A multidimensional tool in disaster medicine: Development of the disaster anxiety scale

This study aimed to develop a multidimensional scale to assess disaster-related anxiety, addressing the limitations of generic and disaster-specific anxiety instruments. The new tool, the Multidimensional Disaster Anxiety Scale (MDAS), was designed to enable a comprehensive and practical evaluation of anxiety across all disaster types, with the potential to improve identification of vulnerable groups and inform psychosocial interventions.

The methodological study followed a systematic process: item pool development, pilot testing, data collection, and assessment of reliability and validity. The initial item pool was generated through literature review and expert consultations, resulting in a draft with 30 items. These were reviewed for content validity by multidisciplinary experts, and items with low Content Validity Ratio (CVR) or deemed irrelevant were excluded. The sample, determined as 600 individuals, was selected using the cluster sampling method. After performing the Exploratory Factor Analysis (EFA), the sample was equally divided into two groups in order to collect data for the Confirmatory Factor Analysis (CFA). Statistical analyses included item-total correlations, Cronbach's alpha, split-half reliability, EFA, CFA, composite reliability (CR), and average variance extracted (AVE).

After validity and reliability analyses, the MDAS was finalized with 18 items across two subdimensions: Cognitive (Ideational) and Reactive. EFA revealed two factors, accounting for 57.1% of the total variance, with all factor loadings above 0.50. Cronbach's alpha demonstrated high internal consistency for the total scale (0.917), as well as the Cognitive (0.909) and Reactive (0.899) subscales. CFA confirmed the two-factor model with good fit indices (CFI=0.99, TLI=0.99, RMSEA=0.071, SRMR=0.071). CR and AVE values exceeded recommended thresholds for construct reliability and validity. The scale uses a 5-point Likert response format; scores range from 18 to 90, with higher scores indicating greater disaster anxiety.

The MDAS is a valid, reliable, and sensitive instrument for the multidimensional assessment of disaster-related anxiety in the general population. Its generic structure allows application across various disaster contexts, supporting its utility in disaster preparedness, response, and recovery phases. The scale facilitates identification of individuals at risk, evaluation of intervention effectiveness, and clinical follow-up after disasters. Future research should further assess its psychometric properties, diagnostic performance, and establish cut-off values for clinical use.