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Development and initial validation of the COVID Stress Scales
Open accessAbstract
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.
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“Since the onset of the pandemic, an important number of studies have been interested in its psychological impacts and showed increases in rates of mental health disturbances.”
From At the Peak of the Second Wave of COVID-19, Did Millennials Show Different Emotional Responses from Older Adults? (2022) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Moreover, faced with the increase in the prevalence of psychological distress [3,4], it seems useful to invest in the development of prevention tools.”
From At the Peak of the Second Wave of COVID-19, Did Millennials Show Different Emotional Responses from Older Adults? (2022) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“While the CSS is a novel measure, initial data suggest that the CSS is reliable (Cronbach’s α for individual subscales ranged from 0.86–0.95) and valid [97].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [97]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“While an initial five-factor structure was proposed, subsequent studies have proposed a six-factor solution [97,98].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [97]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“As per Taylor et al. (2020), anxiety mainly related to worries about catching the virus and socio‐economic concerns.”
From Living through lockdown: A qualitative exploration of individuals' experiences in the UK. (2022) · cites this paper as Taylor et al. (2020)
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“The CSS is a 36-item measure of COVID distress.”
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BackgroundInfluentialDevelopment and validation of COVID-19 Impact Scale
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COVID-19 Impact Battery: Development and Validation
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BackgroundThe Association Between Sociability and COVID-19 Pandemic Stress
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Vulić‐Prtorić, A., Selak, M. B., & Sturnela, P. (2020) · doi:10.31234/osf.io/vtfxg · Cited by 15
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“The CSS (Taylor et al., 2020), a 36-item self-report measure, was used to measure COVID-related stress.”
COVID-19 a zaburzenia obsesyjno-kompulsyjne: czy pandemia zmienia obraz OCD?
Hryniszak, W., Sanna, K., & Szramka-Pawlak, B. (2022) · Wydawnictwo Liberi Libri eBooks · doi:10.47943/lib.9788363487607.rozdzial09 · Cited by 12
Mądrzycka-Borska, Z., Małek, K., Malinowska, E., Płatos, M., Wojnarowska, A., de Raad, W. E., & Osińska, A. (2022) · Wydawnictwo Liberi Libri eBooks · doi:10.47943/lib.9788363487607.rozdzial12 · Cited by 12
Maciantowicz, O., & Choiński, M. (2022) · Wydawnictwo Liberi Libri eBooks · doi:10.47943/lib.9788363487607.rozdzial06 · Cited by 12
Pisula, E., & Bargiel-Matusiewicz, K. M. (2022) · Wydawnictwo Liberi Libri eBooks · doi:10.47943/lib.9788363487607.rozdzial08 · Cited by 12
Powrót do rodzinnych domów w czasie pandemii COVID-19 w doświadczeniu polskich studentów
Wagner, A., & Cierpka, A. (2022) · Wydawnictwo Liberi Libri eBooks · doi:10.47943/lib.9788363487607.rozdzial11 · Cited by 12
Cyniak‐Cieciura, M., & Zawadzki, B. (2022) · Wydawnictwo Liberi Libri eBooks · doi:10.47943/lib.9788363487607.rozdzial04 · Cited by 12
Adamczyk, D., Jaworska, D., Affeltowicz, D., & Maison, D. A. (2022) · Wydawnictwo Liberi Libri eBooks · doi:10.47943/lib.9788363487607.rozdzial01 · Cited by 12
Cannizzaro, E., Cirrincione, L., Malta, G., Fruscione, S., Mucci, N., Martines, F., & Plescia, F. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20054613 · Cited by 14
“All this, to‐ gether with the continuous evolution of rules to be followed, has led to the genesis of a condition of general consistent malaise that has facilitated the beginning of various forms of stress and related disorders [16–22], including the one now identified as ‘COVID‐19 stress’ [23].”
BackgroundMental health during the COVID-19 pandemic: Stress and strain profiles in the German population
Nin, V., Willmund, G., Jungmann, S. M., Asmundson, G. J. G., & Piefke, M. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.990407 · Cited by 14
“(19, 25) and standard psychological questionnaires to identify the interplay between stress, personality, and behavior in the German population.”
BackgroundInfluentialShek, D. T. L., Chai, W., & Zhou, K. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20115952 · Cited by 12
“COVID Stress Scale.”
MethodA randomized clinical trial of a gamified app for the treatment of perfectionism
Amitai Abramovitch, A., Uwadiale, A. Y., & Robinson, A. D. (2023) · British Journal of Clinical Psychology · doi:10.1111/bjc.12444 · Cited by 15
“However, the utilization of a psychometrically valid COVID Stress Scale (Taylor et al., 2020) to assess the relative impact of pandemic-related stress demonstrated that it did not affect the result of this study in any meaningful way.”
Marais, F., & Niemandt, N. (2023) · doi:10.4102/aosis.2023.bk398.09 · Cited by 13
Rattka, M., Stuhler, L., Winsauer, C., Dreyhaupt, J., Thiessen, K. D., Baumhardt, M., Markovic, S., Rottbauer, W., & Imhof, A. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.638954 · Cited by 13
“Patients in the lockdown period had a median FCV-19S Score of 12 (9, 17) and CSS score of 31 (13, 50), compared to a FCV-19S score of 14 (9, 17) (p = 0.”
BackgroundMethodInfluentialConsumers’ Channel Switching Behaviour from Off-line to On-line: The Role of the Fear of Covid-19
Martinelli, E. M., Canio, F. D., & Nardin, G. (2021) · Springer proceedings in business and economics · doi:10.1007/978-3-030-76935-2_5 · Cited by 13
Catellani, P., Carfora, V., & Piastra, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.696770 · Cited by 13
“…lockdown due to the COVID-19 pandemic, this role of physical activity has become even more crucial and an increase in physical activity at home has become essential to keep in exercise despite the constraints of external mobility (Taylor et al., 2020; University of Virginia Health System, 2020).”
BackgroundNaveed, S., Lodhi, R. N., Mumtaz, M. U., & Mustafa, F. (2021) · Management Research Review · doi:10.1108/mrr-05-2021-0348 · Cited by 13
Saez-Flores, E., Comer, J. S., Evans, A. D., Karlovich, A. R., Malloy, L. C., Peris, T. S., Pincus, D. B., Salem, H., & Ehrenreich, J. T. (2022) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2022.102586 · Cited by 13
“…behaviors in this measure may provide helpful information for the development of public health strategies to both promote mental health and to increase adherence to mitigation strategies and increase uptake of vaccinations (Asmundson & Taylor, 2020b; Harper et al., 2020; Taylor et al., 2020).”
Businelle, M. S., Garey, L., Gallagher, M. W., Hébert, E. T., Vujanovic, A. A., Alexander, A. C., Kezbers, K. M., Matoska, C. T., Robison, J. H., Montgomery, A., et al. (2022) · JMIR Research Protocols · doi:10.2196/38905 · Cited by 13
“The baseline assessment (completed via Insight) includes demographic questions (eg, employment status, income, and insurance), subjective social status [81], Black racial identity [82], acculturation [83], discrimination [84,85], COVID-19 [86], coping [87], attendance at religious services [88], self-rated health [89]…”
Jarvis, M. A., Martin, P., Williams, M. H., Walters, F., Baloyi, O. B., Hoffman, J., & Chipps, J. A. (2021) · Health SA Gesondheid · doi:10.4102/hsag.v26i0.1641 · Cited by 13
“While not yet qualified, nursing students have also been rendering care to patients infected with SARS-CoV-2 and faced with rapid changes in the clinical settings (Taylor et al. 2020).”
BackgroundWagener, A., Stassart, C., & Etienne, A.-M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19105908 · Cited by 12
“In line with the previous, Blix et al. (2021) [3] and Taylor et al. (2020) [4] evidenced that more than 25% of the general population experienced Int.”
BackgroundResultKassim, M. A. M., Pang, N. T. P., Kamu, A., Arslan, G., Mohamed, N. H., Zainudin, S. P., Ayu, F., & Ho, C. M. (2023) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-021-00622-y · Cited by 12
Taylor, S., Paluszek, M. M., Landry, C. A., Rachor, G. S., & Asmundson, G. J. G. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.110779 · Cited by 13
Hope and bridgebuilding leadership in a post-COVID-19 context: Insights from 1 Peter
Leuven, E. T. F., & Kok, J. (2023) · doi:10.4102/aosis.2023.bk398.05 · Cited by 12
Leadership and the communication of ethics: Rawls and the COVID-19 pandemic
Kotzé, M. (2023) · doi:10.4102/aosis.2023.bk398.10 · Cited by 12
Denton, R. A. (2023) · doi:10.4102/aosis.2023.bk398.06 · Cited by 12
Healing nostalgia among congregational leaders in post-COVID-19 Africa
Brunsdon, A. R. (2023) · doi:10.4102/aosis.2023.bk398.07 · Cited by 12
Bloated self-interest or humble Christian leadership: Reflections from Matthew 23:3–12
Viljoen, F. P. (2023) · doi:10.4102/aosis.2023.bk398.02 · Cited by 12
Paul as leader in the New Testament: How to avoid the ‘power paradox’
Cornelius, E. M. (2023) · doi:10.4102/aosis.2023.bk398.03 · Cited by 12
Christ-centred leadership in the Pauline Letters
Toit, P. L. G. D. (2023) · doi:10.4102/aosis.2023.bk398.04 · Cited by 12
Zvolensky, M. J., Bakhshaie, J., Redmond, B. Y., Smit, T., Nikčević, A. V., Spada, M. M., & Distaso, W. (2024) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2988 · Cited by 11
D’Silva, A., Hua, N., Modayil, M. V., Seidel, J. E., & Marshall, D. A. (2024) · Digestive Diseases and Sciences · doi:10.1007/s10620-024-08672-7 · Cited by 14
“…i ca t e h i gh e r l e v e l s o f C OV I D - 19 -r e l a t e d s t r e ss a nd a nx i e t y ; VA S v i s u a l a n a l og s ca l e , s c o r e r a ng e s b e t w ee n 0 a nd 100 , u s e o f t h i s m ea s u r e a nd i n t e r p r e t a ti on o f s c o r e s d e p e nd e n t on s t udy [23, 52].”
Metadata
- Authors
- Taylor, S., Landry, C. A., Paluszek, M. M., Fergus, T. A., McKay, D., & Asmundson, G. J. G.
- Affiliations
- University of British Columbia (CA)
- University of Regina (CA)
- Baylor University (US)
- Fordham University (US)
- Corresponding author
- Asmundson, Gordon J.G.
- ORCID
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 72
- Pages
- 102232
- ISSN
- 0887-6185 (ISSN-L)
- PMC
- PMC7198206
- OpenAlex
- W3020973746
- Cited by
- 1,169
- References
- 34
- Citations by year
- 2026: 34 · 2025: 67 · 2024: 111 · 2023: 219 · 2022: 270 · 2021: 344 · 2020: 123
- FWCI
- 95.11
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Anxiety Disorders (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Fordham Research Commons (Fordham University) (submittedVersion, cc-by-nc-nd)
- Funders
- Canadian Institutes of Health Research
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- COVID Stress Scale, COVID-19 pandemic, pandemic stress, anxiety, fear of contamination, economic impact of pandemic, compulsive checking, reassurance seeking, traumatic stress symptoms, scale development, scale validation, mental health screening
- MeSH terms
- COVID-19, Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Canada, Fear, Female, Health Services Needs and Demand, Humans, Male, Mental Health Services, Middle Aged, Pneumonia, Viral, Psychometrics, Stress, Psychological, Reproducibility of Results, Coronavirus Infections, Young Adult, Pandemics
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