Can Changing How We Interpret Situations Help Reduce COVID-19 Fear and Stress?

What you need to know

• A brief computer-based training program helped reduce negative interpretations and fear related to COVID-19
• The training did not directly reduce post-traumatic stress symptoms, but reductions in fear were linked to improvements in stress symptoms
• Changing how we interpret ambiguous situations may be a helpful tool for managing pandemic-related stress and anxiety

Background on post-traumatic stress and COVID-19

The COVID-19 pandemic has been a challenging and stressful experience for many people around the world. In addition to concerns about physical health, the pandemic has taken a toll on mental health as well. Some people have experienced symptoms of post-traumatic stress related to the pandemic.

Post-traumatic stress symptoms can develop after experiencing or witnessing a traumatic event. These symptoms may include:

• Reliving or re-experiencing the traumatic event through nightmares or flashbacks
• Avoiding reminders of the trauma
• Negative changes in thoughts and mood
• Feeling on edge, irritable, or having trouble sleeping

While we often associate post-traumatic stress with events like combat, accidents, or assaults, research has shown that the COVID-19 pandemic has been traumatic for many people. Studies have found rates of pandemic-related post-traumatic stress symptoms ranging from 7% to over 50% in different populations.

How we interpret situations matters

When faced with unclear or ambiguous situations, people with anxiety or post-traumatic stress tend to interpret things in a more negative or threatening way. This is called a negative interpretation bias. For example, if someone coughs nearby, a person with COVID-related anxiety may immediately assume it’s COVID and feel afraid, while someone else may think it’s just a cold.

These negative interpretations can fuel anxiety and stress. The good news is that research suggests we may be able to shift these interpretation patterns through training.

The current study

Researchers in China conducted a study to test whether a brief computerized training program could help reduce negative interpretations related to COVID-19. They also wanted to see if the training could lower fear of COVID-19 and post-traumatic stress symptoms.

The study included 59 adults who had been infected with COVID-19 a few months earlier and were experiencing elevated post-traumatic stress symptoms. The participants were randomly assigned to one of two groups:

1. Interpretation Modification Program (IMP) - This was the active training designed to reduce negative interpretations

2. Interpretation Control Condition (ICC) - This was a control version that did not try to change interpretation patterns

Both groups completed assessments before and after a single 30-minute training session on a computer.

How the training worked

The training presented participants with ambiguous health-related scenarios. For example:

“You notice your heart is beating faster than usual…”

Participants then saw two possible interpretations - one negative and one neutral/positive:

Negative: “You are having a heart attack” Neutral: “You just climbed some stairs”

In the active IMP training, participants received positive feedback for choosing the neutral interpretations and negative feedback for choosing the threatening ones. This was intended to train them to interpret ambiguous situations in less negative ways.

The control ICC training gave no feedback on interpretation choices.

Key findings

After a single brief training session:

• The IMP group showed a greater reduction in negative interpretations compared to the control group
• The IMP group had a significant decrease in fear related to COVID-19, while the control group did not
• Both groups showed some improvement in post-traumatic stress symptoms, but there was no significant difference between groups

Interestingly, the researchers found that reductions in fear were linked to improvements in post-traumatic stress symptoms, but only for the IMP group. This suggests the training may have helped reduce stress symptoms indirectly by lowering fear.

What this means

This study provides evidence that a brief computerized training can help shift how people interpret ambiguous health-related situations. Just one 30-minute session was able to reduce negative interpretations and COVID-related fear.

While the training did not directly reduce post-traumatic stress symptoms more than the control condition, the link between reduced fear and improved stress symptoms in the IMP group is promising. It suggests that targeting interpretation biases may be a helpful tool for managing pandemic-related anxiety and stress.

Some key takeaways:

• How we interpret ambiguous situations can fuel anxiety and stress
• These interpretation patterns can be shifted through targeted training
• Reducing negative interpretations may help lower fear and indirectly improve stress symptoms
• Brief computerized trainings could be an accessible tool to help people manage pandemic-related mental health impacts

Limitations and future directions

It’s important to note some limitations of this study:

• It only included a single brief training session. Multiple sessions may produce stronger effects.
• The study did not include long-term follow-up, so it’s unclear how long the effects might last.
• Participants were not clinically diagnosed with post-traumatic stress disorder, so results may differ in clinical populations.

Future research could explore:

• Whether multiple training sessions lead to greater and longer-lasting benefits
• If the training is helpful for people with clinically diagnosed post-traumatic stress disorder
• How interpretation training might be combined with other treatments for anxiety and stress

Practical implications

While more research is still needed, this study suggests some potentially helpful strategies for managing pandemic-related stress and anxiety:

• Be aware of how you tend to interpret ambiguous health-related situations. Do you often jump to the worst-case scenario?

• Try to generate multiple possible interpretations for unclear situations, including neutral or positive ones.

• Remind yourself that your first interpretation may not always be accurate, especially if you’re feeling anxious.

• Consider seeking out resources or apps that provide training in more balanced thinking patterns.

• If you’re struggling with significant anxiety or stress related to the pandemic, don’t hesitate to reach out to a mental health professional for support.

Conclusions

• Brief computerized training can help reduce negative interpretations and fear related to COVID-19
• Shifting interpretation patterns may indirectly help improve post-traumatic stress symptoms
• How we interpret ambiguous situations is an important factor in anxiety and stress that can potentially be modified

While the COVID-19 pandemic has been a challenging experience for many, this research provides hope that relatively simple cognitive training approaches may be able to help people manage its mental health impacts. By becoming more aware of our thinking patterns and working to interpret situations in more balanced ways, we may be able to reduce unnecessary fear and stress in uncertain times.