Along with the measurement scales, an Arabic written sociodemographic questionnaire was prepared. The questionnaire conveyed three main categories reflecting the general personal information, socioeconomic status, and medical history of participants. The measurement scales used were the Arabic versions of the Hopkins Symptom Checklist - 25 and the Fear of COVID-19 Scale.

The Fear of COVID-19 Scale (FCV–19S) was first established in March 2020 by Ahorsu et al. its foremost purpose was to evaluate fear resulting from the spread of COVID-19.25 It includes seven statements; the individual is asked to precisely determine the level of his/her agreement or disagreement based on a five-point Likert scale (Appendix I). The total score is obtained by summing up the responses and ranges between 7 and 35. The higher the score, the greater the fear of COVID-19.25 The scale portrayed strong psychometric properties and stable unidimensional structure upon assessing fear originating from COVID-19 within the Iranian population.25 Furthermore, the FCV-19S was translated and validated among diverse countries, including Italy, Eastern Europe, Bangladesh, Saudi Arabia, and Turkey.26, 27, 28, 29, 30 This study used the Lebanese validated Arabic version of the FCV-19S (A-FCV-19S) (Zein et al., submitted). The A-FCV-19S validated among the Lebanese population showed high internal consistency with an alpha coefficient of 0.849. The scale extracted 2 factors demonstrating good fit with the data (X2/df = 3.760, root-mean-square error of approximation = 0.048 (95% CI of 0.043–0.080), comparative Fit Index = 0.963, Goodness-of-Fit Index = 0.973, Adjusted Goodness-of-Fit Index = 0.941). Factor 1 expressed “fear and worry” and Factor 2 expressed “somatic symptoms of fear”. Moreover, fear was positively correlated with anxiety and depression (r = 0.550 and 0.452 respectively, p-value < 0.0001 for both), indicating good criterion validity (Zein et al., submitted).

The Hopkins Symptom Checklist (HSCL) aims to evaluate the patients’ psychoneurotic complaints.31 The scale is available in multiple versions, in which the number of items ranges between 25 and 90.32 The HSCL-25 was used within this study; it is a brief self-report screening test that validates the presence of anxiety and depression symptoms.33 This shortened version has been validated within several populations and translated into several languages, including Arabic.34 The checklist consists of 25 questions, with four response selections for each item (1 = not at all, 2 = a little, 3 = quite a bit, and 4 = extremely). The total score of the scale is obtained by summing up the 25 responses and averaging them together. A separated sub score for anxiety symptoms can be obtained by summing up and averaging the first 10 items. As for the score of depression symptoms, it is obtained by summing up and averaging the last 15 items.35 The initial authors reported that the cutoff for the total score of the HSCL-25 is 1.75.35 However, for the Lebanese population, a cutoff of 2 was conveyed for the anxiety subscale and 2.1 for the depression subscale.34 It is important to note that, the Lebanese Arabic validated version of the HSCL-25 was used within this study.

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