4.9. Psychological distress

The Impact of Events Scale – Revised (IES-R) was used to measure psychological post-traumatic stress symptoms (^{Weiss & Marmar, 1997}). The IES-R has been extensively used as a measure of post-traumatic stress symptoms in community and clinical samples (e.g., ^{Beck, et al., 2008}). The scale contains 22 items (e.g., “I thought about it when I didn't mean to”) that were responded to on a 5point Likert scale that ranged from 0 (“not at all”) to 4 (“extremely”). The instructions preceding the items read: “The following is a list of difficulties people sometimes have after stressful life events. Please read each item, and then indicate how distressing each difficulty has been for you during the past 7 days with respect to the Coronavirus situation.” The internal consistency of the scale was high (Cronbach's α = 0.97). A total IES-R score was calculated. Higher scores indicated greater trauma symptoms. The possible range of scores for the IES-R was 0–88.