Development and initial validation of the COVID Stress Scales

TLDR

During pandemics, people often experience a range of stress and anxiety responses, including fears of infection, contamination, xenophobia, economic consequences, compulsive checking, and traumatic stress symptoms. The study aimed to develop the 36‑item COVID Stress Scales to better understand and assess COVID‑19–related distress. The scales were intentionally designed for easy adaptation to future pandemics and were initially validated in large population‑representative samples from Canada and the United States. A stable five‑factor solution was found, with strong reliability and validity, intercorrelated scales indicating a COVID Stress Syndrome and suggesting the scales are useful for understanding distress and identifying those needing mental health services.

Abstract

Research and clinical observations suggest that during times of pandemic many people exhibit stress- or anxiety-related responses that include fear of becoming infected, fear of coming into contact with possibly contaminated objects or surfaces, fear of foreigners who might be carrying infection (i.e., disease-related xenophobia), fear of the socio-economic consequences of the pandemic, compulsive checking and reassurance-seeking regarding possible pandemic-related threats, and traumatic stress symptoms about the pandemic (e.g., nightmares, intrusive thoughts). We developed the 36-item COVID Stress Scales (CSS) to measure these features, as they pertain to COVID-19. The CSS were developed to better understand and assess COVID-19-related distress. The scales were intentionally designed so they could be readily adapted for future pandemics. The CSS were developed and initially validated in population-representative samples from Canada (N = 3479) and the United States (N = 3375). A stable 5-factor solution was identified, corresponding to scales assessing COVID-related stress and anxiety symptoms: (1) Danger and contamination fears, (2) fears about economic consequences, (3) xenophobia, (4) compulsive checking and reassurance seeking, and (5) traumatic stress symptoms about COVID-19. The scales performed well on various indices of reliability and validity. The scales were intercorrelated, providing evidence of a COVID Stress Syndrome. The scales offer promise as tools for better understanding the distress associated with COVID-19 and for identifying people in need of mental health services.