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      COVID stress syndrome: Concept, structure, and correlates


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          Research shows that the COVID Stress Scales have a robust multifactorial structure, representing five correlated facets of COVID‐19‐related distress: (a) Fear of the dangerousness of COVID‐19, which includes fear of coming into contact with fomites potentially contaminated with SARSCoV2, (b) worry about socioeconomic costs of COVID‐19 (e.g., worry about personal finances and disruption in the supply chain), (c) xenophobic fears that foreigners are spreading SARSCoV2, (d) traumatic stress symptoms associated with direct or vicarious traumatic exposure to COVID‐19 (nightmares, intrusive thoughts, or images related to COVID‐19), and (e) COVID‐19‐related compulsive checking and reassurance seeking. These factors cohere to form a COVID stress syndrome, which we sought to further delineate in the present study.


          A population‐representative sample of 6,854 American and Canadian adults completed a self‐report survey comprising questions about current mental health and COVID‐19‐related experiences, distress, and coping.


          Network analysis revealed that worry about the dangerousness of COVID‐19 is the central feature of the syndrome. Latent class analysis indicated that the syndrome is quasi‐dimensional, comprising five classes differing in syndrome severity. Sixteen percent of participants were in the most severe class and possibly needing mental health services. Syndrome severity was correlated with preexisting psychopathology and with excessive COVID‐19‐related avoidance, panic buying, and coping difficulties during self‐isolation.


          The findings provide new information about the structure and correlates of COVID stress syndrome. Further research is needed to determine whether the syndrome will abate once the pandemic has passed or whether, for some individuals, it becomes a chronic condition.

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          Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

          Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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            A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

            The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early 2020. The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people’s lives. It has also triggered a wide variety of psychological problems, such as panic disorder, anxiety and depression. This study is the first nationwide large-scale survey of psychological distress in the general population of China during the COVID-19 epidemic.
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              The Fear of COVID-19 Scale: Development and Initial Validation

              Background The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases. Methods The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results After panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α = .82) and test–retest reliability (ICC = .72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459). Conclusion The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals.

                Author and article information

                Depress Anxiety
                Depress Anxiety
                Depression and Anxiety
                John Wiley and Sons Inc. (Hoboken )
                05 July 2020
                [ 1 ] Department of Psychiatry University of British Columbia Vancouver British Columbia Canada
                [ 2 ] Department of Psychology University of Regina Regina Saskatchewan Canada
                [ 3 ] Department of Psychology and Neuroscience Baylor University Waco Texas
                [ 4 ] Department of Psychology Fordham University New York New York
                Author notes
                [*] [* ] Correspondence Steven Taylor, Department of Psychiatry, University of British Columbia, Vancouver, BC V6E 2A1, Canada.

                Email: steven.taylor@ 123456ubc.ca

                © 2020 The Authors. Depression and Anxiety published by Wiley Periodicals LLC

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 2, Tables: 2, Pages: 9, Words: 6185
                Funded by: Canadian Institutes of Health Research and the University of Regina , open-funder-registry 10.13039/501100000024;
                Award ID: 439751
                Research Article
                Research Articles
                Custom metadata
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.5 mode:remove_FC converted:15.07.2020

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry
                anxiety, coronavirus, covid‐19, fear, pandemic, stress, xenophobia


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