COVID-19, which was declared in January 2020 to be a public health emergency of international concern by WHO  has major impacts all over the world . COVID-19 has been confirmed as a potentially fatal and infectious virus . As the COVID-19 pandemic burgeons, the number of people infected from COVID-19 are sharply increasing . Fear of this overwhelming infectious disease has caused distress that is an unprecedented threat to psychological coping, leading to clinical and sub-clinical disorders, including anxiety and depression [2, 5, 6]. COVID-19 not only directly leads to death but also produces psychological disorders among healthy people who are not suffering from it . It is urgent to probe the factors that cause and relieve psychological disorders, and this effort would be crucial in protecting the public mental health in case of epidemic. This study explores factors from a socio-cultural psychology perspective that can contribute to relief for the psychological disorders triggered by the pandemic. Our research provided valuable practical insight into means of preventing psychological disorders and intervention during epidemics and pandemics in relation to socio-cultural psychology.
Risk perception of COVID-19 and psychological disorders
The emergence of COVID-19 has led to psychological disorders and conditions of anxiety and depression . These reactions may originate in the risk perception of COVID-19. The theory of risk perception divides it into the two psychological dimensions of dread risk and unknown risk . Dread risk perception would coincide with the rapid spread of COVID-19  and its threat to life , while unknown risk perception would be aligned with the first appearance of COVID-19 . Accordingly, faced with COVID-19, people perceive high risk in COVID-19, resulting in the assessment of the presence of COVID-19 as a harmful and life-threatening stress event. The transactional theory of stress and coping indicates that people constantly appraise stimuli within their environments, and when such stimuli are considered stressful (implying threat, harm, or challenge), distress is provoked [11-13]. Put simply, the risk perception of COVID-19 can create psychological disorders, especially for a potential risk of death .
Moderating role of cultural tightness
Tightness–looseness was first proposed by Pelto  as a set of unique cultural patterns that complement other measured cultural dimensions [15, 16]. Tightness-looseness is defined as a shared structure and refers to the extent to which social norms are pervasive, clearly defined, and reliably imposed . Regions that have a culture with higher tightness tend to have historically suffered from famine, warfare, natural disaster, and disease . Such disaster-prone regions have learned to save lives by establishing tight rules and order [18, 19]. That is, social threat creates tight culture. Tight culture has two core characteristics: strong social norms and low tolerance for deviant behavior . Previous studies have shown that strict social norms and situational constraints in culturally tight areas reduce subjective well-being and induce anxiety and depression to some degree [18, 20]. However, it has also been found that the rules consciousness established by situational constraints in culturally tight areas is the background for the development of self-confidence and self-esteem [21, 22]. In this environment, tight culture may benefit mental health. In this study, we speculate that strict social norms in cultural tight may be an effective treatment for psychological disorders in the context of a pandemic.
To fight a pandemic, governments in tight areas tend to formulate more stringent social norms and intervention policies to contain the spread of the disease . This tight programming may effectively inhibit the spread of the COVID-19, alleviating potential psychological disorders experienced as part of the risk perception of COVID-19. Further, tight areas can be expected to have a higher degree of situational constraint [17, 23], and individuals in such areas are naturally attuned to and support responses to situational demands in their tight culture system . Thus, chronic individual psychological processes may be mirrored in the tight culture system . First, people in tight areas have greater self-monitoring, reflecting their adaptability to chronic situational restrictions . Thus, people may be able to quickly adapt to restrictions on going out due to the presence of disease, reducing their anxiety or depression due to isolation. In addition, people in areas with tight cultures have greater prevention self-guidance and better self-regulatory strength , which enables them to adjust negative affect. This leads people in epidemic contexts less likely to suffer psychological disorders. In short, the increased psychological disorders associated with increased risk perception of COVID-19 may be less pronounced among people in tight cultural areas. This study investigates the protective role that tight culture might play in this context.
Mechanisms underlying the effects of tight culture on psychological disorders
In general, individuals with higher perceived risk feel that they have less ability to cope with the virus . Especially in the early stages of the outbreak, people feel insecure due to the sharp increase in cases of infection and in deaths, along with the scarcity of masks and disinfectant supplies, weakening perceived protection efficacy. Perceived protection efficacy is the belief that individuals and groups can protect themselves from COVID-19 . However, not all people with high risk perception develop low perceived protection efficacy during a crisis event, as many social and psychological factors mutually affect perceived protection efficacy. In addition to the psychological factors, cultural factors, especially cultural tightness, may also have played a protective role in perceived protection efficacy.
First, tight areas developed strict and comprehensive intervention measures during the pandemic, which effectively slowed the spread of the virus and reduced the pace of increase of the number of infections and deaths, increasing the stability and controllability of the situation. This can be expected to have improved people’s confidence in fighting the pandemic and led people to believe that the government has the ability to protect them from COVID-19, perhaps mitigating the reduction in perceived protection efficacy owing to the risk perception of COVID-19. On the other side, in tight cultural areas, tolerance of deviation from norms is low, and severe sanctions are imposed on those who violate them [17, 18]. These social norms drive people to abide more strictly by the rules set by the government, including actively isolating themselves at home, maintaining social distance, and taking the initiative to adopt protective measures. This gives them and others a sense of security and makes people feel that they have the ability to protect themselves, as well as lifting perceived protection efficacy. Accordingly, people living in tight cultural areas can continue to experience higher perceived protection efficacy even in the context of greater risk perception due to COVID-19.
Protection–motivation theory proposes that the perceived threat of a health risk depends on psychological factors, including the ability to cope, and people with high perceived protection efficacy generate less psychological disorders . Thus, we speculate that the inhibitory effects of tight culture in the positive prediction of risk perception on psychological disorders can be achieved by promoting perceived protection efficacy.
The present research
Tightness is a unique cultural factor and is a useful supplement to other cultural dimensions, and has received increasing attention from researchers. Studies of the influence of tight culture on psychological disorders in case of the pandemic outbreak have been constrained. To fill this gap, we build and examine a model that links cultural tightness and risk perception in COVID-19 with psychological disorders. This study explores the moderating effects of cultural tightness and its underlying mechanisms on psychological disorders. Following these corollaries, we proposed the following hypotheses. First, greater risk perception of COVID-19 leads to greater psychological disorders. Second, cultural tightness moderates the relationship between risk perception of COVID-19 and psychological disorders, such that the tighter the culture, the less positive the predictive effects of risk perception of COVID-19 on psychological disorders. Last, perceived protection efficacy mediates the moderating effect of cultural tightness on risk perception of COVID-19 and psychological disorders. In particular, cultural tightness can indirectly relieve people’s psychological disorders by weakening the negative predictive effects of risk perception of COVID-19 on perceived protection efficacy.