{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T13:07:32Z","timestamp":1786712852762,"version":"build-2736575974"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.<\/jats:p>","DOI":"10.3389\/fpsyg.2021.640955","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T07:55:33Z","timestamp":1618386933000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution"],"prefix":"10.3389","volume":"12","author":[{"given":"David","family":"Dias Neto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Nunes da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda Sofia","family":"Roberto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Lubenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios","family":"Constantinou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana","family":"Nicolaou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demetris","family":"Lamnisos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savvas","family":"Papacostas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"H\u00f6fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovambattista","family":"Presti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Squatrito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilis S.","family":"Vasiliou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"McHugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Louis","family":"Monest\u00e8s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Baban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Alvarez-Galvez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Paez-Blarrina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Montesinos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonsoles","family":"Valdivia-Salas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorottya","family":"Ori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimo","family":"Lappalainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartosz","family":"Kleszcz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Gloster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Karekla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelos P.","family":"Kassianos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1080\/08870446.2016.1153640","article-title":"Can illness beliefs, from the common-sense model, prospectively predict adherence to self-management behaviours? A systematic review and meta-analysis","volume":"31","author":"Aujla","year":"2016","journal-title":"Psychol. Heal"},{"key":"B2","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s10880-012-9337-9","article-title":"A systematic review of the literature exploring illness perceptions in mental health utilising the self-regulation model","volume":"20","author":"Baines","year":"2013","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4","volume":"67","author":"Bates","year":"2015","journal-title":"J. Stat. Softw"},{"key":"B4","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1080\/14768320600976240","article-title":"Ethnic differences in illness perceptions, self-efficacy and diabetes self-care","volume":"22","author":"Bean","year":"2007","journal-title":"Psychol. Heal"},{"key":"B5","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/j.jpsychores.2005.10.020","article-title":"The brief illness perception questionnaire","volume":"60","author":"Broadbent","year":"2006","journal-title":"J. Psychosom. Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1080\/08870446.2015.1070851","article-title":"A systematic review and meta-analysis of the Brief Illness Perception Questionnaire","volume":"30","author":"Broadbent","year":"2015","journal-title":"Psychol. Heal"},{"key":"B7","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1177\/0049124104268644","article-title":"Multimodel inference: understanding AIC and BIC in model selection","volume":"33","author":"Burnham","year":"2004","journal-title":"Sociol Methods Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1037\/0033-2909.112.1.155","article-title":"A power primer","volume":"112","author":"Cohen","year":"1992","journal-title":"Psychol. Bull"},{"key":"B9","first-page":"31","volume-title":"Perceived Stress in a Probability Sample of the United States. The Social Psychology of Health. The Claremont Symposium on Applied Social Psychology.","author":"Cohen","year":"1988"},{"key":"B10","doi-asserted-by":"publisher","first-page":"559951","DOI":"10.3389\/fpsyg.2020.559951","article-title":"Adolescents in quarantine during COVID-19 pandemic in Italy: perceived health risk, beliefs, psychological experiences and expectations for the future","volume":"11","author":"Commodari","year":"2020","journal-title":"Front. Psychol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1080\/15248371003699969","article-title":"Twelve frequently asked questions about growth curve modeling","volume":"11","author":"Curran","year":"2010","journal-title":"J. Cog. Dev"},{"key":"B12","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1590\/S0102-79722012000400006","article-title":"Longitudinal assessment of illness perceptions in young adults with cancer","volume":"25","author":"De Castro","year":"2012","journal-title":"Psicol. Reflex e Crit"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2458-9-213","article-title":"The effects of gender and age on health related behaviors","volume":"9","author":"Deeks","year":"2009","journal-title":"BMC Public Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.jpsychores.2015.10.006","article-title":"Illness perceptions and coping in physical health conditions: a meta-analysis","volume":"79","author":"Dempster","year":"2015","journal-title":"J. Psychosom. Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/BF02090456","article-title":"The common-sense model of illness representation: theoretical and practical considerations","volume":"5","author":"Diefenbach","year":"1996","journal-title":"J. Soc. Distress Homeless"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijerph17165728","article-title":"Risk perception and depression in public health crises: Evidence from the covid-19 crisis in China","volume":"17","author":"Ding","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B17","unstructured":"COVID-19 pandemic2020"},{"key":"B18","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1080\/14768320600774462","article-title":"Lay perceptions of serious illnesses: An adapted version of the Revised Illness Perception Questionnaire (IPQ-R) for healthy people","volume":"22","author":"Figueiras","year":"2007","journal-title":"Psychol. Health"},{"key":"B19","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1080\/13548506.2016.1153677","article-title":"Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients","volume":"22","author":"Figueiras","year":"2017","journal-title":"Psychol. Health Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1027\/1016-9040\/a000348","article-title":"Challenges in \u201ctailoring\u201d adjustment","volume":"24","author":"Figueiras","year":"2019","journal-title":"Eur. Psychol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1093\/jpepsy\/jsu043","article-title":"Longitudinal trajectories of illness perceptions among adolescents with type 1 diabetes","volume":"39","author":"Fortenberry","year":"2014","journal-title":"J. Pediatr. Psychol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.jpsychores.2013.05.003","article-title":"Illness perceptions, mood and quality of life: a systematic review of coronary heart disease patients","volume":"75","author":"Foxwell","year":"2013","journal-title":"J. Psychosom. Res"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e0241101","DOI":"10.1371\/journal.pone.0241101","article-title":"Risk perception and precautionary health behavior toward COVID-19 among health professionals working in selected public university hospitals in Ethiopia","volume":"15","author":"Girma","year":"2020","journal-title":"PLoS ONE"},{"key":"B24","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s12609-015-0187-y","article-title":"Illness perceptions in women with breast cancer - a systematic literature review","volume":"7","author":"Kaptein","year":"2015","journal-title":"Curr. Breast Cancer Rep"},{"key":"B25","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1080\/07347332.2012.741092","article-title":"Illness perceptions and quality of life in Japanese and Dutch women with breast cancer","volume":"31","author":"Kaptein","year":"2013","journal-title":"J. Psychosoc. Oncol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1002\/smi.1252","article-title":"Life context and the experience of chronic illness: Is the stress of life associated with illness perceptions and coping?","volume":"25","author":"Karademas","year":"2009","journal-title":"Stress Heal"},{"key":"B27","first-page":"42","article-title":"The common-sense model of self-regulation of health and illness","volume-title":"The Self-Regulation of Health & Illness Behaviour","author":"Leventhal","year":"2003"},{"key":"B28","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/s10865-016-9782-2","article-title":"The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management","volume":"39","author":"Leventhal","year":"2016","journal-title":"J. Behav. Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40536-018-0061-2","article-title":"Effect size measures for multilevel models: definition, interpretation, and TIMSS example","volume":"6","author":"Lorah","year":"2018","journal-title":"Large-scale Assess. Educ"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.5281\/zenodo.1284472","author":"L\u00fcdecke","year":"2020","journal-title":"Sjstats: Statistical Functions for Regression Models"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12889-017-4324-6","article-title":"Health beliefs, illness perceptions and determinants of breast screening uptake in Malta: a cross-sectional survey","volume":"17","author":"Marmar\u00e0","year":"2017","journal-title":"BMC Public Health"},{"key":"B32","volume-title":"R: A language and environment for statistical computing [Computer software]","year":"2019"},{"key":"B33","volume-title":"Hierarchical Linear Models: Applications and Data Analysis Methods","author":"Raudenbush","year":"2020"},{"key":"B34","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1080\/08870440412331279764","article-title":"Illness perceptions and distress in women at increased risk of breast cancer","volume":"19","author":"Rees","year":"2004","journal-title":"Psychol Heal"},{"key":"B35","unstructured":"RevelleW.\n          Psych: Procedures for personality and psychological research. Evanston, Il: Northwestern University2018"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12875-020-01148-3","article-title":"Identifying high-need patients with multimorbidity from their illness perceptions and personal resources to manage their health and care: a longitudinal study","volume":"21","author":"Rijken","year":"2020","journal-title":"BMC Fam. Pract"},{"key":"B37","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.ssmph.2016.03.005","article-title":"Intraclass correlation values for adolescent health outcomes in secondary schools in 21 European countries","volume":"2","author":"Shackleton","year":"2016","journal-title":"SSM \u2013 Popul. Heal"},{"key":"B38","unstructured":"SteeleF.\n          Module 5: Introduction to Multilevel Modelling Concepts. LEMMA VLE, University of Bristol, Centre for Multilevel Modelling2010"},{"key":"B39","doi-asserted-by":"publisher","first-page":"831","DOI":"10.5114\/aoms.2013.38678","article-title":"A longitudinal study on illness perceptions in hemodialysis patients: changes over time","volume":"9","author":"Tasmoc","year":"2013","journal-title":"Arch. Med Sci"},{"key":"B40","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1080\/08870449608400270","article-title":"The illness perception questionnaire: a new method for assessing the cognitive representation of illness","volume":"11","author":"Weinman","year":"1996","journal-title":"Psychol. Heal"},{"key":"B41","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1080\/08870446.2016.1158259","article-title":"The relation of illness perceptions to stress, depression, and fatigue in patients with chronic lymphocytic leukaemia","volume":"31","author":"Westbrook","year":"2016","journal-title":"Psychol. Heal"},{"key":"B42","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1038\/s41586-020-2521-4","article-title":"OpenSAFELY: factors associated with COVID-19 death in 17 million patients","volume":"584","author":"Williamson","year":"2020","journal-title":"Nature"},{"key":"B43","doi-asserted-by":"publisher","first-page":"2387","DOI":"10.2147\/PPA.S118413","article-title":"Illness perceptions and stress: Mediators between disease severity and psychological well-being and quality of life among patients with Crohn's disease","volume":"10","author":"Zhang","year":"2016","journal-title":"Patient Prefer Adherence"}],"updated-by":[{"DOI":"10.3389\/fpsyg.2023.1227506","type":"corrigendum","label":"Corrigendum","source":"publisher","updated":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000}}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2021.640955\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T14:49:09Z","timestamp":1686667749000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2021.640955\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,14]]},"references-count":43,"alternative-id":["10.3389\/fpsyg.2021.640955"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2021.640955","relation":{"corrigendum":[{"id-type":"doi","id":"10.3389\/fpsyg.2023.1227506","asserted-by":"object"}]},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,14]]},"article-number":"640955"}}