New York City young adults' psychological reactions to 9/11: findings from the Reach for Health longitudinal study

Cumulative effects of pre-pandemic vulnerabilities and pandemic-related hardship on psychological distress among pregnant individuals

OBJECTIVE

Our primary objective was to determine whether pre-existing vulnerabilities and resilience factors combined with objective hardship resulted in cumulative (i.e., additive) effects on psychological distress in pregnant individuals during the COVID-19 pandemic. A secondary objective was to determine whether any of the effects of pandemic-related hardship were compounded (i.e., multiplicative) by pre-existing vulnerabilities.

METHOD

Data are from a prospective pregnancy cohort study, the Pregnancy During the COVID-19 Pandemic study (PdP). This cross-sectional report is based upon the initial survey collected at recruitment between April 5, 2020 and April 30, 2021. Logistic regressions were used to evaluate our objectives.

RESULTS

Pandemic-related hardship substantially increased the odds of scoring above the clinical cut-off on measures of anxiety and depression symptoms. Pre-existing vulnerabilities had cumulative (i.e., additive) effects on the odds of scoring above the clinical cut-off on measures of anxiety and depression symptoms. There was no evidence of compounding (i.e., multiplicative) effects. Social support had a protective effect on anxiety and depression symptoms, but government financial aid did not.

CONCLUSION

Pre-pandemic vulnerability and pandemic-related hardship had cumulative effects on psychological distress during the COVID-19 pandemic. Adequate and equitable responses to pandemics and disasters may require more intensive supports for those with multiple vulnerabilities.

Psychological outcomes for young adults after disastrous events: A mixed-methods scoping review

RATIONALE

Young adulthood (18 to 34) is a time of transitional change where individuals can be highly susceptible to mental health concerns. Despite similar vulnerabilities to their adolescent counterparts, the psychological outcomes for young adults following disasters are not well understood.

OBJECTIVE

This scoping review aimed to explore the literature on the psychological outcomes for young adults after disaster events.

METHODS

A systematic search of the literature was conducted in seven electronic databases, including PsycINFO, Medline, CINAHL, PILOTS, EMBASE, Scopus, and ProQuest dissertations and theses global. In total, 91 reports from 15 countries were included.

RESULTS

Findings suggested that young adults experience a range of psychological consequences after disasters, including posttraumatic stress symptoms, depression, anxiety, and other psychological outcomes, such as general/non-specific psychological distress. Pre-disaster, peri-disaster, and post-disaster factors were also found to influence the degree of psychological outcomes experienced by young adults, including prior psychological functioning and disaster exposure, among a host of other factors.

CONCLUSION

Future research is recommended to better understand young adults' psychological outcomes, experiences, and service needs following disasters.

Predictors of National and Community Resilience of Israeli Border Inhabitants Threatened by War and Terror

The present study investigates predictors of the national resilience (NR) and community resilience (CR) of civilians who live on Israel's northern border, and are facing for years acts of terror and threats of war. A sample of 1515 kibbutz (communal settlement) members who live next to this northern Israeli border has responded to questionnaires pertaining to the investigated resiliencies. Results indicate that under these conditions psychological reactions (trust in community institutes and individual resilience), rather than demographic characteristics, are the best predictors of NR and CR; although NR is further predicted by right-wing political attitudes. Our data suggest that CR and NR are not predicted by objective examinations of the strength of one's community or country. Both of them are perceived as stronger the greater the trust of the respondents in their own ability to cope with adversities, and in the ability of their close community to take care of them and their families in face of terror.

Temporal focus, emotions, and support for intergroup aggression

Emotions play an important role in conflict and aggression between groups. Two studies examined the link between temporal focus (past vs. future) and emotion (anger vs. fear) in the context of the threat of terrorism. Study 1 showed that manipulating emotion (fear vs. anger) in the context of terrorist threat against the United States induced different temporal foci. Fear elicited a future focus, whereas anger elicited a past focus. Study 2 manipulated temporal focus (past vs. future) and showed an increase in anger versus fear, respectively. These concordant emotional responses predicted support for intergroup aggression, as did political conservatism and beliefs in American superiority. Anger, but not fear, mediated the effect of past versus future framing on support for aggression. These results support temporal focus as a previously unconsidered but important determinant of the link between emotions and support for intergroup aggression.

Suicidal ideation and hopelessness in PTSD: spiritual well-being mediates outcomes over time

Background There is an increased interest in understanding the mechanisms through which post-traumatic stress disorder (PTSD) relates with hopelessness and suicidal ideation. Spiritual well-being could help explain the link between PTSD and both hopelessness and suicidal ideation in African Americans. However, no study has examined the mediational role of existential and religious well-being among these variables. Objectives To examine if initial levels of existential and religious well-being mediated the relation between levels of PTSD symptoms and prospective levels of hopelessness and suicidal ideation in a sample of African American females. Design The study used a longitudinal design with a 10-week time interval. Methods The sample comprised of 113 disadvantaged African American women survivors of a recent suicide attempt recruited from a southern hospital. Self-report measures of PTSD symptoms, hopelessness, suicidal ideation, and spiritual well-being were administered to examine the variables of interest. Bootstrapping techniques were used to test the mediational models. Results Existential, but not religious well-being, mediated the relationship between levels of PTSD symptoms severity and both levels of hopelessness and suicidal ideation over time. Conclusions Existential well-being appears to play a promising protective role against the negative effects of PTSD on both hopelessness and suicidal ideation.

Children's Mental Health in the Context of Terrorist Attacks, Ongoing Threats, and Possibilities of Future Terrorism

Over the past two decades, the field has witnessed tremendous advances in our understanding of terrorism and its impacts on affected youth. It is now well established that a significant proportion of exposed youth show elevated PTSD symptoms in the months following a terrorist attack. In more recent years, research has expanded beyond confirming our understanding of the association between direct terrorism exposure and child PTSD symptoms by elucidating (a) links between terrorism exposure and non-PTSD clinical outcomes (e.g., externalizing problems, substance use), (b) individual differences associated with divergent patterns of risk and resilience, (c) the clinical correlates of media-based contact with terrorism, (d) clinical outcomes associated with exposure to recurrent terrorist attacks, and (e) exposure to extended contexts of uncertainty and the possibilities of future terrorism. Researchers studying the effects of terrorism and political violence on youth have increasingly examined a much broader range of regions in the world, affording needed opportunities to consider the generalizability of prior findings to youth living in different political contexts, in less developed regions of the world, and/or in regions with different rates of recurrent terrorism. In order to understand and, in turn, best meet the clinical needs of the majority of terrorism-affected youth across the globe, more targeted research on exposed youth is needed in developing regions of the world and regions enduring more recurrent terrorist attacks.

Sense of coherence and gender as a predictor of the effect of laboratory induced stress on cognitive performance

The current experimental study examined sense of coherence (SOC) as a predictor of the effect of induced stress (time limit and posing a threat) on the level of overall cognitive performance (based on three subscales: mathematics, shapes, and analogies). Results indicated the following: (a) induced stress (experimental group, n = 80) scored lower on the overall cognitive score, compared to the no-stress (control group, n = 81); (b) subjects in the stress group with higher SOC performed better on the overall cognitive score, compared to subjects with lower SOC; however, in the no-stress group there was no significant effect of SOC on cognitive performance;

Optimism as a predictor of the effects of laboratory-induced stress on fears and hope

The objective of the current study is to explore optimism as a predictor of personal and collective fear, as well as hope, following laboratory-induced stress. Students (N = 107; 74 female, 33 male) were assigned randomly to either the experimental (stress--political violence video clip) or the control group (no-stress--nature video clip). Questionnaires of fear and hope were administered immediately after the experiment (Time 1) and 3 weeks later (Time 2). Structural equation modeling indicated the following: (a) Optimism significantly predicted both fear and hope in the stress group at Time 1, but not in the no-stress group. (b) Optimism predicted hope but not fear at Time 2 in the stress group. (c) Hope at Time 1 significantly predicted hope at Time 2, in both the stress and the no-stress groups. (d) Gender did not predict significantly fear at Time 1 in the stress group, despite a significant difference between genders. This study supports previous studies indicating that optimism plays an important role in people's coping with stress. However, based on our research the data raise the question of whether optimism, by itself, or environmental stress, by itself, may accurately predict stress response.

Elderly people coping with the aftermath of war: resilience versus vulnerability

OBJECTIVES

The present study compares coping of elderly people and two younger groups 1 year after a war. Coping was determined by stress symptoms and posttraumatic recovery and two levels of resiliency.

DESIGN AND SETTING

Thirty-six streets (covering most of the city streets) were sampled randomly from the map of Kiryat Shemona (a town next to the Lebanese border) about a year after the end of the Second Lebanon War.

PARTICIPANTS

The sample constituted 870 adult residents of the town. Participants were divided into three age groups: elderly (age 65 years and older, N = 108), adults (age 46-64 years, N = 252) and young adults (age 20-45 years, N = 462).

MEASUREMENTS

1) Stress symptoms measured by short version of Brief Symptom Inventory; 2) Individual resilience measured by Sense of Coherence Inventory; 3) Posttraumatic Recovery Inventory (PTR); and 4) Public Resilience Scale (included a scale for community and national resilience).

RESULTS

The results indicated 1) The elderly group reported significantly higher levels of stress symptoms and lower levels of PTR; 2) Females in the three age groups reported higher levels of stress symptoms and lower levels of PTR and individual resilience than males; 3) Individual and public resilience negatively predicted stress symptoms and positively predicted posttraumatic recovery across three age groups; and 4) Public resilience has a differential effect on stress symptoms in each of the three age groups but not on PTR.

CONCLUSION

Results question the division of older people into a vulnerable or inoculated group, indicating that the participants responded concurrently in a more vulnerable and a more resilient manner. Older people were characterized by higher levels of postwar stress symptoms, as well as a higher sense of coherence.

Evaluating risk factors and possible mediation effects in posttraumatic depression and posttraumatic stress disorder comorbidity

OBJECTIVES

On September 11, 2001 (9/11), attacks on the World Trade Center (WTC) killed 341 Fire Department of the City of New York (FDNY) firefighters and injured hundreds more. Previous WTC-related studies reported high rates of comorbid depression and posttraumatic stress disorder (PTSD), identifying disability retirement, alcohol use, and early arrival at the WTC site as correlates. However, those studies did not evaluate risk factors that could have mediated the observed comorbidity. We identified unique risk factors for each condition in an effort to better understand comorbidity.

METHODS

We screened retired WTC-exposed firefighters using self-administered questionnaires including the Center for Epidemiologic Studies Depression Scale, the Post Traumatic Stress Disorder Checklist, and the Alcohol Use Disorders Identification Test. We performed regression analyses to compare independent predictors of elevated depression and PTSD risk, and also tested a mediation hypothesis.

RESULTS

From December 2005 to July 2007, 23% and 22% of 1,915 retirees screened positive for elevated depression and PTSD risk, respectively, with comorbidity > 70%. Controlling for comorbidity, we identified unique risk factors for (1) depression: problem alcohol use and (2) PTSD: early arrival at the WTC site.

CONCLUSIONS

Our data support the premise that PTSD and depression are different responses to trauma with unique risk factors. The data also suggest a hypothesis that PTSD mediates the relationship between early WTC arrival and depression, while depression mediates the relationship between alcohol use and PTSD, a more complex relationship than shown in previous studies. Clinicians should consider these factors when evaluating patients for depression and PTSD.

Postwar winners and losers in the long run: determinants of war related stress symptoms and posttraumatic growth

The study focuses on the long-term impact of war on adolescents (N = 821) and adults (N = 870) living in a war afflicted Israeli community a year after the war. Results indicate the following: (a) stress symptoms and posttraumatic growth (PTG) correlate negatively with each other. (b) Age was positively associated with stress symptoms and negatively with PTG. (c) Economic condition predicted stress symptoms as well as PTG of adults better than exposure to traumatic events, whereas for school students the best predictor of stress symptoms was exposure to traumatic events while the best predictor of PTG was age of participants.