Modeling anxiety and fear of COVID-19 using machine learning in a sample of Chinese adults: associations with psychopathology, sociodemographic, and exposure variables

Anxiety Stress Coping. 2021 Mar;34(2):130-144. doi: 10.1080/10615806.2021.1878158. Epub 2021 Jan 26.


Objectives: Research during prior virus outbreaks has examined vulnerability factors associated with increased anxiety and fear.

Design: We explored numerous psychopathology, sociodemographic, and virus exposure-related variables associated with anxiety and perceived threat of death regarding COVID-19.

Method: We recruited 908 adults from Eastern China for a cross-sectional web survey, from 24 February to 15 March 2020, when social distancing was heavily enforced in China. We used several machine learning algorithms to train our statistical model of predictor variables in modeling COVID-19-related anxiety, and perceived threat of death, separately. We trained the model using many simulated replications on a random subset of participants, and subsequently externally tested on the remaining subset of participants.

Results: Shrinkage machine learning algorithms performed best, indicating that stress and rumination were the most important variables in modeling COVID-19-related anxiety severity. Health anxiety was the most potent predictor of perceived threat of death from COVID-19.

Conclusions: Results are discussed in the context of research on anxiety and fear from prior virus outbreaks, and from theory on outbreak-related emotional vulnerability. Implications regarding COVID-19-related anxiety are also discussed.

Keywords: COVID-19; Coronavirus; anxiety; machine learning; viruses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety Disorders / psychology*
  • COVID-19 / psychology*
  • China
  • Cross-Sectional Studies
  • Fear / psychology*
  • Female
  • Humans
  • Machine Learning*
  • Male
  • Mass Media / statistics & numerical data*
  • Models, Statistical
  • SARS-CoV-2
  • Socioeconomic Factors*
  • Surveys and Questionnaires