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.

The goal was to develop and validate a measure for COVID-19 as traumatic stress. The scale consisted of three dimensions: “threat/fear of infection and death,” “economic hardship,” and “disturbed routines/isolation.” The measure was tested on a snowball sample of 1374 participants from seven countries online. Principal and confirmatory factor analysis conducted on separate subsamples randomly drawn from the sample proved its structural validity. Measures of PTSD, depression, anxiety, cumulative traumas, and well-being were used to test its convergent, divergent, and predictive validity. Results validated the reliability, the structural, convergent, divergent, and predictive validity of the scale and its subscales.

Understanding the dynamics of mental health stigma through existing frameworks, especially in minorities with higher stigma, is problematic. There is a need to reconceptualize stigma, particularly in highly traumatized groups. The current study examines the validity of a new development-based trauma framework that conceptualizes stigma as a type III chronic trauma that contributes to negative mental health effects. This framework proposes that public stigma is a unique chronic traumatic stress that mediates the effects of similar trauma types in mental health patients. To test this proposition, this study explores the relationships between internalized stigma of mental illness (ISMI), different trauma types, and posttrauma spectrum disorders. ISMI, posttraumatic stress disorder, other posttrauma spectrum disorders, and cumulative trauma measures were administered to a sample of 399 mental health patients that included Arab (82%), Muslim (84%), and refugee (31%), as well as American patients (18%). Age in the sample ranged from 18 to 76 years (M = 39.66, SD = 11.45), with 53.5% males. Hierarchical multiple regression, t tests, and path analyses were conducted. Results indicated that ISMI predicted posttraumatic stress disorder and other posttrauma spectrum disorders after controlling for cumulative trauma. ISMI was associated with other chronic collective identity traumas. While Arab Americans, Muslims, and refugees had higher ISMI scores than other Americans, the elevated chronic trauma levels of these groups were significant predictors of these differences. The results provide evidence to support ISMI traumatology model. Implications of the results for treating victims of ISMI, especially Arab Americans, Muslims and refugees are discussed.

A Palestinian sample was used to explore the dynamics of posttraumatic growth (PTG) across different trauma types. Cumulative trauma, posttraumatic stress disorder, depression, anxiety, PTG, and stress-related growth (SRG) measures were administered. As predicted, only type I traumas were associated with PTG. Type II traumas were not associated with PTG, while type III collective identity traumas were negatively associated with PTG. Results indicated that PTG was not a significant predictor of any mental health symptoms and that PTG is different from SRG, which seems to describe growth in non-traumatic situations. The results suggest that it is important to analyze trauma profiles rather than single trauma.