The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type.

COVID-19 is a new type of trauma that has never been conceptually or empirically analyzed in our discipline. This study aimed to investigate the impact of COVID-19 as traumatic stress on mental health after controlling for individuals' previous stressors and traumas. We utilized a sample of (N = 1374) adults from seven Arab countries. We used an anonymous online questionnaire that included measures for COVID-19 traumatic stress, posttraumatic stress disorder, anxiety, depression, and cumulative stressors and traumas. We conducted hierarchical multiple regression, with posttraumatic stress disorder, depression, and anxiety as dependent variables. In the first step, in each analysis, we entered the country, gender, age, religion, education, and income as independent variables (Kira, Traumatology 7(2):73-86, 2001; Kira, Torture, 14:38-44, 2004; Kira, Traumatology, 2021, https://doi.org/10.1037/trm0000305). In the second step, we entered cumulative stressors and traumas as an independent variable. In the third step, we entered either COVID-19 traumatic stressors or one of its subtypes (fears of infection, economic, and lockdown) as an independent variable. Finally, we conducted structural equation modeling with PTSD, depression, and anxiety as predictors of the latent variable mental health and COVID-19 as the independent variable. Results indicated that COVID-19 traumatic stressors, and each of its three subtypes, were unique predictors of PTSD, anxiety, and depression. Thus, COVID-19 is a new type of traumatic stress that has serious mental health effects. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-021-00577-0.

The effects of COVID-19 continuous traumatic stress on mental health: The case of Syrian refugees in Turkey

COVID-19 presents continuous cumulative multilayered traumatic stressors that have a significant mental health impact on refugees and especially Syrian refugees. A sample of 417 Syrian refugees in Turkey participated in an online survey that included measures for COVID-19 traumatic stress (COVID-19TS), cumulative stressors and traumas, posttraumatic stress disorder (PTSD), depression, generalized anxiety, and existential death and status anxieties. We conducted an independent samples t test between those hospitalized due to COVID-19 infection (N = 47) and the others. Further, we conducted path analysis supplemented by PROCESS macro to identify the mediators. The path model included cumulative stressors and traumas and COVID-19TS as independent variables, existential status and death anxieties as mediating variables, and PTSD, depression, and anxiety as outcome variables. We conducted multigroup invariance to test the path model equivalence across genders and tortured and nontortured groups. Results indicated that the participants are highly traumatized and include a relatively high number of torture survivors (N = 102). Being tortured was a decisive risk factor for being hospitalized for COVID-19, with over 75% of the hospitalized been torture survivors. The sample participants have high rates of PTSD, depression, and anxiety, especially among those hospitalized due to COVID-19 and those with a history of torture. COVID-19TS has the highest association with its economic trauma. COVID-19TS is directly associated with elevated PTSD, depression, and anxiety comorbid symptoms and indirectly via existential death and status anxieties as mediators. The path model was strictly invariant across genders and tortured and nontortured groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Coping with COVID-19 continuous complex stressors: The "will-to-exist-live, and survive" and perfectionistic striving

COVID-19 challenges the known traditional coping skills of the individual. New innovative concepts are evolving that may help fill some gaps in our knowledge of intrinsic human strengths to cope with the COVID-19 pandemic, such as the "will-to exist-live, and survive" (WTELS) and striving for higher standards of perfectionism. The current study tested a model of coping to 3 main COVID-19 traumatic stressors: fears of infection, economic traumas, and lockdown (related isolation/disturbed routines, and social difficulties). We used a sample of 1,377 participants from 7 Arab countries and measures of COVID-19 traumatic stressors, WTELS, striving for high standards (perfectionism), resilience, social supports, socioeconomic status, and well-being. We conducted structural equation (SEM) analysis to test whether WTELS as an independent variable predicts COVID-19 stressors as a latent variable (with three observed COVID-19 stressors types: fears, economic, and lockdown stressors) and whether this relationship is mediated in part by resilience, striving for high standards, social support, socioeconomic status, and well-being. WTELS indirectly and indirectly via the mediating variables had significant effects on lowering COVID-19 traumatic stress and its 3 stressor types. Alternative models did not fit as well with the data. In addition, the model was strictly invariant across genders. We discuss the conceptual and clinical implications of the results. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Measuring COVID-19 Stressors and Their Impact: The Second-Order Factor Model and Its Four First-Order Factors: Infection Fears, Economic, Grief, and Lockdown Stressors

The current research aims to test the new measurement model of COVID-19 stressors which includes four stressor types: infection fears, lockdown, economic, and grief in one second-order factor. Using a sample of 2732 from 11 Arab countries and measures for COVID-19 stressors, PTSD, depression, anxiety, and executive function, we conducted exploratory and confirmatory factor analyses, multigroup invariance, and correlations. A second-order factor with four first-order factors model fit the data well. All factors were significantly correlated with PTSD, depression, anxiety, working memory, and inhibition deficits. The measure and its four subscales have robust psychometrics and were invariant across genders. [ABSTRACT FROM AUTHOR] Copyright of Journal of Loss & Trauma is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The differential mental health impact of COVID-19 in Arab countries.

COVID-19 pandemic's mental health impact on Arab countries is under-researched. The goal of this investigation was to study the differential impact of COVID-19 on the mental health of Arab countries. A questionnaire including measures of COVID-19 traumatic stress, PTSD, depression, anxiety, and cumulative stressors and trauma was distributed anonymously online in seven Arab countries (Egypt (N = 255), Kuwait (N = 442), Jordan (N = 216), Saudi Arabia (N = 212, Algeria (N = 110), Iraq and Palestine (N = 139)). We used ANOVA and stepwise regression to analyze the data. For each country, regression, PTSD, depression, and anxiety were dependent variables; we entered in the first-step, gender, age, religion, education, and income. In the second step, we entered "cumulative stressors and traumas." In the third step, we entered COVID-19 traumatic stress. The ANOVA results indicated that the differences in COVID19 traumatic stress, PTSD, depression, and anxiety between the countries were significant. Post-hoc analysis indicated that Egypt is significantly higher than all the other Arab countries in COVID-19 traumatic stress, PTSD, anxiety, and depression. The subsample from Palestine and Iraq had a significantly higher cumulative trauma load than the other Arab countries but did not have higher levels of COVID-19 traumatic stress or PTSD. Stepwise regression indicated that COVID-19 traumatic stress accounted for significant variance above and beyond the variance accounted for by previous cumulative stressors and traumas for anxiety in all countries and PTSD and depression in all countries except for Algeria. We discussed the implications for these results for the urgent mental health needs of Arab countries.