Associations of risk perception of COVID-19 with emotion and mental health during the pandemic

•Risk perception of COVID-19 was associated with more negative/less positive emotions.•Risk perception of COVID-19 was inversely associated with subsequent mental health.•The association between risk perception and mental health was mediated by emotions.•Specification curve analysis was used to avoid subjective analytical decisions. Although there are increasing concerns on mental health consequences of the COVID-19 pandemic, no large-scale population-based studies have examined the associations of risk perception of COVID-19 with emotion and subsequent mental health. This study analysed cross-sectional and longitudinal data from the PsyCorona Survey that included 54,845 participants from 112 countries, of which 23,278 participants are representative samples of 24 countries in terms of gender and age. Specification curve analysis (SCA) was used to examine associations of risk perception of COVID-19 with emotion and self-rated mental health. This robust method considers all reasonable model specifications to avoid subjective analytical decisions while accounting for multiple testing. All 162 multilevel linear regressions in the SCA indicated that higher risk perception of COVID-19 was significantly associated with less positive or more negative emotions (median standardised β=-0.171, median SE=0.004, P