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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.

To understand how the COVID-19 pandemic is disproportionately affecting minorities' victims of discrimination, we examined its impact as traumatic stress, coupled with intersected discriminations, on socioeconomic status and well-being. We used previously collected data from 1,374 participants from seven Arab countries. The data included measures of COVID-19 traumatic stress, collective identity trauma (intersected discrimination), socioeconomic status, well-being, existential status and death anxieties, posttraumatic stress disorder, depression, and general anxiety. We analyzed the data using path analysis and multigroup invariance. Results indicated that COVID-19 traumatic stress coupled with collective identity traumas (intersected discrimination) increased existential status and death anxieties and contributed significantly to lower social status and reduced well-being, and increased posttraumatic stress disorder, anxiety, and depression. The conclusion is that COVID-19 creates a vicious cycle, with disparities/inequalities increasing infection and death from COVID-19, and COVID-19 increasing disparities/inequalities further. We found that these relationships' path model is strictly invariant across gender and strongly invariant across the country groups tested. We discussed the conceptual, clinical, and social justice implications and limitations of the study.

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. Electronic supplementary material The online version of this article (10.1007/s12144-020-01148-7) contains supplementary material, which is available to authorized users.

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.

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