Development and Validation of the COVID-19 Infection Fear Scale in a Collectivist Cultural Context: A Study From South Korea

Objective Understanding the specific fears associated with coronavirus disease-2019 (COVID-19), particularly within different cultural contexts, is crucial for developing effective mental health interventions. This study aims to develop and validate the COVID-19 Infection Fear Scale (CIFS) in a collectivist cultural context such as Korea. Methods A total of 1,002 adults aged 19 to 70 participated in an online survey in May 2020. The CIFS was developed through a multi-disciplinary approach, categorizing public fears into two domains: fear of infection and fear of negative outcomes post-infection. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to validate the factor structure. Reliability and construct validity were assessed through correlations with anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), suicidal ideation, and coping strategies. Results The CIFS demonstrated high internal consistency. EFA and CFA supported a two-factor model. The Rasch analysis confirmed good item fit, with infit and outfit indices within the acceptable range. Differential item functioning analysis indicated minor sex and age biases, addressed without removing items. Construct validity was supported by significant correlations with anxiety, depression, suicidal ideation, and coping strategies. Fear of negative consequences post-infection showed a stronger correlation with psychological distress than fear of infection. Conclusion The CIFS is a reliable and valid tool for measuring fear related to COVID-19 infection and its consequences, particularly within a collectivist cultural context. This scale can aid in identifying individuals at higher risk of psychological distress and inform targeted interventions.