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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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Cited by
Sorted by citations
Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020
Mertens, G., Gerritsen, L., Duijndam, S., Salemink, E., & Engelhard, I. M. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102258 · Cited by 1,264
“This is in part already achieved by the CSS (Taylor et al., 2020), which assesses anxiety and stress symptoms relating to the coronavirus pandemic across five different factors (see the Introduction).”
InfluentialBakioğlu, F., Korkmaz, O., & Ercan, H. (2021) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00331-y · Cited by 812
“On the other hand, the situation in question may be thought to lead to a cycle; decreased positivity may increase fear of COVID-19; increased fear may increase levels of intolerance of uncertainty, depression, anxiety, and stress (Harper et al. 2020; Satici et al. 2020a; Taylor et al. 2020).”
BackgroundCOVID stress syndrome: Concept, structure, and correlates
Taylor, S., Landry, C. A., Paluszek, M. M., Fergus, T. A., McKay, D., & Asmundson, G. J. G. (2020) · Depression and Anxiety · doi:10.1002/da.23071 · Cited by 673
“In a study of a population‐representative sample of 6,854 adults from the United States and Canada, Taylor et al. (2020) reported data on reliability (i.e., internal consistency), validity (i.e., convergent, discriminant), and factor‐analytic stability (i.e., using two independent subsamples of the full sample) of the…”
BackgroundMethodResultInfluentialSelf-citationJungmann, S. M., & Witthöft, M. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102239 · Cited by 635
“For example, it was assumed that people with pre-existing health anxiety or hypochondriasis would be particularly vulnerable to anxiety and adverse behaviors during pandemics such as COVID-19, but there is little empirical research on this (Asmundson & Taylor, 2020).”
InfluentialAsmundson, G. J. G., Paluszek, M. M., Landry, C. A., Rachor, G. S., McKay, D., & Taylor, S. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102271 · Cited by 451
Self-citation
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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