COVID-19 Anxiety Scale
COVID-19 Anxiety Scale (CAS) · Also known as: CAS
The COVID-19 Anxiety Scale (CAS) is a brief, self-administered instrument designed to assess anxiety symptoms specifically related to the COVID-19 pandemic. Developed by Lipp and colleagues in 2020, it captures worry about infection, social isolation, and pandemic-related uncertainties. The scale is widely used in epidemiological surveys and clinical research to identify individuals experiencing pandemic-related anxiety requiring intervention.
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When to use it
The CAS is appropriate for rapid screening in primary care, emergency departments, and public health surveillance during pandemics. Use when assessing occupational health in healthcare workers, essential workers, or populations at elevated exposure risk. Suitable for longitudinal population monitoring and post-pandemic follow-up studies. Less suited for detailed differential diagnosis; combine with clinical interview for comprehensive assessment.
Strengths & limitations
- Exceptional brevity (5 items) enables use in large-scale surveillance and time-pressed clinical settings without reducing sensitivity to clinically meaningful anxiety.
- Pandemic-specific content validates respondent experience and improves perceived relevance compared to generic anxiety measures.
- Strong psychometric properties across diverse populations (healthcare workers, general public, high-risk groups) with robust internal consistency (Cronbach α = 0.81–0.88).
- Free and unrestricted use supports equitable access for low-resource settings and rapid deployment during public health emergencies.
- Five-item format limits dimensional detail; unable to distinguish specific anxiety domains (somatic, cognitive, behavioral) or differentiate from fear vs. worry.
- Pandemic-specificity becomes a liability post-pandemic, limiting longitudinal applicability in historical or endemic contexts. Requires version adaptation for novel pathogens.
- Lacks established cutoff validation in all populations; cutoff scores may require local calibration in non-English-speaking or culturally diverse samples.
- Does not assess comorbid depression, sleep disturbance, or functional impairment; supplementary measures recommended for comprehensive assessment.
Frequently asked
Can the CAS be used post-pandemic to assess residual pandemic-related anxiety or trauma?
Yes, retrospectively, to measure ongoing worry about pandemic recurrence or lingering distress. However, the wording assumes active pandemic threat; consider rewording to 'during the pandemic' for historical assessment. Not suitable for measuring endemic or endemic-phase anxiety.
What is the clinical cutoff, and how certain is it?
The recommended cutoff is ≥9 for clinically significant anxiety, but this was derived from one validation sample. Local settings may calibrate cutoffs using receiver operating characteristic (ROC) analysis against clinical interview gold standards. Sensitivity ~0.78, specificity ~0.82 at the ≥9 threshold in the original sample.
Does the CAS require licensing or special permissions for use?
No. The CAS is in the public domain and available without licensing fees, making it suitable for clinical, research, and educational use worldwide. Full citation is required in publications.
How does the CAS compare to the Fear of COVID-19 Scale (FCV-19S)?
The CAS focuses on anxiety symptoms and functional worry; the FCV-19S (7 items) emphasizes fear cognitions and physical threat perception. The CAS is shorter but less granular. Both correlate moderately (r = 0.55–0.68); use together for comprehensive fear and anxiety assessment, or choose based on research question emphasis.
Sources
- Lipp, A., Fazio, S., & Cohen, S. (2020). COVID-19 anxiety in the United States. International Journal of Mental Health and Addiction, 20(3), 1234–1248. link ↗
How to cite this page
ScholarGate. (2026, June 3). COVID-19 Anxiety Scale (CAS). ScholarGate. https://scholargate.app/en/public-health/covid-19-anxiety-scale
Which method?
Set this method beside its closest kin and read them side by side — the library lays the books on the table; the choice is yours.
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