In Japan, discrimination against individuals infected with COVID-19 and suicides exceeding the number of COVID-19 deaths are of great concern. 1,2 The increasing number of COVID-19 cases and deaths, shortages of the medical system, and the media strongly invoke emotional reactions, leading to anxiety, intolerance of uncertainty, obsessions, and risk factors for suicide. 3 The Coronavirus Anxiety Scale (CAS) 4 and Obsession with COVID-19 Scale (OCS) 5 were among the first published screeners to identify cases likely to have dysfunctional anxiety and obsessions related to COVID-19, and CAS-J and OCS-J were developed as their Japanese versions in this study (Table S1). According to previous studies, [4][5][6][7][8] the CAS distinguishes between anxiety triggered by COVID-19 and general anxiety. The same applies to the OCS. According to the DSM-5 cross-sectional symptom scale, the original version 4,5 regards a score of 9 or more on the CAS as dysfunctional COVID-19-related anxiety and a score of 7 or more on the OCS as having COVID-19-related obsessivecompulsive symptoms. The CAS has been translated into 26 languages and the OCS has been translated into 21 languages.This study aimed to develop and evaluate the psychometric properties of the Japanese versions of the CAS and OCS (hereafter, CAS-J and OCS-J) to assess anxiety and obsessive-compulsive symptoms among the Japanese population evoked by the COVID-19 pandemic.The study participants consisted of 293 Japanese adults. Of these, 100 were students recruited from Tsuruga Nursing University and 193 were recruited through social media, such as Facebook, from 22 July to 5 September 2020. Table S2 summarizes the sociodemographic characteristics of the study participants. The survey was conducted anonymously and was confidential. Information about the study was provided to participants in plain Japanese, with informed consent recorded online.An online survey was performed, and demographic items were included, namely, gender, age, residential area, and occupation (in particular, whether the person is a medical professional or not), as well as COVID-19-specific anxiety and obsessive-compulsive symptoms. The questionnaires used were: CAS-J and OCS-J, which included COVID-19-specific anxiety and obsessive-compulsive symptoms; the Overall Anxiety Severity and Impairment Scale (OASIS), 9 which included general anxiety; and the Obsessive-Compulsive Inventory-Revised (OCI-R), 10 which included general obsessive-compulsive symptoms. These scales P < 0.01. All Inter-item correlations were statistically significant (P < 0.01).
Background The coronavirus disease 2019 (COVID-19) has caused mental health issues in both adults and adolescents. The Coronavirus Anxiety Scale (CAS) and Obsession with COVID-19 Scale (OCS) questionnaires measure anxiety and persistent and disturbed thoughts (also known as obsessions) related to COVID-19. We developed Japanese versions of the CAS (i.e., CAS-JA) and OCS (i.e., OCS-JA) questionnaires to make them suitable for adolescents and validated the characteristics of these scales. Methods Two online surveys were administered to high school students aged 15–18 years. A total of 263 students participated in the first survey and almost half of them participated in the second survey. In the first survey, participants responded to the CAS-JA, OCS-JA, generalized anxiety and obsessive–compulsive subscales of the Spence Children’s Anxiety Scale (SCAS), and Kessler 6 Scale (K6). The SCAS and K6 were used to verify discriminant validity and inter-scale correlations. In the second survey, the participants completed the CAS-JA and OCS-JA again to verify test–retest reliability. We performed a confirmatory factor analysis and calculated the model fit indices. Additionally, we examined the internal consistency reliability, convergent validity, and inter-item correlations of the CAS-JA and OCS-JA. Moreover, differences in CAS-JA and OCS-JA responses by gender and region of residence (state of emergency and non-emergency areas) were examined. Results The results of the single-factor model confirmatory factor analysis of model fit indices were above the threshold. The required criteria for internal consistency reliability, test–retest reliability, and discriminant and convergent validity were met in both the CAS-JA and OCS-JA. No statistically significant differences attributed to residence and gender were found in both questionnaires. Conclusions The results indicate that the CAS-JA and OCS-JA questionnaires are useful in measuring COVID-19-related anxiety, and persistent and disturbed thoughts in Japanese adolescents.
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