*3.2. Logistic Regression Model*

Based on the above descriptive analyses, the independent variables entered in the logistic regression model for predicting perceived threat were gender, having minor children and education. In this case, the total score for the variable on the questionnaire was previously dichotomized by visual grouping and percentiles based on the cases explored.

The cutoff point was set at 31.5, forming two intervals or groups, one medium-low threat with scores equal to or lower, and medium-high threat, with higher scores. Later recording of the variable (once the cutoff points had been found by visual grouping) was done manually.

Table 3 shows the results of the logistic regression analysis: regression coefficients, standard error of the estimate, Wald statistic, degrees of freedom and associated probability, partial correlation coefficient and cross-product.

**Figure 1.** (**a**) Perceived threat by gender. (**b**) Perceived threat by whether there were minor children in their care.

**Table 3.** Results derived from the logistic regression for probability of perceived threat.


Note. (a) Women; (b) With minors in their care.

The odds ratio found for each variable indicates that risk of perceiving strong threat is higher among women with minor children in their care and with low education.

Overall fit of the model (χ<sup>2</sup> = 32.57; df = 3; *p* < 0.001), was confirmed by Hosmer– Lemeshow test (χ<sup>2</sup> = 1.54; df = 5; *p* = 0.908). In addition, the Nagelkerke R2 indicated that 4.2% of the variability in the response variable would be explained by the logistic regression model.

### **4. Discussion**

The novel results of this study found possible psychological problems related to perceived threat from the infectious disease COVID-19.

In the first place, analysis of the threat perceived by the population showed that neither participant age nor marital status influenced perception of threat. However, gender did influence that perception. It was observed that women were particularly more prone to perceive the COVID-19 disease as a threat. This might be attributed to a woman's traditional role in society as planner and caregiver of the family unit [41–43], related to a feeling of moral and affective obligation [40]. Although men have become more involved with childcare since the economic crisis of 2008, or when they are unemployed, it seems that this trend is not maintained when they are employed, devoting less time to caring for children than mothers [40]. This is not the case of women, who care for the family regardless of whether they are otherwise employed.

Another factor found to be positively related to perception of threat was having children in one's care, which could be associated with fear that the children would be infected by the disease or even lost [23,28,49].

A lower level of education was associated with perceived threat from COVID-19, perhaps related to access to sources of information and to understanding based on previous knowledge [47,48,50]. Thus, a higher level of education would be associated with a greater critical capacity of information consumed and processed and the tendency to seek other sources of information to corroborate or refute information acquired [51].

It is worth mentioning that information sources, whether communication media or social networking sites, may generate uncertainty [18,35,36,38] because of the way the news is explained, providing incoherent data which could generate anxiety or fear in an epidemic, or by way of "false experts" who generate biased and erroneous interpretations of data, causing confusion and unease.

A clear example that social networks can generate a high percentage of untrustworthy information if one does not know how to filter it is YouTube, where during the Zika pandemic, it was found that 25% of the videos published on that subject contained unreliable and biased information [38]. This was also true during the Ebola pandemic, where 63.5% of the videos analyzed contained unreliable information [37], and also at other social networking sites [36]. This situation of uncertainty due to access to unclear and even biased information can generate a high level of uncertainty associated in turn with anxiety and depressive symptoms [20].

In addition, it was found that women without an education and with minor children in their care had a stronger feeling of threat from COVID-19. This could explain the association in the sample studied, as they did not have enough knowledge to enable them to filter information received from the communication media or social networks, thus generating anxiety and stress, a normal response of fear and protection for loved ones [19,49] in the traditional caregiver role of women [40,42,43].

Even though the COVID-19 pandemic is considered a public health emergency [12] understood as a binomial made up of physical and mental health [21], it should be highlighted that there are no studies on the analysis of threat perceived by the population and the possible importance of this perception on development of alterations in mental health during crisis situations, such as the COVID-19 pandemic. In this regard, the increase in minor mental disorders in the Spanish population during the economic crisis of 2008 should be emphasized [44]. This situation and experiences in countries where the fight against the disease has been longer, such as China, makes intervention for possible psychological affectation necessary in the population as a public health response [18,22,25].

In spite of the contributions made in this study, it is important to emphasize its limitations. The study sample, due to the nonprobability sampling used, was not representative. In this respect, it should be mentioned that a high percentage of participants were women, and that most of the participants had a higher education, which also affects the representativeness of the results. Moreover, there may have been social desirability biases associated with the self-reports used for data collection. Lastly, (although it might not be considered a real limitation, it should be noted that) due to the sudden occurrence of the pandemic, we were unable to assess the mental health burden in a Spanish population beforehand. Therefore, future research should improve the sampling technique to avoid possible biases.

Finally, while our original research goal was to analyze the perception of the threat associated with the COVID-19 pandemic and control strategies for reducing the spread of the virus, we realize that previous studies have also been done in countries like Italy [52], Greece [53] or Canada [54] that suggest a relationship between the COVID-19 pandemic and control strategies, with the appearance of anxiety and depression disorders in these populations. Therefore as a future line of research, we will delve more deeply into the relationship of anxiety and depression to the Spanish population's mental health during the COVID-19 pandemic.

### **5. Conclusions**

In conclusion, the results of this study show that in a situation such as the one we are now experiencing, there is a feeling of threat from COVID-19, which is worsened by isolation during lockdown. Some groups in the sample had a greater perception of threat, especially women with lower education who have children in their care, and they were more sensitive to minor mental disorders appearing, such as anxiety or stress.

We believe this situation may be similar to past economic crises which have caused a significant increase in burnout [54] and mental disorders in Spain. Therefore, healthcare authorities should evaluate the implementation of policies directed at providing the material and human resources for healthcare professional teams in community care, so these professionals can detect and act quickly against any minor mental health disorder derived from the stress and fear from perceived threat of COVID-19 and daily abnormal situations through community activities and even educational intervention.

**Author Contributions:** M.d.C.P.-F. contributed to the concept, design, and analysis and interpretation of the data. I.H.-P. contributed to collecting the data, to the concept and design, and manuscript preparation. M.d.M.M.J. contributed to the concept, design, and analysis and interpretation of the data. N.F.O. contributed to the technical details and manuscript preparation. J.J.G.L. contributed to critically revising the manuscript for important intellectual content and the final approval of the version to be published. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University of Almería (protocol code UALBIO2020/021 25/06/2020).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study.

**Data Availability Statement:** The data presented in this study are available on request from the corresponding author.

**Acknowledgments:** The present study was undertaken in collaboration with Excma. Diputación Provincial.

**Conflicts of Interest:** The authors declare no conflict of interest.
