Introduction

The COVID-19 pandemic has impacted the world severely, with more than 9.8 million of people infected and close to 500,000 deceases registered. It has also caused an imminent psychosocial and economic crisis, along with social distancing, self-isolation and travel restrictions that reduced the workforce; it is needless to say that many jobs have been lost (^{Nicola et al., 2020}; ^{World Health Organization [WHO], 2020}). A relevant psychosocial aspect to consider under these circumstances is the widespread fear where our moral judgments and social attitudes become harsher and more conservative (^{Robson, 2020}). Widespread fear is a feeling of anxiety when faced with the possibility of being a victim; thus, it is possible to identify two elements of widespread fear to COVID-19: on the one hand, the emotion of fear, also defined as social anxiety, and on the other, a risk cognition of being a victim (^{Ruiz Pérez, 2007}). Catastrophes, insecurity and several social phenomena have filled the void left by ineffective social welfare policies and are intended to be solved by institutional security that positions widespread fear as a crucial issue in the interpretation of reality (^{Fonseca Vindas & Sandoval García, 2006}). Concerning widespread fear, among quarantine symptoms (social distancing and isolation) related to the CORONAVIRUS in a review of 3,166 papers from 24 selected, post-traumatic stress symptoms, confusion, and anger were commonly reported (^{Brooks et al., 2020}). In a study analyzing post-traumatic stress disorder (PTSD), resilience, and social withdrawal as avoidance, it was found that avoidant coping strategies are usually used to escape direct confrontation with stressful circumstances. Wishful thinking or social withdrawal were positively associated with PTSD symptom development. A lack of social support may increase vulnerability to PTSD symptomatology (^{Thompson, Fiorillo, Rothbaum, Ressler, & Michopoulos, 2018}). In addition, retrospective and prospective studies have found that avoidant coping increases vulnerability and PTSD symptoms (^{Gil, 2005}; ^{Hooberman, Rosenfeld, Rasmussen, & Keller, 2010}; ^{Najdowski & Ullman, 2009}). The COVID-19 pandemic is without doubt one of the biggest challenges in modern history. This study is centered in the psychosocial perspective, which approaches studies about people and social context, the perceptions of widespread fear perceptions that communities build, considering their confidence and capability to provide community coping strategies to cope with the emerging SARS-CoV2 pandemic crisis.

These dimensions can be measured and understood as a construct called widespread fear to COVID-19, a synonym of social anxiety. This core construct has been related to several coping strategies, and to several PTSD symptoms based on PTSD DSM-5 criteria (^{American Psychiatric Association [APA], 2013}). Widespread fear to COVID-19 is an emotional stress-related fear, usually associated to anxiety, stigmatization, and discrimination. (^{Person et al., 2004}) described underlying anxiety about a disease with an unknown cause and possible fatal outcome, which directly precipitate psychological distress event rates through indirect outcomes, like: increased smoking rates, sedentary lifestyles, and direct acute coronary syndrome (^{Chávez-Valdez, Esparza-Del Villar, Ríos Velasco-Moreno & Relojo-Howell, 2019)}. Described widespread fear as a kind of collective fear that develops physio emotional coping strategies that enhance perception of uncertainty, unhealthier behaviors, post-traumatic stress traits, and anxiety disorders. (^{Person et al., 2004}) warns us about empirical studies, which have shown that during serious disease outbreaks, when the public requires immediate information, there is usually a subgroup of the population that is at potentially greater risk of experiencing fear, stigmatization, and discrimination. (^{Chávez-Valdez et al., 2019}). Suggest that there is a prevalence of post-traumatic stress traits in threatened collectives. ^{Ruiz Pérez (2007)} refers to certain coping strategies that reproduce fear in threatened communities.

Therefore, the purpose of this study is to determine the association between post-traumatic stress symptoms and widespread fear to COVID-19 ^{Ruiz Pérez (2007)} Social anxiety scale, in Spanish (Escala de Miedo Difuso) with respect to coping strategies during the contingency due to COVID-19 in the Mexican population. Hypotheses werenʼt established due to the insufficient amount of data to establish them.

The specific aims/objectives of this study were:

Method

Results

Discussion and conclusion

Our study aim was to determine the associations between post-traumatic stress symptoms and widespread fear to COVID-19 with respect to coping strategies during the contingency due to COVID-19 in the Mexican population.

During the months of April and May 2020, 1,454 participants were registered and signed an informed consent, of which 711 filled out sociodemographic data (country, city, gender, age, email, among others). Of these, 711 participants, only 654 had a Mexican birth certificate. Subsequently, several filters were applied using the provided email as a reference. When reviewing the post-traumatic stress traits scale, 555 participants completed this scale, and when comparing the aforementioned with the widespread fear scale 540 participants completed the scale also; a complete sample comprising both scales reached 394 participants. A final filter was performed adding a coping strategies scale, which defined the final sample into 370 participants.

Considering the results of the multiple regression analyzing widespread fear predicted by the coping factors a value of R² = .50 (p < .01) was obtained. In addition, there were no statistically significant associations with the criterion G PTSD functional significance (^{APA, 2013}) at the time data collection for this study was completed. This is crucial because, at this point, no dysfunctional performance on physical health, work, or relationships associated to the pandemic can be demonstrated. It is important to note that most people that experience difficult situations or stressors tend to cope well and do not develop PTSD symptoms since there is no perception of a traumatic event.

PTSD total symptomatology in SARS-CoV2-threatened communities was strongly predicted by physiological coping, so a strong reactive response in this communities, with a high prevalence of widespread fear to COVID-19, predicted by emotional focused coping, was a growing warning. PTSD symptomatology found in the sample and the widespread fear to COVID-19 is a relevant convergent finding. However, as a divergent finding, it also warns us about no other significant coping strategies preferred by our sample. In this case, cognitive confrontation and behavioral promotion coping strategies, which have a beneficial role to seek aid in case of a mental health pandemic outbreak, were not statistically significant by Mexican SARS-CoV2-threatened communities.

These results are in accordance with recent literature related to psychological symptoms due to the COVID-19 pandemic. In the study carried out by ^{Germani, Buratta, Delvecchio, and Mazzeschi (2020)} with a sample of 1,183 Italian adults, factors like: worrying and social fear, restlessness, and psychological maladaptation were observed. ^{Talevi et al. (2020)} suggest that during the pandemic, the general population suffered considerable psychological distress in terms of anxiety, depression, PTSD. These authors claim that these findings are also observed with severity worldwide. This aspect helps to the generalizability (external validity) of the study, an effort to engage in COVID-19’s trauma-related research.

There are other points of agreement, like associate traumatic events with coping strategies, mental health and well-being measures (^{Cherewick, Doocy, Tol, Burnham, & Glass, 2016}). High levels of socio economic and cultural vulnerability, post-traumatic stress traits in young people, widespread fear and a variety of traumatic stressors usually impact psychosocial health and well-being (^{Chávez-Valdez et al., 2019}).

Regarding the limitations of this study, it should be mentioned that, although 370 participants constitute a considerable sample, they do not represent still the whole circumstances of the Mexican population struggling with this pandemic. However, the authors know that this is the first study of such dimensions analyzing the pandemic effects in the Mexican population, a country where mental health services are lacking, and more epidemiological and psychology interventions should be applied (^{Martínez, Galván, Saavedra, & Berenzon, 2017}).

Another limitation was that not enough detail of the sociodemographic characteristics of the participants was obtained. This was decided in order to maintain the anonymity of the participants, the gathered information pertained to gender, age, educational level, city, and employment status. In future studies, more detailed information of the participants will be gathered.

Additionally, our scale did not inquiere in terms of time span for the PTSD symptoms, and it is necessary for future studies to include this information to assess if the symptoms indicate PTSD or acute stress disorder. Finally, several studies indicate a comorbidity between PTSD and depression (e.g., ^{Flory & Yehuda, 2015}), and since depression was not evaluated in our study, there are limitations, for example, we cannot differentiate if the symptoms measured by the PTSD scale are better explained by depression. This limitation would also extend to other mental disorders that we did not measure in this study (e.g., anxiety, substance use).

Although participants are from Mexico, it is noteworthy that the symptoms are similar across countries, as mentioned in the studies of ^{Germani et al. (2020)} in Italian participants and ^{Talevi et al. (2020)} in Vietnam and China. More psychometric tests could have been applied to have a wider panorama of the symptomatology, such as: life quality and positive emotions, in order to observe how these areas could be affected during a contingency such as COVID-19.

Our results found that widespread fear to COVID-19 had direct effects on affective coping, while physiological coping had direct effect on PTSD symptomatology, like: cognition and mood, intrusion, avoidance, and hyperarousal.

Substance Abuse and Mental Health Services Administration (^{Center for Substance Abuse Treatment, 2014}) indicate that delayed responses to trauma, among others, anxiety focused flashbacks, and emotional avoidance, can be indicators of more severe responses including intense intrusive recollections that continue during life span despite a return to safety. In this research, bad cognition and mood criterion showed a direct impact in physiological coping and a negative association on positive behavioral coping strategies (^{Center for Substance Abuse Treatment, 2014}).

Also, intrusive memories or flashbacks, hypervigilance and avoidance responses in a recursive mode in a social anxious community can derive to avoidance disorders, like: substance abuse, compulsive eating disorders, and social avoidance (^{Kummer & Harsanyi, 2008}).

Widespread fear to COVID-19 is related with emotional coping strategies and PTSD symptoms, such as: intrusion, generalized eluding or avoidance behaviors, hyperarousal and bad cognitions and mood. The current investigation warns about high physiological coping with traumatic intrusive-eluding symptomatology. We found intrusive and avoidant coping as moderator refugees to lead the pandemic crisis. These coping strategies must warn about severe reliable post-pandemic markers in several mental pathologies, including acute PTSD symptomatology evolution, as an individual diagnose or in comorbidity with mood disorders, persistent increased arousal symptoms, causing anger outbursts and hypervigilance. In the near future, if prevention is not performed, avoidance disorders, compulsive and addictive behaviors, and other dysfunctional behaviors can derive in multi pathological post-pandemic communities.