The worldwide development of novel coronavirus disease 2019 (COVID-19) has resulted
in a number of challenges for healthcare providers (Lin, 2020). One such challenge
is to understand the psychological responses toward the fear of COVID-19. To overcome
this particular challenge, the present authors co-developed the Fear of COVID-19 Scale
(FCV-19S), an instrument with promising psychometric properties that healthcare providers
can use to quickly understand the fear of individuals during COVID-19 outbreak (Ahorsu
et al., 2020). More recently, Bitan et al. (2020) translated the FCV-19S into Hebrew
for Israeli population and found that the Hebrew FCV-19S had good psychometric properties.
However, unlike the single factor found in other published FCV-19S validation studies
(e.g., Ahorsu et al., 2020; Sakib et al., 2020; Satici et al., 2020; Soraci et al,
2020), Bitan et al. (2020) proposed a two-factor model for the Hebrew FCV-19S. However,
the present authors would like to comment on the statistical analysis that Bitan et
al. (2020) used to identify the two-factor structure.
More specifically, Bitan et al. (2020) described that they applied an exploratory
factor analysis to examine the factor structure of the Hebrew FCV-19S and found a
single factor that explained substantial amount of the variance (53.71%). They then
forced the exploratory factor analysis to have a two-factor solution and reanalyzed
the exploratory factor analysis. They were satisfied with the two-factor solution
and concluded that “the two factors corresponded to two distinct factors (p.8)”. The
first factor was described as an emotional fear reaction and the second factor was
described as symptomatic expressions of fear. Although the present authors welcome
that Bitan et al. (2020) tried to ascertain another solution for the FCV-19S factor
structure, their practice is inappropriate in a number of aspects.
First, with other studies having shown a clear single-factor structure for the FCV-19S
(Ahorsu et al., 2020; Reznick et al., 2020; Sakib et al., 2020; Satici et al., 2020;
Soraci et al., 2020), Bitan et al. (2020) should have used confirmatory factor analysis
rather than exploratory factor analysis to examine the factor structure of the Hebrew
FCV-19S. Second, Bitan et al. (2020) did not provide any justification as to why they
forced the exploratory factor analysis to produce a two-factor solution. They first
identified a single factor and the present authors and readers may be left wondering
why Bitan et al. (2020) did not keep the single-factor solution. Bitan et al. (2020)
did not outline any theoretical assumptions or framework as to why they performed
a two-factor solution. However, even if they had a theoretical assumption for two-factor
solution, confirmatory factor analysis rather than exploratory factor analysis should
have been used (Watkins, 1989). Additionally, they should have used an oblique method
rather than an orthogonal method (i.e., Varimax in the SPSS) in the factor rotation.
Third, the present authors suspect that the Bitan et al. (2020) actually conducted
a principal component analysis (PCA) rather than a real exploratory factor analysis
in their study. The reason for suspicion is because IBM SPSS Statistics for Windows
software sets PCA as a default extraction method under the category of factor analysis.
Therefore, Bitan et al. (2020) probably did not notice this, and they may have wrongly
used PCA to examine the factor structure of the Hebrew FCV-19S. Exploratory factor
analysis and PCA, from the view of psychometrics, have different goals. Principal
component analysis is a technique for researchers to reduce the dimensionality of
their data and provide parsimonious data for further statistical analysis. Exploratory
factor analysis is a technique for researchers to identify and assess latent constructs
(i.e., a concept that cannot be measured directly, such as fear assessed in the FCV-19S).
Although the exploratory factor analysis that Bitan et al. (2020) carried out on testing
factor structure of the Hebrew FCV-19S was misplaced, the other psychometric testing
performed by Bitan et al. (2020) was appropriate. More specifically, Bitan et al.
(2020) reported the very good internal consistency (α=0.86) for the Hebrew FCV-19S.
They also found that the Hebrew FCV-19S had satisfactory concurrent validity as evidenced
by the significant association with relevant demographics (e.g., females had higher
fear than males). The Hebrew FCV-19S also demonstrated good convergent and discriminant
validity as evidenced by the significant correlations with anxiety (r=0.43), followed
by stress (r=0.33) and depression (r=0.24).
To conclude, the present authors believe that the FCV-19S is a psychometrically robust
instrument that can help healthcare providers to quickly understand how an individual
fears COVID-19 during the pandemic. With only seven items, the FCV-19S has the great
advantage of brevity and will be especially useful in a busy clinical setting because
it is so quick to administer. Another advantage of the FCV-19S is the many different
language versions that have already been published in such a short time since the
FCV-19S was initially developed which will allow cross-cultural comparisons to be
made. For example, the first paper published FCV-19S provides both Persian and English
versions (Ahorsu et al., 2020). Other language versions such as Bangla (Sakib et al.,
2020), Turkish (Satici et al., 2020), Arabic (Alyami et al., 2020), Italian (Soraci
et al., 2020), Russian (Reznick et al., 2020), and Hebrew (Bitan et al., 2020) have
been already translated and tested for psychometric properties. Moreover, research
teams in over 20 different countries have approached the present authors and requested
to validate the FCV-19S. The present authors are also aware of several studies that
found the excellent psychometric properties of the FCV-19S are currently under review.
Therefore, the use of FCV-19S is highly recommended during the COVID-19 pandemic.
Uncited References:
Reznik et al., 2020, Satici, Gocet-Tekin, Deniz and Satici, 2020, Tabachnick and Fidell,
2007