Arabic COVID-19 Psychological Distress Scale: Development and initial validation

Objective: To develop a psychometrically reliable instrument to assess psychological distress during the COVID-19 pandemic across Arab countries. Design: The new instrument was developed through the review of relevant literature. We adapted multiple items from the following tools: The Fear of COVID-19 Scale, Social Phobia Inventory, Health Anxiety Inventory, Swine Influenza Anxiety Scale and the Arabic Scale of Death Anxiety to design our new assessment tool which is called COVID-19 Psychological Distress Scale (CPDS). For psychometric analyses and validation, we conducted a cross-sectional study that solicited data through a web-based survey using the newly developed CPDS. Setting and participants: This validation study was conducted in four Arab countries, including Algeria, Kuwait, Saudi Arabia and Yemen. A total of 1337 participants from these countries have voluntarily responded to our survey questionnaire that included the newly developed scale. Results: The final version of the CPDS comprised 12 items. Participants from Algeria (n=447), Kuwait (n=437), Saudi Arabia (n=160) and Yemen (n=293) have completed the 12-item CPDS. Exploratory factor analysis (used on the Algerian sample) suggested a two-factor structure of the CPDS. The two-factor structure was then supported by the confirmatory factor analysis with an independent sample. Additionally, Rasch analyses showed that all the items fit well in their embedded construct; only one item showed somewhat substantial differential item functioning across gender and country. Conclusion: The 12-item CPDS was found to be measurement invariant across country and gender. The CPDS, with its promising psychometric properties, might help healthcare professionals to identify people with COVID-19-induced psychological distress