Abstract
Objective: The whole world has fought the pandemic process and its effects. This problem has affected people psychologically and physically. To slow these effects, the importance of safety measures has been emphasized. This study aimed to evaluate psychological distress levels and compliance with safety measures of people who applied for psychological/psychiatric help during the COVID-19 pandemic and to examine social, cognitive, and emotional factors related to them. In line with this purpose, a social-cognitive model was developed.

Methods: 298 participants who applied to a psychologist/psychiatrist during the pandemic completed self-report measures assessing stress levels, intolerance of uncertainty, risk perception, affect, coping strategies, social trust, media exposure, family members’ and friends’ worries, attitudes toward safety measures, psychological distress, and compliance behaviors. Data were analyzed using descriptive statistics, correlations, regression analyses, and Hayes’ PROCESS macro to test mediation effects. In addition, the proposed model was tested using structural equation modeling with AMOS 24.

Results: Cognitive factors (stress levels and intolerance of uncertainty) and negative affect directly predicted psychological distress. Negative affect also significantly mediated the relationships between social factors (social trust, family/friends' worry, media exposure) and psychological distress. Compliance with safety measures was predicted by risk perception, positive attitudes toward measures, and functional coping as cognitive factors, and social trust and media exposure as social factors.

Conclusion: The results underline the critical role of social, cognitive, and emotional factors in shaping psychological and behavioral outcomes during crises. Mediation analyses also show that social-cognitive factors influence psychological outcomes through negative affect.

Key words: Compliance with safety measures, COVID-19, Pandemic, Psychological distress, Social-cognitive model