Adaptation and validation of the Arabic version of the COVID-19 anxiety scale


  • Alshomrani A. T. Department of Internal Medicine, College of Medicine, University of Bisha, Kingdom of Saudi Arabia
  • Ayman M. El-Ashkar Department of Basic Medical Sciences, College of Medicine, University of Bisha, Kingdom of Saudi Arabia
  • Adel M. Aboregela Department of Basic Medical Sciences, College of Medicine, University of Bisha, Kingdom of Saudi Arabia
  • Abdulaziz Nasser Alshahrani Abqaiq General Hospital, Buqaiq, KSA
  • Abdullah Hassan Alhalafi Department of Community Medicine, College of Medicine, University of Bisha, KSA



COVID-19, Arabic-version, CAS, Saudi Arabia, Validation


Background: Marked dysfunctional psychological consequences of COVID-19 necessitate an invention of new tailored scales that can assess and monitor these manifestations. Coronavirus Anxiety Scale (CAS) is new reliable and validated scale constructed to measure COVID-19-related anxiety. Objectives were to make a well-structured CAS Arabic version and to assess its validity.

Methods: Sousa and Rojjanasriratw scale adaptation guidelines were followed for CAS translation to Arabic language and a survey of sociodemographic data, CAS and validated COVID-19 fear scale Arabic-version distributed to cross-sectional university students’ sample. Internal consistency, factor analysis, average variable extracted composite reliability, Pearson correlation, and mean differences were calculated.

Results: 233 students responded to the survey, and 44.6% were female. Cronbach’s alpha was 0.94, item-total correlations 0.891-0.905 and inter-item correlations 0.722-0.805. The factor analysis test showed one factor that explains 80.76% of the cumulative variances, average variance extracted 0.80 and composite reliability 0.95, and the two scales’ correlation r-value was 0.472. No significant difference between the scales regarding the score means when compared. The independent t-test showed no differences in means within each identified sociodemographic group.

Conclusions: The translated Arabic version of CAS has high internal consistency reliability and convergent validity values, and factor analysis addressed unidimensional measures. So, the Arabic CAS version is a reliable and valid version that maintains the original English scale reliability and validity properties.


WHO. Coronavirus disease (COVID-19). Available at: tab=tab_1. Accessed on 12 January 2022.

COVID-19 Dashboard. Ministry of Saudi Arabia. Available at: Accessed on 12 January 2022.

Evren C, Evren B, Dalbudak E, Topcu M, Kutlu N. Measuring anxiety related to COVID-19: a Turkish validation study of the coronavirus anxiety scale. Death Stud. 2020;0(0):1-7.

Serafini G, Parmigiani B, Amerio A, Aguglia A, Sher L, Amore M. The psychological impact of COVID-19 on the mental health in the general population. QJM. 2020;113(8):229-35.

Alhalafi AH. Prevalence of anxiety and depression during the coronavirus disease 2019 pandemic in Riyadh, Saudi Arabia: a web-based cross-sectional survey. J Pharm Res Int. 2020;32(27):65-73.

SPA. Saudi Arabia: Covid-19 vaccination is mandatory for entering all places from today, Aug 1. The official Saudi Press Agency. Saudi Press Agency. 2021. Available at: Accessed on 12 January 2022.

Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatr Res. 2020;288.

Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain Behav Immun. 2020;87:40-8.

Lee S, Jobe M, Mathis A. Mental health characteristics associated with dysfunctional coronavirus anxiety. Psychol Med. 2020;51(8):1403-4.

Ahmed M, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated psychological problems. Asian J Psychiatr. 2020;51.

Albagmi FM, Alnujaidi HY, Al Shawan DS. Anxiety levels amid the covid-19 lockdown in Saudi Arabia. Int J Gen Med. 2021;14:2161-70.

Lee S. Coronavirus anxiety scale: a brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401.

Ahmed O, Faisal RA, Sharker T, Lee SA, Jobe MC. Adaptation of the Bangla version of the COVID-19 anxiety scale. Int J Ment Health Addict. 2022;20(1):284-95.

Magano J, Vidal D, e Sousa H, Pimenta Dinis M, Leite Â. Validation and psychometric properties of the portuguese version of the coronavirus anxiety scale (Cas) and fear of covid-19 scale (fcv-19s) and associations with travel, tourism and hospitality. Int J Environ Res Public Health. 2021;18(2):1-14.

Sepúlveda-Vázquez C, Moreno-Torres L. Validation and adaptation into Spanish of the COVID-19 anxiety scale. Rev Med Inst Mex Seguro Soc. 2021;59(5):412-6.

Sousa V, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2011;17(2):268-74.

Coronavirus Anxiety Project. Available at: Accessed on 12 January 2022.

Lee S. Replication analysis of the coronavirus anxiety scale. Dusunen Adam. 2020;33(2):203-5.

Lee S, Mathis A, Jobe M, Pappalardo E. Clinically significant fear and anxiety of COVID-19: a psychometric examination of the coronavirus anxiety scale. Psychiatr Res. 2020;290.

Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scale: development and initial validation. Int J Ment Health Addict. 2020:1-9.

Satici B, Gocet-Tekin E, Deniz M, Satici S. Adaptation of the fear of COVID-19 scale: its association with psychological distress and life satisfaction in Turkey. Int J Ment Health Addict. 2021;19(6):1980-8.

Alyami M, Henning M, Krägeloh C, Alyami H. Psychometric evaluation of the Arabic version of the fear of COVID-19 scale. Int J Ment Health Addict. 2021;19(6):2219-32.

Fornell C, Larcker D. Evaluating structural equation models with unobservable variables and measurement error. J Mark Res. 1981;18(1):39-50.

Wu TH, Chang CC, Chen CY, Wang J Der, Lin CY. Further psychometric evaluation of the Self-Stigma scale-short: measurement invariance across mental illness and gender. PLoS One. 2015;10(2):1-12.

Lee S. How much “Thinking” about COVID-19 is clinically dysfunctional? Brain Behav Immun. 2020;87:97-8.




How to Cite

A. T., A., El-Ashkar, A. M., Aboregela, A. M., Alshahrani, A. N., & Alhalafi, A. H. (2023). Adaptation and validation of the Arabic version of the COVID-19 anxiety scale. International Journal Of Community Medicine And Public Health, 10(4), 1293–1297.



Original Research Articles