Scale to assess Covid-19 fears could help save lives

A scale that assesses the level of fear of Covid-19 among the general population has been developed by an international team of researchers led by Amir Pakpour, Professor of Health Psychology at Qazvin University in Iran and affiliated researcher at the School of Health and Welfare, Jönköping University. The scale is now being used in research in over 30 countries worldwide and hopes to complement clinical efforts by identifying the need for education about the virus and support for those affected by the pandemic.

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Amir Pakpour lives in Qazvin, Iran and has been affiliated to the School of Health and Welfare at Jönköping University since 2016. In the beginning of February 2020, he gathered an online group of international psychology researchers to work intensively on developing a scale that indicates the level of fear individuals have towards the Covid-19 virus.

“A young relative of mine in Iran passed away from not seeking medical treatment in time from an illness unrelated to Covid-19, due to fear of going to the hospital during the pandemic. So, I felt I had to do something. There have also been several stories of people in Iran dying due to the spread of fake news. One horrible story that was reported from Iran was that people had passed away after ingesting industrial alcohol. This was because of fake rumours that drinking alcohol would give protection from the virus. Fear combined with misinformation has proven to be deadly,” he says.

Scale can help manage widespread fear

The emergence of Covid-19 has led to fear, worries and anxiety among individuals worldwide. The new scale, called FCV-19S, has been developed as a complement to the clinical efforts to treat Covid-19 cases and to help prevent the spread of the virus.

“Unfortunately, fear can amplify the damage the disease does. With further information on how individuals react to the threat of Covid-19, healthcare providers can design and develop appropriate programs to manage this widespread fear. So, we have developed this assessment scale, which is now being used by researchers in 30 countries and studies all around the world,” says Amir Pakpour.

The scale was developed in several steps, firstly through a literature study where the research group found 30 measures of fear that assess fear on different populations and diseases. The researchers then developed a 10-item scale, where participants responded to statements such as 'It makes me uncomfortable to think about Covid-19' and 'When watching news and stories about Covid-19 on social media, I become nervous or anxious'.

“The participants indicate their level of agreement using a five-item, or so-called Likert-type, scale. The answers go from strongly disagree to strongly agree and a total score is then calculated from the answers. The higher the score, the greater the fear of Covid-19,” says Amir Pakpour.

Link to depression and anxiety indicators

In the results of the first studies made in Iran, the research group found that the scores using this new assessment scale correlated significantly to methods used to assess depression and anxiety.

“However, it is not clear if the scores on our scale would show to what extent the individuals’ fear would lead to them doing Covid-19 preventive behaviours, such as handwashing, social distancing and so on. Nor does it show if their fears stem from public messages about Covid-19 that are perceived as scary or threatening,” says Amir Pakpour.

He emphasizes that it is important to systematically assess fear in this time of crises.

“Without knowing the level of fear about the disease among different demographic groups, it is difficult to know whether education and prevention programs are needed, and how and where one should communicate,” Amir Pakpour says.

Fear can sometimes have a positive effect

Amir Pakpour Photo: Patrik Svedberg

The first studies using the FCV-19S scale have shown some of the practical effects which fear of Covid-19 may have. In a recently published study conducted by Amir Pakpour and his team on college students in the United Kingdom, the results indicated that fear of Covid-19 could be associated with changed behaviours.

“I believe that fear, to some extent, may help change people’s attitude and behaviour. A perceived threat could act as a motivational factor to perform a behaviour that facilitates Covid-19 prevention. These early results show evidence that individuals seem to engage in preventative health behaviours when they perceive a threat as severe. When they see themselves as susceptible to the virus and find the risk of infection highly severe, they start to practice preventative behaviours, such as washing their hands more often or practice social distancing,” Amir Pakpour finishes.

Amir Pakpour is Professor of Health Psychology and the Director of Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. He is also an affiliated researcher at the School of Health and Welfare, Jönköping University.

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Read the full article on the Fear of Covid-19 assessment scale via this link External link, opens in new window..

Read Amir Pakpour and Mark D Griffiths article about The fear of Covid-19 and its role in preventive behaviors via this link External link, opens in new window.

Read more about Amir Pakpour in this issue from 2017 of Me & JU (In Swedish) via this link External link, opens in new window..

Read more about Amir Pakpour’s sleep research via this link External link, opens in new window.