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IntroductionWe tested the association between the stress of COVID-19 and mental distress manifested by anxiety, depression, and stress, and whether well-being and resilience mediate the relationship between the two variables in a population of Palestinian adults. Namely, we hypothesized that stress of COVID-19 will be positively associated with mental health problems (anxiety, depression, and stress); well-being and resilience will be negatively associated with mental health problems (anxiety, depression, and stress); and well-being and resilience will mediate the association between the stress of COVID-19 and mental health problems (anxiety, depression, and stress).Material and methodsDepression, Anxiety and Stress Scale-21, the Resilience Scale for Adults, the WHO-5 Well-Being Index, and the COVID-19 Stress Scales were administered to 860 participants via online survey. Structural equation modelling (SEM) was applied to address the study hypothesis.ResultsParticipants recorded a mild level of stress of COVID-19 and high scores for resilience and well-being. A conceptual model depicting COVID‑19 stress as a predictor, mental distress as an outcome variable, and resilience and subjective well-being as mediators was confirmed.ConclusionsPalestinians are exposed to mental distress in an environment characterized by ongoing stressors. Conversely, the capability of Palestinians to conserve good levels of well-being and resilience protects them from mental distress even in the wake of the COVID-19 outbreak. On the other hand, COVID-19 can be considered a new critical event demanding and diminishing the people’s resiliency recourses in Palestine. Implications for clinical practice and research are discussed.

The main goal of this study was to examine the psychometric properties of the COVID Stress Scales (CSS) in the Palestinian context and the factorial structure of the instrument. The CSS, a newly emerging internationally standardized measure of stress related to being exposed to or contracting COVID-19, was translated and validated for a Palestinian context to ensure that it can be used to measure COVID-19 stress. The sample of the study consisted of 860 Palestinian adults living in the West Bank of Palestine. Participants' age ranged from 20 to 48 years old (M = 34.7, SD =13.46). They were all recruited from online advertisements, e-mail campaigns, blogs, social media, and SMS campaigns. The CSS was found to be valid in the Arabic language within a Palestinian context. The confirmatory factor analysis yielded six factors: (1) Fears about the dangerousness of COVID-19, (2) fears about the personal social, and economic consequences of COVID-19, fears of disruption in the supply chain, fears of looting or rioting, (3) COVID-19-xenophobia, fears that foreigners are sources of COVID-19, (4) fears about sources of COVID-19-related contamination,(5) traumatic stress symptoms related to COVID-19, and (6) COVID-19-related checking which is consisting with the ordinal structure the scale. The CSS demonstrated a high level of validity and reliability in a Palestinian context and therefore can be considered for future studies as the COVID-19 pandemic persists. Further investigations using the Arabic Language of CSS may have far-reaching implications for measuring and combating the stress of COVID-19 at a personal and societal level for uniquely at-risk populations such as in the occupied territories of Palestine.

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