Health anxiety as a mediator between resilience factors, and physical health and well-being over time during the COVID-19 pandemic

Gratitude and hope are established predictors of mental and physical health and well-being. Scarce literature investigates relevant mediators of these relationships in a single model and during the COVID-19 pandemic. The current study investigated the mediating role of health anxiety (measured three months after baseline) in the relationship of gratitude and hope at baseline with alcohol use, fatigue, pain, and well-being six months later. The sample was composed of 788 mostly male (58.1%), White (70.3%), middle-aged adults (<i>M</i>_<i>age</i> = 38.0, <i>SD</i> = 11.8). Structural equation models (SEM) were used to analyze the data. Gratitude at baseline's indirect effect of health anxiety three months later was both small and negative for alcohol use (<i>ab</i> = ‒.06, 95% CI [-.10, -.03]) and pain (<i>ab</i> = ‒3.01, 95% CI [-4.34, -1.68]). Health anxiety appears to be a robust mediator of the relationship between gratitude and mental and physical health outcomes. Hope was a stronger and more direct predictor of well-being compared to gratitude. The findings of this study may provide evidence for examining health anxiety levels as a risk factor when trying to promote resilience factors in individuals who report health issues, particularly during times of environmental contagion.