The source of coronavirus anxiety: a longitudinal network analyses of the symptoms in the coronavirus anxiety scale (CAS) and their associations with depression, anxiety, stress and alcohol use

Abstract 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. 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 it requires validation and examination. This study fulfils this need using Longitudinal Network Analysis. A total of 968, 462 and 276 adults from an Australian community sample across 3 time points completed the CAS, and measures of depression, anxiety, stress, and alcohol use. Regularized partial correlation network analysis (EBICglasso)was subsequently employed 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, both cross-sectionally and longitudinally. The network produced was found stable both cross-sectionally and across time. In terms of network structure, the most central CAS symptom identified being abdominal distress, followed by tonic immobility and the least being dizziness. Furthermore, 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. 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.