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Network Analyses of the Symptoms in the Coronavirus Anxiety Scale (CAS) and its Associations with Depression, Anxiety, Stress and Alcohol Use


 Background

The Covid-19 Pandemic and subsequent actions taken by national/international organizations has generated a large amount of anxiety which may roam into the realm of pathology – COVID Anxiety. In order to measure this phenomenon, measures such as the CAS have been developed. The CAS being a self-report measure of anxiety-related physiologically symptoms that are aroused by information and thoughts related to COVID-19. However, as the CAS is fairly new tit requires validation and examination. This study fulfils this need through the use of Network Analysis.
Methods

The study used regularized partial correlation network analysis (EBICglasso) to examine the network structure of ratings of COVID anxiety symptoms as presented in the Coronavirus Anxiety Scale (CAS) and how these symptoms are related to distress (combination of depression, anxiety, stress) and alcohol use. A total of 968 adults from an Australian community sample completed the CAS, and measures of depression, anxiety, stress and alcohol use.
Results

The findings showed that the most central CAS symptom was abdominal distress, followed by tonic immobility. The symptom with the lowest strength centrality value was dizziness. Also, the network revealed at least moderate effect size connections for tonic immobility with dizziness, sleep disturbances abdominal distress, and for abdominal distress with appetite loss. Additionally, distress was associated positively with dizziness, tonic immobility and appetitive loss. Alcohol use was associated positively with dizziness and abdominal distress, and negatively with tonic immobility and appetitive loss.
Conclusions

Overall, the findings showed a novel understanding of the structure of the COVID anxiety symptoms in the CAS, and how these symptoms are associated with distress and alcohol use. The clinical implications of the findings for assessment and treatment of COVID anxiety and its comorbidity with distress and alcohol use are discussed.