COVID-19-Specific Obsessive Compulsive Symptoms Scale (C19-OCS)

Abstract

The COVID-19-Specific Obsessive Compulsive Symptoms Scale (C19-OCS), developed by Avşar & Avşar in 2023, is a specialized psychometric instrument designed to quantify the severity of obsessive-compulsive symptoms (OC) that specifically manifest in the context of the COVID-19 pandemic. Its development began with an extensive review, generating 49 initial items, which were refined to 17 following content validity analysis.

The final, validated 16-item scale structure was confirmed using a sample primarily consisting of university students in Turkey. Methodological approaches included Mokken Scale Analysis (MSA) and Exploratory Factor Analysis (EFA), which established a robust two-factor model. The C19-OCS demonstrates strong psychometric properties, confirmed through comprehensive assessments of internal consistency (e.g., Cronbach’s alpha, Composite Reliability) and temporal stability (test-retest reliability), alongside rigorous evaluation of convergent and discriminant validity.

Keywords

Contamination Fears and Cleaning, Coronavirus Disease, Obsessive Compulsive Symptoms, Mokken Scale Analysis, Obsessive Thoughts, Compulsions, Contagion, Mental Health Assessment

Authors

Avşar, Asiye Şengül, Avşar, Volkan

Purpose

The primary purpose of the C19-OCS is to provide a focused and reliable measure for assessing psychological distress related to pandemic-specific behaviors. It was specifically developed to quantify the prevalence and intensity of obsessive thoughts, particularly those related to contamination, and their resultant behavioral manifestations, such as excessive cleaning and washing compulsions, directly tied to the fear of the Coronavirus Disease.

By isolating these specific symptoms, the scale allows clinicians and researchers to distinguish general anxiety or traditional Obsessive-Compulsive Symptoms from those uniquely triggered or exacerbated by the global public health crisis.

Construct

The C19-OCS measures a two-dimensional construct of Obsessive-Compulsive Symptoms specifically focused on the pandemic context. This construct comprises two interrelated but distinct factors:

• Obsessive thoughts: Reflecting persistent, unwanted, and intrusive thoughts concerning infection, illness, or spreading the virus.

• Contamination fears and cleaning: Reflecting the behavioral component, specifically excessive washing, sanitizing, or other ritualistic compulsions aimed at reducing perceived exposure risks.

Validity

The validity of the C19-OCS was evaluated using multiple psychometric approaches, confirming its ability to measure the intended construct reliably.

Convergent Validity: Strong convergent validity was established based on the Average Variance Extracted (AVE) values. The AVE values for the two factors were 0.53 and 0.63, respectively. Since both values exceed the recommended threshold of 0.50 (Hair et al., 2019), this provides robust statistical evidence that the items within each factor are highly correlated and successfully measure their intended latent construct.

Discriminant Validity: Discriminant validity was assessed using the Fornell & Larcker (1981) criterion. The square roots of the AVE values for the two dimensions (0.73 and 0.79) were found to be higher than the correlation between the two dimensions (0.71). This result confirms that the two factors (“Obsessive thoughts” and “Contamination fears and cleaning”) are empirically distinct constructs and do not overlap excessively.

Content and Criterion-Related Validity: While initial development involved content validity analysis resulting in item reduction, specific detailed data regarding the final formal assessment of content validity and criterion-related validity were not explicitly presented in the source publication abstract.

Reliability

The C19-OCS demonstrated high levels of reliability across multiple coefficients, indicating both internal consistency and temporal stability.

Internal Consistency: Various coefficients confirmed the homogeneity of the scale items. The internal consistency measures, including Cronbach’s alpha (α), Guttman lambda 2 (λ), and McDonald’s omega (ω), consistently ranged from 0.82 to 0.92 for both the total scale and its individual factors, signifying excellent internal consistency. Additionally, the Composite Reliability (CR) values ranged from 0.91 to 0.95, further supporting the scale’s reliability.

Test-Retest Reliability: Temporal stability was evaluated over a two-week interval. The resulting test-retest reliability coefficients ranged from r = 0.74 to 0.78 (p < 0.01). These coefficients suggest good stability, indicating that scores obtained from the C19-OCS are consistent over time for individuals whose underlying symptom levels have not changed.

Factor Analysis

The underlying structure of the C19-OCS was rigorously investigated using both non-parametric and parametric factor analysis techniques.

Mokken Homogeneity Model (MHM): Mokken Scale Analysis was initially employed to assess the scalability of the items. Item 3 (“I am tired of watching the news about COVID-19”) was identified as having a scalability coefficient below the accepted threshold of 0.30 and was subsequently removed, leading to a finalized 16-item scale that adheres to the MHM criteria.

Exploratory Factor Analysis (EFA): An Exploratory Factor Analysis using the Principal Axis Factoring (PAF) method, supported by Parallel Analysis (PA), confirmed the scale’s construct validity. The analysis of the 16 remaining items revealed a clear and interpretable two-factor solution, which collectively accounted for 49.30% of the total variance. These factors were named “Obsessive thoughts” and “Contamination fears and cleaning.”

Confirmatory Factor Analysis (CFA): CFA was performed primarily to calculate the Average Variance Extracted (AVE) values used to establish convergent validity. While CFA is typically used to confirm model fit, specific goodness-of-fit indices (e.g., CFI, RMSEA) were not provided as direct evidence of construct validity in the source documentation.

Instrument

Test Type: Original

Format: The C19-OCS consists of 16 items. Participants are required to rate their level of agreement with each statement based on their experiences over the preceding month. Responses utilize a 5-point Likert scale, ranging from 1 = strongly disagree to 5 = strongly agree. The administration method used during validation was electronic.

Language Available: English

Population Group: Human (Male and Female)

Age Group: Adulthood (18 yrs & older), encompassing Young Adulthood (18-29 yrs), Thirties (30-39 yrs), Middle Age (40-64 yrs), and Aged (65 yrs & older).

Population Details: The validation study was conducted in Turkey, utilizing adult respondents between 18 and 65 years of age, many of whom were university students.

Test Methodology: The comprehensive methodology included assessments of Test Validity (Content Validity, Convergent Validity, Criterion Validity, Discriminant Validity), Test Reliability (Internal Consistency, Test-Retest Reliability), and Factor Analysis (Exploratory Factor Analysis and Confirmatory Factor Analysis).

Keywords

Obsessive Compulsive Symptoms, Contamination Fears, Exploratory Factor Analysis, Psychological Assessment, Obsessive Thoughts, Reliability, Validity

Authors

Author ORCID Identifier: Avşar, Volkan: http://orcid.org/0000-0001-9427-9425

Affiliation Email addresses: Avşar, Asiye Şengül: Recep Tayyip Erdoğan University Department of Measurement and Evaluation in Education. Avşar, Volkan: Recep Tayyip Erdoğan University Department of Psychological Counselling and Guidance. Email: [email protected]

Correspondence Address: Avşar, Volkan: [email protected]

Permissions & Fee and Test Year

Permissions: Contact Corresponding Author

Fee: No

Test Year: 2023

References

Şengül Avşar, A., & Avşar, V. (2023). Development of the COVID-19-specific obsessive compulsive symptoms scale with various validity and reliability proofs. International Journal of Cognitive Therapy, 16(1), 58–80. https://doi.org/10.1007/s41811-022-00155-9

Items of the COVID-19-Specific Obsessive Compulsive Symptoms Scale (C19-OCS)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

This is a 16-item measure. The specific items are available in the Appendix of the source reference, on Page 75.

Factors and Subscales:

• Obsessive thoughts

• Contamination fears and cleaning