A New 7-Item Test of COVID’s Effect on Your Mental Health

Looking at your life now compared to what it was like before the COVID-19 pandemic, it’s clear that nothing is the same. As you take measures to protect your physical health, you may now be paying less attention to your mental health. However, public health experts know that the effects of the pandemic have already had a major impact on people’s feelings of well-being.

If you stop and think about your own inner life in recent months, you probably can remember times when you felt that you were peering out over a void, not sure what lay ahead for your own physical safety.

You may have ventured outside your home, either due to work or just a desire to get out, and wondered what hidden dangers could threaten your health if you got too close to someone else or touched a potentially contagious surface. Occasionally, you have felt especially vulnerable, such as when you hear of friends or family who’ve been struck by the disease.

In a newly-published international investigation, Ben Gurian University of the Neved’s Alexander Reznik and colleagues (2020) report on their efforts to quantify the nature of COVID-19 anxiety. Approached by colleagues at the end of March for help on a project to develop a new test measuring COVID-19 fear, Reznik recruited a research team from Russia and Belarus to coordinate a rapid-response study.

Within 48 hours, the Israeli-led researchers had distributed “The Fear of COVID-19 Scale (FCV-19S)” through their international network based on contacts within the University of the Negev—Regional Alcohol and Drug Abuse Research (RADAR) Center. Translated into Russian, the measure was completed by 850 faculty, students, colleagues, and friends whose data became the basis for evaluating the psychometric qualities of the FCV-19S. The participants ranged in age from 12 to 74 with an average of 35 years old.

As background to the study, the authors noted that “Unlike armed conflicts that tend to have boundaries, infectious disease outbreaks are one of the most distressing forms of disaster to deal with psychologically because of the uncertainty they cause.” People feel vulnerable and at risk, and “staying braced for the unknown takes a toll on physical and mental wellbeing” (p. 2). Knowing how to quantify these psychological impacts can help mental health experts both understand the extent of pandemic fears and potentially intervene.

Using the countries of Russia and Belarus for this study presented an interesting test case, Reznik et al. note, because of the initial dismissiveness of their governments at the outbreak of the pandemic. The fact that so many people responded within a mere two days suggested, they believed, the extent to which COVID-19 fear had potentially taken hold.

Before getting to the findings, try taking this test yourself so you can compare yourself to the study’s respondents. Rate yourself on each item using a 1-7 scale where 1 = strongly disagree and 7 = strongly agree.

1. I am most afraid of COVID-19.
2. It makes me uncomfortable to think about COVID-19.
3. My hands become clammy when I think about COVID-19.
4. I am afraid of losing my life because of COVID-19.
5. When watching news and stories about COVID-19 on social media, I become nervous or anxious.
6. I cannot sleep because I’m worrying about getting COVID-19.
7. My heart races or palpitates when I think about getting COVID-19.

Based on the scores reported for the Russian-Belarus samples, if your rating was about a 2.5 per item, or a total of 17 overall, your level of COVID-19 anxiety is average. The largest number of individuals scored between 12 and 22, which again would place you at about a 2- to 3-rating per item (i.e. agree to somewhat agree). Given that the total range of scores across all participants was 7 to 34, this result suggests that COVID-19 anxiety is indeed a measurable phenomenon.

The items within the scale with the strongest relationship to overall COVID-19 anxiety tapped into the physiological reaction of a racing heart, followed next by fear of losing one’s own life. Women received significantly higher scores than men, and the students in the sample were more fearful than their older counterparts (university graduates). Perhaps surprisingly, people reporting a strong religious identification had higher COVID-19 fears than those who did not.

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There were higher scores among Russians than those of Belarus nationality, but both groups scored lower than a separately-reported sample of Iranian respondents. Data from the Iranian respondents showed the highest average item score on the physiological signs of anxiety, namely a racing heart and palpitations. Unfortunately, the authors didn't report correlations with age.

Recognizing that the FCV-19S requires considerably more statistical testing, the authors nevertheless believe that the scale has potential utility both at individual and at public health levels. From your own point of view, it can be somewhat reassuring to know that it’s normal to experience occasional bouts of a racing heart or fear of death due to this invisible but very real phenomenon. Rather than try to shove these fears to the back of your consciousness, you may be able to tackle them with the ordinary coping methods you use to deal with other stressors in your life.

Given the focus of the authors on harmful substance use, Reznik et al. also suggest that knowing the signs of COVID-19 fear can also help prevent or reduce what can become problem behaviors that develop in response to this fear. Within the sphere of larger efforts to manage population-level COVID-19 fear, the authors also suggest the value of tip sheets about helpful ways of coping to be disseminated among the public. You hear a great deal about social distancing from your public health officials, but you may not hear as much about how to prevent the mental health effects from spreading.

The Reznik et al. study also raises the question of what is an “appropriate” level of COVID-19 fear. On the one hand, if yours is overly low, this may suggest you’re not confronting the reality of the pandemic perhaps quite as much as may be warranted. On the other hand, if your fears become crippling, you may not be able to take the steps necessary to look out for those all-important contributions to your health or your feelings of psychological well-being.

You can also notice what situations trigger your highest and potentially harmful levels of COVID-19 fear. Are you spending too much time reading COVID-19 related social media posts and do those posts contain accurate information? Perhaps you might focus once in a while on uplifting human interest stories, which can reinforce your own sense of resilience.

To sum up, knowing that COVID-19 fear is a measurable phenomenon is the first step toward understanding the mental health effects that you’re experiencing now. Monitor yours and aim to keep it to levels that allow you to function, even if you're not completely fulfilled, on a daily basis.

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