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.