Psychological factors responsible for low adherence to mask-wearing measures during the COVID-19 pandemic

• Published in: BJPsych open Vol. 8; no. 6; p. e203
• Main Authors: Kılıç, Cengiz, Yıldız, M. İrem, Emekli, Esra, Gülşen, Gülhan, Alp, Anıl
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 23-11-2022
• Subjects: Anxiety; anxiety disorders; Attitudes; Coronaviruses; COVID-19; COVID-19 vaccines; Cronbach's alpha; Data collection; epidemiology; face masks; Fear & phobias; Gender; General Adult; Masks; Medical research; Mental disorders; Mental health; Pandemics; Phobias; Public health; Social networks; Turkey; COVID-19; epidemiology; anxiety disorders; Phobias; face masks
• ISSN: 2056-4724; 2056-4724
• DOI: 10.1192/bjo.2022.603

The COVID-19 pandemic has led to >6 million deaths. Anti-mask movements may decrease the effects of preventive measures. Psychological factors that may be related to anti-mask behaviour are not well researched.
This study aims to determine the psychological correlates of anti-mask attitudes and behaviour in an online general population sample, focusing on the possible role of claustrophobia.
Data on attitudes and behaviour toward mask-wearing were collected from an online sample of 3709 people. Predictors of both anti-mask attitudes and behaviour were assessed with linear and logistic regression analyses.
Few people (3.3%) were overtly opposed to mask-wearing; mask opposition was more common in men than women. Predictors of negative attitude toward mask-wearing and low adherence to mask-related measures were similar and included male gender, lower education, lower income, being employed, having had COVID-19 and lower COVID-19-related anxiety. Psychopathology measures did not show a prediction, whereas claustrophobia had a significant prediction that was over and above those of other predictors. Avoidance behaviour had similar predictors, except for higher COVID-19-related anxiety.
Although low adherence to mask-wearing during the pandemic was not related to having a mental disorder, it may partly be caused by psychological factors. Those who had a negative attitude also reported lower adherence behaviour, and were characterised by being male, having lower education, being employed and having lower COVID-19-related anxiety; claustrophobia was a strong predictor of attitude. Understanding psychological factors responsible for low adherence may help to decrease morbidity and mortality in future pandemics.