Factor structure and psychometric properties of the Arabic version of the 9-item Trier Inventory for Chronic Stress (TICS-9)

Abstract

Background Chronic stress is a major determinant of physical and psychological health, yet validated instruments for assessing long-term psychosocial stress remain limited in Arabic-speaking populations. Objective The present study aimed to translate and culturally adapt the 9-item Trier Inventory for Chronic Stress (TICS-9) into Arabic and to evaluate its psychometric properties in an adult sample. Methods The English 9-item short version of the TICS was translated following International Test Commission guidelines, including independent forward translations, back-translation, and expert committee review to ensure conceptual and linguistic equivalence. A cross-sectional online survey was conducted among 291 Arabic-speaking adults in Saudi Arabia. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega. Confirmatory factor analysis (CFA) was performed using robust weighted least squares estimation (WLSMV) appropriate for ordinal data. Construct-related evidence was explored using hierarchical regression analyses with demographic and medical variables. Results The Arabic TICS-9 demonstrated excellent internal consistency (α = 0.876; ω = 0.904). CFA provided preliminary support for a unidimensional structure with moderate to strong standardized loadings (0.583–0.819). Model fit showed a mixed pattern in the initially specified model but improved after theoretically justified post hoc residual correlations were added between item pairs with overlapping content. Income was inversely associated with chronic stress scores after adjustment for education, work status, and marital status. Depression was associated with higher stress scores after controlling for other chronic conditions. Conclusion These findings provide initial evidence of internal consistency and preliminary structural support for the Arabic TICS-9 in Saudi Arabic-speaking adults. Further studies are needed to evaluate test–retest reliability, convergent validity, and measurement invariance across populations.