The Arabic Version of the Impact of Event Scale-Revised: Psychometric Evaluation among Psychiatric Patients and the General Public within the Context of COVID-19 Outbreak and Quarantine as Collective Traumatic Events

Abstract

The Coronavirus Disease-19 (COVID-19) pandemic has provoked the development of negative emotions in almost all societies since it first broke out in late 2019. The Impact of Event Scale-Revised (IES-R) is widely used to capture emotions, thoughts, and behaviors evoked by traumatic events, including COVID-19 as a collective and persistent traumatic event. However, there is less agreement on the structure of the IES-R, signifying a need for further investigation. This study aimed to evaluate the psychometric properties of the Arabic version of the IES-R among individuals in Saudi quarantine settings, psychiatric patients, and the general public during the COVID-19 outbreak. Exploratory factor analysis revealed that the items of the IES-R present five factors with eigenvalues > 1. Examination of several competing models through confirmatory factor analysis resulted in a best fit for a six-factor structure, which comprises avoidance, intrusion, numbing, hyperarousal, sleep problems, and irritability/dysphoria. Multigroup analysis supported the configural, metric, and scalar invariance of this model across groups of gender, age, and marital status. The IES-R significantly correlated with the Depression Anxiety Stress Scale-8, perceived health status, and perceived vulnerability to COVID-19, denoting good criterion validity. HTMT ratios of all the subscales were below 0.85, denoting good discriminant validity. The values of coefficient alpha in the three samples ranged between 0.90 and 0.93. In path analysis, correlated intrusion and hyperarousal had direct positive effects on avoidance, numbing, sleep, and irritability. Numbing and irritability mediated the indirect effects of intrusion and hyperarousal on sleep and avoidance. This result signifies that cognitive activation is the main factor driving the dynamics underlying the behavioral, emotional, and sleep symptoms of collective COVID-19 trauma. The findings support the robust validity of the Arabic IES-R, indicating it as a sound measure that can be applied to a wide range of traumatic experiences.

Rasch Modeling and Multilevel Confirmatory Factor Analysis for the Usability of the Impact of Event Scale-Revised (IES-R) during the COVID-19 Pandemic

“…Additionally, the COVID-19 pandemic has induced many negative psychological responses, which significantly burden mental wellbeing [ 4 , 18 , 19 , 20 , 21 , 22 ]. The COVID-19-related news and rumors, conspiracy beliefs amongst the general public during the early stages of the crisis, the spread of rumors and fake information through mass media and social media, the lack of vaccines during the early pandemic period, and inequity in vaccine distribution or health care provision, as well as disease-associated stigma, were all reported in the literature to be associated with significant impacts on mental health [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. Moreover, the COVID-19-induced emotional reactions due to infection and pandemic-associated mitigation measures (e.g., lockdown, facemasks, travel restrictions, etc.)…”

“…Although the IES-R was first introduced in the 1990s by Weiss and Marmar [ 42 ], it surprisingly has generated little evaluation of the psychometric properties and construct validity of the scale, during either this pandemic or previous traumatic events [ 5 , 23 , 48 , 54 , 61 ]. However, the IES-R showed high internal consistency for the three subscales (intrusion, avoidance, and hyperarousal), and the test–retest correlation coefficients ranged from 0.51 to 0.94 among a traumatic sample.…”

“…The IES-R has been translated into several languages [ 23 , 54 , 56 , 58 , 62 , 63 , 64 ], with diverse findings regarding its factor structure. Specifically, prior findings suggest changing the factor structure of the IES-R from a single-factor structure to a three-factor structure, with items ranging from 10 to 20.…”

Emotional Reaction to the First Dose of COVID-19 Vaccine: Postvaccination Decline in Anxiety and Stress among Anxious Individuals and Increase among Individuals with Normal Prevaccination Anxiety Levels

“…Indeed, those who market conspiracy beliefs tend to express greater fear and greater tendency toward psychopathology. They employ conspiracy beliefs as a method of coping with uncertainty surrounding the pandemic [ 3 , 17 ]. Therefore, vaccine hesitancy is largely attributed to negative emotions, which are accelerated by antivax rumors about COVID-19 vaccines [ 5 , 15 ].…”

Factors influencing hospital anxiety and depression among emergency department nurses during the COVID-19 pandemic: A multi-center cross-sectional study

“…Depression is a disorder associated with a low mood that impacts an individual’s day-to-day functioning ( 3 ). Depression and anxiety symptoms experienced during the pandemic may be associated with individuals’ perception of COVID-19 as a collective traumatic event ( 4 , 5 ). Both of these conditions are key determinants of psychological distress.…”