The BFI has been shown to produce scores with good reliability and validity. 14 Since the BFI uses two items per trait, it was not possible to produce meaningful internal reliability estimates in this sample.
Internal locus of control
The three-item ‘Internal’ subscale of the Locus of Control Scale 13 was used. The questions were answered on a seven-point Likert scale ranging from ‘strongly disagree’ (1) to ‘strongly agree’ (7), and higher scores reflect higher levels of internal locus of control. The internal reliability of the scale score in this sample was good (α = 0.77).
Death anxiety
Death anxiety was measured using the 17-item Death Anxiety Inventory. 15 Responses are based on a five-point Likert scale ranging from ‘totally disagree’ (1) to ‘totally agree’ (5). Death anxiety scores range from 17 to 85 with higher scores reflecting higher levels of death anxiety. The internal reliability of the scale scores in this sample was excellent (α = 0.92).
Resilience
Resilience was measured using the Brief Resilience Scale 16 which includes six items answered on a five-point Likert scale ranging from ‘strongly disagree’ (1) to ‘strongly agree’ (5). Higher scores reflect higher levels of resilience, and the internal reliability of the scale scores in this samples was acceptable (α = 0.69).
Data analysis
Descriptive statistics were calculated to determine what proportion of the sample agreed/disagreed with the six statements relating to mental health issues in Ireland. Hierarchical multiple regression analysis was used to identify the sociodemographic and psychological factors that were uniquely associated with mental health attitudes. The nine sociodemographic variables were added to the model in block 1, and the ten psychological variables were added in block 2.