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Mayer Y, Shiffman N, Bergmann E, Natoor M, Khazen S, Lurie I, Enav Y. Mental Health Outcomes of Arab and Jewish Populations in Israel a Month after the Mass Trauma Events of October 7, 2023: A Cross-Sectional Survey of a Representative Sample. Psychiatry Res 2024; 339:116042. [PMID: 38945101 DOI: 10.1016/j.psychres.2024.116042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 07/02/2024]
Abstract
On October 7, 2023, a war erupted in Israel following a mass terror attack including mass shootings, violent events, civilian abductions, and numerous fatalities, ranking as the third most deadliest terror attack. This cross-sectional, population-based study evaluated the impact on the mental health and utilization of mental health services in the Arab and Jewish populations. Conducted through a virtual platform, the study compared demographic factors, exposure to war-related events, anxiety, and post-traumatic stress symptoms among 517 participants in a representative sample of the adult population in Israel (79.1% Jewish, 20.9% Arab). Jews reported higher exposure to war-related events, but a majority expressed a lack of interest in mental help. In contrast, more Arabs desired mental help but faced barriers like stigma and scarce resources. Arabs showed a greater preference for group therapy and medical treatment. Trust in official bodies was consistently higher among Jews. Both populations exhibited similar levels (12-15.4%) of probable post-traumatic stress disorder (PTSD). This study equips clinicians, researchers and policymakers with real-time insights into improving mental health support for the culturally diverse needs of Jewish and Arab communities following exposure to mass trauma.
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Affiliation(s)
- Yael Mayer
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel.
| | - Noga Shiffman
- Mental Health Center, Mayanei HaYeshua Medical Center, Bnei Brak, Israel
| | - Eyal Bergmann
- Psychiatry and Mental Health Division, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Maha Natoor
- Department of Sociology and Anthropology, Tel Aviv University
| | - Sammar Khazen
- Psychiatry and Mental Health Division, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Ido Lurie
- Shalvata Mental Health Center, Hod Hasharon, Israel; Department of Psychiatry, School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Enav
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel
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Groweiss Y, Blank C, Hamdan S, Neria Y, Levi-Belz Y. The mental health impact of the October 7th terror attack on Jews and Arabs in Israel: A nationwide prospective study. Psychiatry Res 2024; 337:115973. [PMID: 38776726 DOI: 10.1016/j.psychres.2024.115973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/14/2024] [Accepted: 05/18/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION On October 7, 2023, Israeli citizens came under an unprecedented terrorist attack that impacted the entire country. Recent research has begun to document the mental health impact of the attack but has yet to address the question of whether the attack had a differential impact across ethnic communities. In this nationwide prospective cohort study, we aimed to determine possible differences in psychopathology between Jews and Arabs in the post-October 7th attack. Specifically, we aimed to understand the role ethnicity may play in changes in probable PTSD, depression, and anxiety diagnoses from pre- to post-attack. METHODS The sample comprised 656 participants (332 female, 50.7%) aged 18-85 (M = 41.01, SD = 13.72). Of this cohort, 557 participants (84.9%) were Jews, and 99 (15.1%) were Arabs, reflecting their national proportionality. Validated self-report questionnaires were completed to assess PTSD, depression, and anxiety at two time points: August 20 to 30th, 2023 (T1; 6-7 weeks before the attack) and November 9-19, 2023 (T2; 5-6 weeks after the attack). RESULTS At T2, Arab Israeli participants reported significantly higher prevalences of probable PTSD, depression, and anxiety diagnoses than Jewish Israeli participants. A series of hierarchical logistic regressions revealed that, compared with Jews, Arab participants presented with higher prevalence of probable PTSD (OR = 2.53 95% CI = 1.46-4.37, p < 0.0001), depression (OR = 1.68 95% CI = 1.35-3.01, p < 0.0001) and anxiety (OR = 6.42 95% CI = 3.95-10.52, p < 0.0001), controlling for prevalences of probable diagnoses at T1 as well as for trauma-related variables. DISCUSSION Citizens belonging to the Arab ethnic minority in Israel were found to be at higher risk for psychopathology in the aftermath of the October 7, 2023, terrorist attack compared with their Jewish majority counterparts. Thus, it becomes critical to employ culturally sensitive assessments and interventions following the attack to prevent the development of chronic symptoms and disorders.
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Affiliation(s)
- Yoav Groweiss
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - Carmel Blank
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel; Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - Sami Hamdan
- School of Behavioral Sciences, the Academic College of Tel-Aviv Yaffo (MTA), Tel-Aviv, Israel
| | - Yuval Neria
- Department of Psychiatry and New York State Psychiatric Institute, Columbia University Irving Medical Center, NY, USA
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel; Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel.
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A 20-years+ review of the Stanford Acute Stress Reaction Questionnaire (SASRQ): Psychometric properties and findings. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100269] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Tannous-Haddad L, Hadar-Shoval D, Alon-Tirosh M, Asraf K, Tzischinsky O. Difference between Minorities and Majorities in the Association between COVID-19-Related Stress and Psychological Distress: A Socio-Ecological Perspective and the Moderating Role of Parenthood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8283. [PMID: 35886135 PMCID: PMC9317738 DOI: 10.3390/ijerph19148283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/28/2022]
Abstract
This study introduces a socio-ecological perspective of differences in psychological distress between the Palestinian minority and Jewish majority citizens of Israel during lockdown due to COVID-19. The study examines the association between COVID-19-related stress and psychological distress, and the moderating effect of parenthood. Online questionnaires, completed by 1934 participants (1391 Jews, 552 Palestinians; 1306 parents, 637 without children; 54.86% female, 45.13% male; M age = 40.38, SD = 13.77) assessed COVID-19-related stressors and depression, anxiety, and stress. The Palestinian minority showed a higher level of COVID-19-related stress and psychological distress than the Jewish majority. Parenthood showed a moderating effect on the association between COVID-19-related stress and distress for the Jewish majority but not the Palestinian minority. The results emphasize the significance of considering social status when seeking to understand the differences between minorities and majorities in terms of distress and resilience during pandemic events, and the need for cultural sensitivity and awareness when issuing instructions in such circumstances. Additionally, the results highlight the potential role of parenthood as a resilience factor, depending upon social status.
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Affiliation(s)
- Lubna Tannous-Haddad
- Behavioral Sciences Department, The Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel; (L.T.-H.); (M.A.-T.)
| | - Dorit Hadar-Shoval
- Psychology Department, The Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel;
| | - Michal Alon-Tirosh
- Behavioral Sciences Department, The Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel; (L.T.-H.); (M.A.-T.)
| | - Kfir Asraf
- Psychology Department, The Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel;
| | - Orna Tzischinsky
- Educational Counseling Department, The Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel;
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Hassan-Abbas NM. Resilience and Risk Factors Predict Family Stress Among Married Palestinians in Israel During the COVID-19 Pandemic. Front Psychol 2022; 13:913330. [PMID: 35814105 PMCID: PMC9263590 DOI: 10.3389/fpsyg.2022.913330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
The present study examined effects of sociodemographic, risk, and resilience factors on marital, parental, and financial stress early in the COVID-19 pandemic. A cross-sectional online survey was conducted among 480 married Palestinians living in Israel, using self-report questionnaires. Descriptive statistics and bivariate correlations were computed. Then, hierarchical multiple regression analyses were conducted to predict each of the three stress measures. Finally, dominance analyses were conducted to compare the contributions of sociodemographic, risk, and resilience factors. The results showed considerable differences between predictors of marital and parental stress and predictors of financial stress. For marital and parental stress, resilience factors mainly family resilience were the strongest predictors, followed by risk factors and then sociodemographic characteristics. For financial stress, risk factors (mainly financial damage and prior stressful life events) were the strongest predictors, followed by sociodemographic characteristics and resilience factors (mainly individual resilience). These results suggest that family and individual resilience reduce marital and parental stress under difficult conditions, including the COVID-19 pandemic. Though resilience has been found to ameliorate financial stress to some extent, it appears that other measures are required to manage stress related to financial difficulties.
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Affiliation(s)
- Niveen M. Hassan-Abbas
- Department of Special Education and Psychology, Department of Behavioral Sciences, Zefat Academic College, Safed, Israel
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“In the Middle, between Anxiety Victims and PTSD, There Are People That Have Some Kind of a Disorder That Has No Name Yet” Insights about the Traumatic Stress Consequences of Exposure to Ongoing Threat. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Current diagnostic criteria for post-traumatic stress disorder (PTSD) do not include symptoms resulting from exposure to ongoing traumatic stress. Thus, existing assessment tools do not fully capture stress symptoms associated with exposure to threats that extend over months or years. We aimed to enumerate the symptoms associated with ongoing exposure to stress and to evaluate the need for a new comprehensive tool designed to assess traumatic stress in these situations. Study methods included focus group sessions, interviews, and a content expert’s workshop. Thematic analysis yielded three main themes: 1. PTSD in its current definition does not capture the whole “traumatic picture” observed in ongoing exposure to threat, 2. Some DSM-5 criteria are not applicable in ongoing exposure to threat, 3. The need for a new tool or modifications of commonly used assessment tools. This study supports the notion that PTSD assessment practices are lacking when assessing traumatic stress in ongoing exposure to threat and highlights the need for a new tool specifically designed for these situations.
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Marciano H, Kimhi S, Eshel Y. Predictors of individual, community and national resiliencies of Israeli Jews and Arabs. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2019; 55:553-561. [PMID: 31792956 DOI: 10.1002/ijop.12636] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 11/11/2019] [Indexed: 11/08/2022]
Abstract
The contribution of individual characteristics to predicting individual, community and national resilience of Israeli Jews and Arabs was investigated. Psychological resilience refers to people's assessment of their ability to withstand negative psychological consequences of major afflictions, and to keep functioning despite these adversities. The following hypotheses were examined: 1. The Jewish sample would score higher than the Arab sample on indices of individual, community and national resilience. 2. Men of both groups would score higher compared with women on these resilience indices. 3. Exposure to terror and fear of upcoming war would negatively predict the resilience of both groups. 4. Higher level of religiosity, right wing political attitudes, higher income, higher education, older age and higher sense of coherence will positively predict the investigated resiliencies. The random sample included 1100 Jews and 350 Arabs who participated in an internet survey. Resilience was defined in this study as the balance of individual, community and national strength (protective factors) to vulnerability (risk factors). The results supported the first three hypotheses whereas the fourth hypothesis was supported only for the Jewish sample. The present study indicated that some predictors had universal effect on resilience, whereas others seemed to be culture specific predictors.
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Affiliation(s)
- Hadas Marciano
- Department of Psychology, Tel Hai College, Qiryat Shemona, Israel.,Ergonomics and Human Factors Unit, University of Haifa, Haifa, Israel
| | - Shaul Kimhi
- Department of Psychology, Tel Hai College, Qiryat Shemona, Israel
| | - Yohanan Eshel
- Department of Psychology, Tel Hai College, Qiryat Shemona, Israel
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Shechory Bitton M, Silawi Y. Do Jews and Arabs Differ in Their Fear of Terrorism and Crime? JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:4041-4060. [PMID: 29294612 DOI: 10.1177/0886260516674198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The current study was carried out with the aim of supplementing the existing literature and broadening the understanding of the determinants of two powerful types of fear, fear of terrorism and fear of crime, by comparing their presence among Jews and Arabs in Israel. Based on an overview of factors influencing fear of victimization, the study focused on individual variables (ethnicity, sex, age, objective, and subjective exposure) as well as on neighborhood disorder and social integration. The sample consisted of 375 Israeli students (191 Jews and 184 Arabs). Predictions of fear of terrorism and crime were conducted with two multiple regressions. Fear of terrorism was significantly predicted by gender (women more than men), higher self exposure to terror, and higher neighborhood disorder. The only interaction found with regard to exposure to incidents showed that previous victimization predicts only fear of terrorism and only among Arabs who were themselves affected or exposed to the victimization of others. Fear of crime was predicted by sector (Jews more than Arabs), gender (women more than men), higher neighborhood disorder, and lower social integration. As far as known, this is the first attempt to examine differences between Jews and Arabs with regard to these two types of fear and to predict their causes. The findings help gain a better understanding as to how people perceive the threat of crime and terrorism, in general and in the Arab-Jewish context in particular. The findings also enable an understanding of the complexity of living under ongoing terrorism threats. The results are discussed in accordance with the literature, concluding with the need for further research that will take into account the wider cultural and social context.
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Braun-Lewensohn O, Kalagy T. Between the Inside and the Outside World: Coping of Ultra-Orthodox Individuals with Their Work Environment After Academic Studies. Community Ment Health J 2019; 55:894-905. [PMID: 30843121 DOI: 10.1007/s10597-019-00392-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 03/01/2019] [Indexed: 02/05/2023]
Abstract
This study has explored how ultra-Orthodox individuals cope when facing secular norms and values in their work environment. The study was conducted in Israel, where 614 ultra-Orthodox adults answered questions regarding demographic characteristics, identities, openness to the workplace, social environment, Brief Cope, community sense of coherence (CSOC) and Employee Satisfaction Inventory. Individuals in the main sectors of the ultra-Orthodox society reported higher CSOC and stronger religiosity while individuals from the minor sectors reported greater openness to the job's social environment. Demographics, coping strategies and CSOC were significant in explaining job satisfaction. The results will be discussed based on stress and coping theories and on the salutogenic theory.
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Affiliation(s)
- Orna Braun-Lewensohn
- Conflict Management & Resolution Program, Department of Interdisciplinary Studies, Ben Gurion University, POB 653, Beer Sheva, Israel.
| | - Tehila Kalagy
- Conflict Management & Resolution Program, Department of Interdisciplinary Studies, Ben Gurion University, POB 653, Beer Sheva, Israel
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Makhoul Khoury S, Ben-Zur H, Ben-Arush M. Mastery and social support moderate the effects of educational level on adjustment of Arab mothers of children diagnosed with cancer. Eur J Cancer Care (Engl) 2018; 27:e12906. [PMID: 30144209 DOI: 10.1111/ecc.12906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 05/22/2018] [Accepted: 07/10/2018] [Indexed: 11/28/2022]
Abstract
The study explored the adjustment of Arab mothers of children diagnosed with cancer, as shown by the mothers' distress and quality of life. The aim was twofold: to examine the associations between educational level, psychosocial resources and adjustment indices and to assess the moderating effects of psychosocial resources on the education and adjustment association. The sample consisted of 100 Arab mothers who completed questionnaires assessing demographic and illness variables, mastery, social support, psychological distress and quality of life. High levels of education and psychosocial resources contributed to low distress and high levels of quality of life. Mastery and social support moderated the effects of education on adjustment: Under low levels of education, higher mastery was related to lower distress and higher quality of life, and higher social support was related to lower distress. Education, mastery and social support are important resources in the context of adjustment to cancer. In addition, psychosocial resources are important factors for adjustment under low levels of education and should be taken into consideration when developing intervention programmes for Arab parents coping with their child's cancer.
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12
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Palgi Y. Subjective age and perceived distance-to-death moderate the association between posttraumatic stress symptoms and posttraumatic growth among older adults. Aging Ment Health 2016; 20:948-54. [PMID: 26028224 DOI: 10.1080/13607863.2015.1047320] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Little research has addressed the association between posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG) in the second half of life. This study examined whether subjective age and perceived distance-to-death moderate this association. METHOD 339 community-dwelling older adults (age range 50-90; M = 65.44, SD = 9.77) were sampled through random dialing to Jewish residents in the south of Israel. Participants completed a phone-questionnaire on PTS symptoms, level of PTG, subjective age, and perceived distance-to-death. RESULTS Higher levels of PTS symptoms were both linearly and curvilinearly related to higher PTG. Additionally, subjective age and perceived distance-to-death moderated this association in a linear way, so that the association was strongest in participants who reported younger subjective age and further distance-to-death. DISCUSSION The findings emphasize the moderating effect of two time perspectives, one that focuses on time since birth and another that concerns the time that remains before death. These two perspectives affect the association between posttraumatic stress and posttraumatic growth within older individuals.
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Affiliation(s)
- Yuval Palgi
- a Department of Gerontology, the Center for Research and Study of Aging , University of Haifa , Haifa , Israel
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13
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Shpigelman CN, Gelkopf M. The experiences and needs of individuals with disabilities exposed to chronic political violence. Disabil Rehabil 2016; 39:23-35. [DOI: 10.3109/09638288.2016.1138557] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Marc Gelkopf
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Predictors of the new criteria for probable PTSD among older adults. Psychiatry Res 2015; 230:777-82. [PMID: 26586141 DOI: 10.1016/j.psychres.2015.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/12/2015] [Accepted: 11/05/2015] [Indexed: 11/24/2022]
Abstract
The definition of post-traumatic stress disorder (PTSD) changed in the fifth edition of the Diagnostic and Statistical Manual (DSM-5) and it is yet unclear how these changes affect the diagnosis of PTSD among older adults. The present study examined the contribution of demographic characteristics, functioning status, health related factors, as well as exposure to rocket attacks to prediction of probable PTSD in older adults. Three-hundred and thirty-nine community-dwelling adults (age range 50-90; M=65.44, SD=9.77) were sampled through random dialing to Jewish residents in the south of Israel. Participants completed a phone-questionnaire that collected background information and reports of relevant symptoms. Analyses showed that self-rated health, incidence of depression episodes, and exposure to rocket attacks predicted the DSM-5 definition of PTSD as well as the subscale of negative alternations in cognition and mood. The current study delineates the unique set of predictors of probable PTSD in older adults, with an emphasis on negative alternations in cognition and mood. Greater attention to unique predictors of PTSD in the second half of life is called for.
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Plotkin-Amrami G, Brunner J. Making up 'national trauma, in Israel: From collective identity to collective vulnerability. SOCIAL STUDIES OF SCIENCE 2015; 45:525-545. [PMID: 26502658 DOI: 10.1177/0306312715589846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We sketch a variety of institutional, discursive, professional, and personal 'vectors', dating back to the 1980s, in order to explain how 'national trauma' was able to go from a cultural into a professional category in Israeli mental health during the Al-Aqsa Intifada (2000-2005). Our genealogy follows Ian Hacking's approach to transient mental illnesses, both illustrating its fertility and expanding its horizon. Thus, we also explore the dynamics that developed in the Israeli mental health community with the advent of 'national trauma': while the vast majority of Israeli psychologists and psychiatrists did not adopt the category, they embraced much of its underlying logic, establishing a link between Israeli identity and the mental harm said to be caused by Palestinian terror. Remarkably, the nexus of national identity and collective psychic vulnerability also prompted the cooperation of Jewish and Palestinian-Israeli mental health scholars seeking to explore the psychological effect that the minority status of Israeli Palestinians had on them during the Al-Aqsa Intifada.
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Massey Z, Chartier KG, Stebbins MB, Canetti D, Hobfoll SE, Hall BJ, Shuval K. Explaining the frequency of alcohol consumption in a conflict zone: Jews and Palestinians in Israel. Addict Behav 2015; 46:31-8. [PMID: 25777746 DOI: 10.1016/j.addbeh.2015.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 02/02/2015] [Accepted: 02/09/2015] [Indexed: 01/21/2023]
Abstract
Experiencing stress and exposure to terrorism may have an adverse effect on health risk behaviors. Few studies have examined alcohol use among adults living in Israel under chronic, stressful terrorism-related conditions. In this study, we examined the relationships of demographics, past stressful events, and terrorism exposure to the frequency of alcohol use and the mediating roles of depressive and post-traumatic stress disorder (PTSD) symptoms. We used three waves of data from a 2007-2008 nationally representative sample of Jewish and Palestinian adults in Israel. We assessed past stressful events, in addition to direct and indirect exposures to terrorism. Results indicated that past stressful events and exposure to terrorism were not directly associated with alcohol use, but were indirectly associated and mediated by depressive and PTSD symptomology. Mental health symptoms were differentially associated with alcohol use. More frequent drinking was mediated by higher levels of depression, including for women and Palestinians; however, PTSD symptom severity was related to less frequent drinking. Mental health may play a prominent role in the frequency of alcohol use among adults exposed to terrorism in Israel. Alcohol use, as a coping mechanism, may differ by demographic characteristics (gender and ethnicity) and psychological symptomology for adults living in a conflict zone in Israel.
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Affiliation(s)
- Zohar Massey
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
| | - Karen G Chartier
- Virginia Commonwealth University School of Social Work, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; The University of Texas School of Public Health, Dallas Regional Campus, Dallas, TX 75390, USA.
| | - Mary B Stebbins
- Virginia Commonwealth University School of Social Work, Richmond, VA, USA; Longwood University, College of Education and Human Services, Farmville, VA 23909, USA.
| | - Daphna Canetti
- University of Haifa, School of Political Science, Terrace Bldg., Haifa 3498838, Israel.
| | - Stevan E Hobfoll
- Rush University Medical Center, Department of Behavioral Sciences, Chicago, IL, USA.
| | - Brian J Hall
- University of Macau, Department of Psychology, Faculty of Social Sciences, Taipa, Macau, People's Republic of China; Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Kerem Shuval
- American Cancer Society, Intramural Research Department, 250 Williams St., Atlanta, GA 30303, USA; American Cancer Society, Intramural Research Department, 250 Williams St., Atlanta, GA 30303, USA.
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Palgi Y, Gelkopf M, Berger R. The inoculating role of previous exposure to potentially traumatic life events on coping with prolonged exposure to rocket attacks: A lifespan perspective. Psychiatry Res 2015; 227:296-301. [PMID: 25863821 DOI: 10.1016/j.psychres.2015.03.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 03/16/2015] [Accepted: 03/21/2015] [Indexed: 11/17/2022]
Abstract
Relatively little research have addressed the effect of prolonged exposure to rocket attacks with a lifespan perspective and only a handful of these studies focused on the effect of this exposure as a function of aging. The present study examined the effects of seven years of rocket attacks fired toward the south of Israel on adult participants of different ages. We examined whether potentially traumatic life events (PTLEs) unrelated to rocket attacks moderated the association between post-traumatic stress (PTS) symptoms and age. Data were obtained from a 2007 telephone survey using the Random Digit Dialing method and including 343 individuals (76.7% participation rate). Exposure to rockets, PTLEs, global distress, and post-traumatic symptomatology were assessed. Older age was associated with a higher level of PTS symptoms. Higher PTLE levels attenuated the association between age and PTS symptoms. Our results suggest that age is a risk factor for developing PTS symptoms under prolonged exposure to rocket attacks. However, previous levels of exposure to other negative events, as well as gender, appear to inoculate a person to stress, thus modulating the age-PTS association.
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Affiliation(s)
- Yuval Palgi
- Department of Gerontology, The Center for Research and Study of Aging, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838 Israel.
| | - Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa; and NATAL Center for the Treatment of Victims of Terror and War, Tel Aviv, Israel; NATAL Center for the Treatment of Victims of Terror and War, Tel Aviv, Israel
| | - Rony Berger
- Department of Emergency Medicine, PREPARED Center for Emergency Response Research, Ben Gurion University of the Negev, Beer-Sheba, Israel
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Palgi Y, Shrira A. A cross-cultural longitudinal examination of the effect of cumulative adversity on the mental and physical health of older adults. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2015; 8:172-179. [PMID: 25961862 DOI: 10.1037/tra0000056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Self-oriented adversity refers to traumatic events that primarily inflict the self, whereas other-oriented adversity refers to events that affect the self by primarily targeting others. The present study aimed to examine whether cultural background moderates the effects of self-oriented and other-oriented adversity on mental and physical health of older adults. Using longitudinal data from the Israeli component of the Survey of Health and Retirement, we focused on 370 Jews and 239 Arabs who reported their exposure to various adversities across the life span, and completed questionnaires regarding mental and physical health. Results showed that the effect of self-oriented adversity on health did not differ among Jews and Arabs. However, other-oriented adversity showed a stronger effect on Arabs' mental and physical health than on Jews' health. Our findings suggest that the accumulation of adverse events that affect the self by primarily targeting others may have a stronger impact in collectivist cultures than in individualist cultures.
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Affiliation(s)
| | - Amit Shrira
- Interdisciplinary Department of Social Sciences
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Berger R, Gelkopf M, Versano-Mor K, Shpigelman CN. Impact of exposure to potentially traumatic events on individuals with intellectual disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 120:176-188. [PMID: 25715185 DOI: 10.1352/1944-7558-120.2.176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study explored the prevalence of posttraumatic symptomatology (PTS) and functional problems among Israeli individuals with intellectual disability (ID) who live in supported residential care settings and who have been exposed to political violence. The sample included 196 residents exposed to chronic missile attacks and 91 residents with ID who were not exposed. Results showed PTS and functional problems to be higher in the exposed group compared to the nonexposed one, although still low compared to the general exposed population. Exposure was found to be related to PTS and functioning problems suggested individuals with ID are reactive to political violence, though the underlying mechanisms are not clear. Implications for research, caretakers, and policy are discussed.
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Gelkopf M, Haimov S, Lapid L. A community long-term hotline therapeutic intervention model for coping with the threat and trauma of war and terror. Community Ment Health J 2015; 51:249-55. [PMID: 25500978 DOI: 10.1007/s10597-014-9786-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 12/02/2014] [Indexed: 10/24/2022]
Abstract
Long-term tele-counseling can potentially be a potent intervention mode in war- and terror-related community crisis situations. We aimed to examine a unique long-term telephone-administered intervention, targeting community trauma-related crisis situations by use of various techniques and approaches. 142 participants were evaluated using a non-intrusive by-proxy methodology appraising counselors' standard verbatim reports. Various background measures and elements in the intervention were quantitatively assessed, along with symptomatology and functioning at the onset and end of intervention. About 1/4 of the wide variety of clients called for someone else in addition to themselves, and most called due to a past event rather than a present crisis situation. The intervention successfully reduced posttraumatic stress symptoms and improved functioning. Most interventions included psychosocial education with additional elements, e.g., self-help tools, and almost 60% included also in-depth processes. In sum, tele-counseling might be a viable and effective intervention model for community-related traumatic stress.
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Affiliation(s)
- Marc Gelkopf
- Department of Community Mental Health, University of Haifa, Mount Carmel, 31905, Haifa, Israel
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Weder N, García-Nieto R, Canneti-Nisim D. Peace, Reconciliation and Tolerance in the Middle East. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2014. [DOI: 10.2753/imh0020-7411390404] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Scrimin S, Moscardino U, Natour M. Socio-ecological correlates of mental health among ethnic minorities in areas of political conflict: a study of Druze adolescents in Israel. Transcult Psychiatry 2014; 51:209-27. [PMID: 24448558 DOI: 10.1177/1363461513520342] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Children and youths living in areas of political conflict are at increased risk of mental health problems, but little is known about psychosocial adjustment among ethnic minorities living in war-afflicted settings. This cross-sectional study used an ecological approach to investigate the unique contributions of child, family/social, and minority related factors as well as traumatic exposure and perceived discrimination to the mental health of 167 Druze adolescents in Northern Israel. Outcome measures included participants' self-reported posttraumatic stress disorder symptoms, psychological distress, and emotional and behavioral problems. Adolescents reported high indirect exposure, moderate discrimination, strong ethnic identity and high religious involvement. Regression analyses showed that female gender, number of traumatic events, and perceived discrimination were associated with more severe mental health outcomes. In addition, low social support and high religious involvement predicted increased PTSD symptom severity, while stronger ethnic identity was associated with less emotional and behavioral problems. Findings are discussed in terms of the cultural characteristics of the Druze community and highlight the need to consider additional stressors, such as discrimination, when working with ethnic minority youth in conflict zones.
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Gelkopf M, Hasson-Ohayon I, Bikman M, Kravetz S. Nature adventure rehabilitation for combat-related posttraumatic chronic stress disorder: a randomized control trial. Psychiatry Res 2013; 209:485-93. [PMID: 23541513 DOI: 10.1016/j.psychres.2013.01.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 01/21/2013] [Accepted: 01/25/2013] [Indexed: 11/19/2022]
Abstract
Chronic combat-related posttraumatic stress disorder (CR-PTSD) is a condition with many treatment barriers. Nature Adventure Rehabilitation (NAR) as a second line or as a supplemental intervention has the potential to overcome some of these barriers and incorporate aspects of successful treatment modalities for PTSD within an experiential learning paradigm. In a pre-post controlled trial, CR-PTSD veterans (n=22) underwent a 1-year NAR intervention compared to a waiting list (WL) control group (n=20). Posttraumatic symptoms (PTS), depression, functional problems, quality of life, perceived control over illness (PCI) and hope were measured by self report measures. PTS, emotional and social quality of life, PCI, hope and functioning improved significantly. Change in PTS was contingent upon change in PCI. The current study is the first to present NAR as a promising supplemental intervention for chronic CR-PTSD. NAR seems to work through a process of behavioral activation, desensitization, gradual exposure to anxiety evoking situations and gaining control over symptomatology.
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Affiliation(s)
- Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel; NATAL: The Israel Trauma Center for Victims of Terror and War, Tel Aviv, Israel
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Lassri D, Soffer-Dudek N, Lerman SF, Rudich Z, Shahar G. Self-Criticism Confers Vulnerability to Psychopathology in the Face of Perceived Stress Related to Missile Attacks: Three Longitudinal Studies. Int J Cogn Ther 2013. [DOI: 10.1521/ijct.2013.6.3.221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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The prevalence of full and partial posttraumatic stress disorder among people with severe mental illness in Israel. J Nerv Ment Dis 2013; 201:244-50. [PMID: 23407211 DOI: 10.1097/nmd.0b013e3182848d1e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Research has shown higher rates of trauma exposure and posttraumatic stress disorder (PTSD) among persons with severe mental illness (SMI). The aim of this study was to assess the prevalence of traumatic events and full and partial PTSD among people with SMI and their associations with trauma-related cognitions and depressive symptoms. A total of 122 persons with SMI were assessed for trauma exposure and PTSD. A subsample of 40 participants, 20 with PTSD and 20 without PTSD, were randomly selected, and their posttraumatic cognitions and depressive symptoms were assessed. The prevalence of traumatic events was 90%, and 19% met full diagnostic criteria for PTSD, and 20% had partial PTSD. The people with PTSD had more depressive symptoms and negative cognitions. PTSD in SMI is highly prevalent and underdiagnosed.
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Kira IA, Ashby JS, Lewandowski L, Alawneh AWN, Mohanesh J, Odenat L. Advances in Continuous Traumatic Stress Theory: Traumatogenic Dynamics and Consequences of Intergroup Conflict: The Palestinian Adolescents Case. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/psych.2013.44057] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Katz G, Grunhaus L, Deeb S, Shufman E, Bar-Hamburger R, Durst R. A comparative study of Arab and Jewish patients admitted for psychiatric hospitalization in Jerusalem: the demographic, psychopathologic aspects, and the drug abuse comorbidity. Compr Psychiatry 2012; 53:850-3. [PMID: 22197215 DOI: 10.1016/j.comppsych.2011.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 11/07/2011] [Accepted: 11/08/2011] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The influence of ethnicity on different aspects of psychiatric hospitalization is far from clear. THE AIM OF THE STUDY The main aim of the study was to compare the Arab and the Jewish inpatients, at the time of admission, for the demographic factors, severity of psychotic, and affective psychopathology and comorbid drug abuse rate. POPULATION, METHOD, AND TOOLS: Among 250 consecutively admitted patients in the Jerusalem Mental Health Center-Kfar Shaul Hospital, 202 Jews and 42 Arabs (aged 18-65 years) were examined within 48 hours after admission. The psychiatric diagnoses were made according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. For the differential measurement of psychopathologic severity, the following rating scales were used: 21-item Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Positive and Negative Syndrome Scale (PANSS), and Young Mania Rating Scale. Urine tests for Δ9-tetrahydrocannabinol (THC), cocaine, opiates, amphetamines, and methamphetamine were performed using the Sure Step TM kits (Applied Biotech, Inc, San Diego, CA, USA). The Structured Clinical Interview Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for drug abuse were applied based on self-report and results of urine analysis. RESULTS The comparison of the 2 population showed that among the Arab inpatients, there were more males (81% vs 67.4%; P < .005). No significant difference in psychiatric diagnosis was observed. The overall severity of positive symptoms (PANSS positive) in Arab group was higher, but only slightly so (P = .05). No significant difference was observed for total rates of PANSS negative subscale. The rates of PANSS-general were also similar. The Arab patients were significantly less depressive according to 21-item Hamilton Depression Rating Scale (P = .032), and the total score of Hamilton Anxiety Rating Scale for the Jewish group was significantly higher (P = .001). No significant difference in general severity of manic symptoms for 2 groups was detected according to Young Mania Rating Scale. The rate of comorbid drug abuse for Jewish inpatients was borderline higher (P = .068). CONCLUSIONS The issue of referral to psychiatric hospitalization could be culturally influenced; it may be the result of disparities in demographic, psychopathologic, and drug abuse comorbid presenting symptoms, which are demonstrated upon admission by patients of different ethnic origins.
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Affiliation(s)
- Gregory Katz
- The Jerusalem Mental Health Center-Kfar Shaul Hospital, Jerusalem, Israel.
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Lerman SF, Rudich Z, Shahar G. Does War Hurt? Effects of Media Exposure After Missile Attacks on Chronic Pain. J Clin Psychol Med Settings 2012; 20:56-63. [DOI: 10.1007/s10880-012-9313-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Schiff M, Pat-Horenczyk R, Benbenishty R, Brom D, Baum N, Astor RA. High school students' posttraumatic symptoms, substance abuse and involvement in violence in the aftermath of war. Soc Sci Med 2012; 75:1321-8. [PMID: 22727650 DOI: 10.1016/j.socscimed.2012.05.010] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 04/09/2012] [Accepted: 05/04/2012] [Indexed: 01/08/2023]
Abstract
This study examined one-year after effects of exposure to war events on adolescents' Posttraumatic Stress Symptoms (PTS) and risk behaviors (substance use and involvement in school violence). In addition, it addressed two potential vulnerability factors: at the micro level, it examined whether childhood trauma raised the vulnerability of Israeli adolescents to PTS and risk behaviors when exposed to war events. At the macro level, we explored whether ethnicity, i.e., being an Israeli Arab, is a vulnerability factor to PTS and risk behaviors. We used a representative sample of 7th to 11th grade students from the north of Israel that included 4151 students: 1800 Jewish (54.4% boys) and 2351 Arab (41.5% boys). We assessed exposure to war events and childhood traumatic events, PTS and PTSD, substance use (alcohol, cannabis, Ecstasy) and involvement in school violence. The findings revealed extensive exposure to war events among both Jewish and Arab students. A year after the war, its effects on adolescents were still manifested in PTS, and involvement in school violence and substance use. Exposure to child physical abuse was associated with higher levels of PTS symptoms, substance use and involvement in violence. Exposure to other traumatic events was also associated with greater PTS symptoms and involvement in violence but not with greater substance use. Arab students were a more vulnerable population. They reported higher PTS symptoms, more cannabis use and greater involvement in school violence than Jewish students. However, exposure to war events had similar effects on both Arab and Jewish students. We conclude that war effects include a broad range of psychological distress and risk behaviors that last long after the war ends, especially among youth who have experienced childhood trauma and high exposure to war-related stressors.
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Affiliation(s)
- Miriam Schiff
- The Hebrew University of Jerusalem, Paul Baerwald School of Social Work and Social Welfare, Jerusalem, Israel.
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Peleg O, Mass-Friedman M. Worry about terror among young adults living in ongoing security uncertainty. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2012; 48:407-21. [PMID: 22551319 DOI: 10.1080/00207594.2012.656126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of the current study was to investigate worry about terror as a mediating variable, with the exogenous variables being media viewing, differentiation of self, and trait anxiety, and the endogenous variables being somatic symptoms and perceptions of security-related stress. Participants were divided into two groups by age/academic level: 248 high school students and 191 university students. A pathway correlation model was used to investigate worry about terror as a mediating variable. The central finding was that worry about terror was a significant mediating variable in the relationship between the extent of media viewing following terror events and the level of perception of security-related stress. That is, young people who said they worried a lot reported a high level of stress relating to the terror events they saw covered in the media. In addition, trait anxiety was found to have an effect on stress perception only via the level of worry about terror. This means that high levels of stress are not experienced by all highly trait-anxious people, but only by those who suffer from higher levels of worry about terror.
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Affiliation(s)
- Ora Peleg
- Department of Counseling, The Academic College Emek Yezreel, near Afula, Israel.
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Thapa SB, Hauff E. Perceived needs, self-reported health and disability among displaced persons during an armed conflict in Nepal. Soc Psychiatry Psychiatr Epidemiol 2012; 47:589-95. [PMID: 21476014 PMCID: PMC3304067 DOI: 10.1007/s00127-011-0359-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 02/18/2011] [Indexed: 10/31/2022]
Abstract
BACKGROUND Most internally displaced persons (IDPs) live in low-income countries and have experienced war. Few studies have assessed their psychosocial needs and disability. We carried out a comprehensive assessment of perceived needs, self-reported health, and disability among IDPs in Nepal and examined factors associated with disability. METHOD A cross-sectional survey among 290 IDPs in Nepal was conducted between June and July 2003. We used the World Health Organization's Disability Assessment Schedule-II (WHO-DAS II) with additional local items to assess disability symptoms and a separate checklist to identify their perceived needs. Depression and anxiety symptoms were measured using the Hopkins Symptom Check List (HSCL-25), while the Posttraumatic Stress Disorder Checklist Civilian Version (PCL-C) was used to assess Posttraumatic Stress Disorder (PTSD) symptoms. RESULTS Different perceived needs such as financial help (70%), housing (40%), food and education for their children (20%) were expressed by the IDPs. Self-reported health status was strongly associated with distress and disability scores. Factors independently associated with disability were higher age, self-reported health, depression, anxiety but not PTSD. There was good correlation between WHO-DAS II and the locally identified items of disability measurement. CONCLUSIONS The reporting of findings only about psychiatric symptoms is insufficient in studying the mental health of displaced and potentially traumatized populations living in low-income countries. Assessments of perceived needs and factors associated with disability give a more comprehensive understanding of the underlying needs among crisis populations, and this can inform intervention programs. Depression and anxiety should be treated effectively to avoid disability.
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Affiliation(s)
- Suraj Bahadur Thapa
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Protective factors and predictors of vulnerability to chronic stress: A comparative study of 4 communities after 7 years of continuous rocket fire. Soc Sci Med 2012; 74:757-66. [DOI: 10.1016/j.socscimed.2011.10.022] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 09/18/2011] [Accepted: 10/17/2011] [Indexed: 11/20/2022]
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Itzhaki M, Bar-Tal Y, Barnoy S. Reactions of staff members and lay people to family presence during resuscitation: the effect of visible bleeding, resuscitation outcome and gender. J Adv Nurs 2011; 68:1967-77. [PMID: 22122510 DOI: 10.1111/j.1365-2648.2011.05883.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM This article is a report on a study conducted to examine the views of healthcare professionals and lay people regarding the effect of family presence during resuscitation on both the staff performing the resuscitation and the relatives who witness it. BACKGROUND Family presence during resuscitation is controversial. Although many professional groups in different countries have recently issued position statements about the practice and have recommended new policy moves, the Israel Ministry of Health has not issued guidelines on the matter. METHODS Study design is factorial within-between subjects. Data were collected in Israel in 2008 from a convenience sample of 220 lay people and 201 healthcare staff (52 physicians and 149 nurses) using a questionnaire based on eight different resuscitation scenarios and manipulating blood involvement and resuscitations outcome. Data were analysed using one-way analysis of variance. FINDINGS Overall, both staff and lay people perceived family presence during resuscitation negatively. Visible bleeding and an unsuccessful outcome significantly influenced both staff's and lay people's perceptions. Female physicians and nurses reacted more negatively to family presence than did male physicians and nurses; lay men responded more negatively than lay women. CONCLUSIONS Changing the current negative perceptions of family presence at resuscitation requires (a) establishing a new national policy, (b) educating healthcare staff to the benefits of the presence of close relatives and (c) training staff to support relatives who want to be present.
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Affiliation(s)
- Michal Itzhaki
- Department School of Health Professions, Tel Aviv University, Israel.
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The challenge of estimating PTSD prevalence in the context of ongoing trauma: the example of Israel during the Second Intifada. J Anxiety Disord 2011; 25:788-93. [PMID: 21543185 DOI: 10.1016/j.janxdis.2011.03.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2010] [Revised: 02/08/2011] [Accepted: 03/30/2011] [Indexed: 11/23/2022]
Abstract
Many studies attempt to gauge population prevalence of post traumatic stress disorder (PTSD) following a major catastrophe. However, little is known about the validity of these estimates in the increasingly common situation of ongoing trauma. During the period of the Second Intifada in Israel, which involved frequent and widespread terrorist attacks, several studies generated estimates of PTSD prevalence in the Israeli population, but yielded widely discrepant findings. A number of focused surveys using symptom checklists estimated population prevalence of PTSD or probable PTSD diagnosis at about 9%. However a large population health study conducted during this same time period using a structured diagnostic interview yielded a very low estimated prevalence of PTSD (0.5%). We examine methodological differences that might account for these striking discrepancies. Inherent limitations of both checklist and structured interview methods may be especially problematic in the context of ongoing trauma. Findings regarding PTSD and associated factors obtained during ongoing trauma should be interpreted with caution.
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Berger R, Gelkopf M. An intervention for reducing secondary traumatization and improving professional self-efficacy in well baby clinic nurses following war and terror: A random control group trial. Int J Nurs Stud 2011; 48:601-10. [DOI: 10.1016/j.ijnurstu.2010.09.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 09/04/2010] [Accepted: 09/07/2010] [Indexed: 10/19/2022]
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Zeidner M, Ben-Zur H, Reshef-Weil S. Vicarious life threat: An experimental test of Conservation of Resources (COR) theory. PERSONALITY AND INDIVIDUAL DIFFERENCES 2011. [DOI: 10.1016/j.paid.2010.11.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gagin R, Unger-Arnov Y, Shinan-Altman S, Tessler A. The suffering is similar--is the treatment equal? An intervention with Arab Terror injured. SOCIAL WORK IN HEALTH CARE 2011; 50:376-389. [PMID: 21614730 DOI: 10.1080/00981389.2011.556980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In the course of the last Intifada and during the Second Lebanon War, all citizens of Israel were exposed to waves of terrorism that claimed many people wounded and killed, unrelated to religious differences, age, gender, or nationality: Jews and Arabs suffered alike. The acts of terror exposed all inhabitants equally to injury, suffering, and the need to adjust. The professional literature attests that minority groups are at a higher risk of experiencing post-traumatic symptoms as a result of exposure to acts of terror. This article describes the treatment with terror injured, Jews and Arabs, in the frame of the project for terror victims at Rambam Medical Center, in cooperation with Operation Embrace. It also covers the project intervention with casualties of the shooting incident in the Arab town of Shefaram, with the cooperation of Shefaram Social Welfare department. The psycho-social work conducted with the injured, Jews and Arabs, emphasized their similarities, their common fate, and the fact that any of us could be injured in a terror act or a war. The suffering, the loss, and the hurt are common to us all. At the same time, the interventions referred to cultural differences and the diverse ways of coping with the aftermath of the events, based on values, faith, and outlook on life arising from cultural background.
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Affiliation(s)
- Roni Gagin
- Social Work Department, Rambam Medical Center, Haifa, Israel.
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Kaplan G, Glasser S, Murad H, Atamna A, Alpert G, Goldbourt U, Kalter-Leibovici O. Depression among Arabs and Jews in Israel: a population-based study. Soc Psychiatry Psychiatr Epidemiol 2010; 45:931-9. [PMID: 19777147 DOI: 10.1007/s00127-009-0142-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Accepted: 09/11/2009] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Depression is the second most common chronic disorder seen by primary care physicians. Risk factors associated with depression include medical and psychosocial factors. While in Israel, the rate and risk factors for depression are considered similar to those in other Western countries, population-based data are limited. The present study aims to estimate the prevalence of depression among Jews and Muslim Arabs, and to consider possible associations with demographic, socioeconomic, and health factors. METHODS The study group (N = 872) was equally divided according to ethnicity, gender, and age group. Depression was measured by the Harvard Department of Psychiatry National Depression Screening Day Scale (HANDS). RESULTS The rate of depression scores in the likely/very likely range was 2.5 times higher among Arabs than among Jews (24.9 vs. 10.6%; P < 0.001). Women were more likely to express symptoms of depressive episode than were men (22.0 vs. 13.6%; P = 0.001), and the depression rate increased with age, from 11.0% in the youngest group (26-35) to 25.0% in the oldest (P = 0.001). The rate of increase in depression by age was different for the genders, rising more steeply for women than for men. However, the age-gender differential was not identical for the two ethnic groups. The differences in depression prevalence between Arabs and Jews were maintained after controlling for confounding variables, except that when controlling for education, the difference between the ethnic groups was no longer significant. After adjusting for all variables in the analysis, no significant association remained between ethnicity and depression (OR = 0.80; 95% CI = 0.45-1.40).
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Affiliation(s)
- Giora Kaplan
- Unit for Mental Health Epidemiology and Research on the Psychosocial Aspects of Illness, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
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Peleg O. Worry about terror in Israel: differences between Jewish and Arab adolescents and young adults. INTERNATIONAL JOURNAL OF CHILDREN'S SPIRITUALITY 2010; 15:273-290. [DOI: 10.1080/1364436x.2010.520304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
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Nuttman-Shwartz O, Dekel R. Ways of coping and sense of belonging in the face of a continuous threat. J Trauma Stress 2009; 22:667-70. [PMID: 19908323 DOI: 10.1002/jts.20463] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study examined the contribution of ways of coping and sense of belonging to stress responses among students in a conflict zone. Students at a college situated in an area exposed to continuous threat were divided according to their place of residence: locations inside and outside of the conflict zone. Rate of posttraumatic stress disorder (PTSD) was similar to rates in previous studies conducted among Israelis who had been exposed to terror. Acceptance as a way of coping and sense of belonging contributed to reducing PTSD symptoms, whereas use of alcohol and seeking support contributed to increasing stress responses. The discussion examines the results in light of the literature on ways of coping and sense of belonging in the face of continuous threat.
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Gelkopf M, Berger R. A school-based, teacher-mediated prevention program (ERASE-Stress) for reducing terror-related traumatic reactions in Israeli youth: a quasi-randomized controlled trial. J Child Psychol Psychiatry 2009; 50:962-71. [PMID: 19207621 DOI: 10.1111/j.1469-7610.2008.02021.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since September 2000 Israeli children have been exposed to a large number of terrorist attacks. A universal, school-based intervention for dealing with the threat of terrorism as well as with terror-related symptoms, ERASE-Stress (ES), was evaluated in a male religious middle school in southern Israel. The program was administered by the homeroom teachers as part of the school curriculum. It consists of 12 classroom sessions each lasting 90 minutes, and included psycho-educational material, skill training and resiliency strategies delivered to the students by homeroom teachers. METHODS One hundred and fourteen 7th and 8th grade students were randomly assigned to the ES intervention or were part of a waiting list (WL). They were assessed on measures of posttraumatic symptomatology, depression, somatic symptoms and functional problems before and 3 months after the intervention or the WL period. RESULTS Three months after the program ended, students in the experimental group showed significant reduction in all measures compared to the waiting-list control group. CONCLUSIONS The ERASE-Stress program may help students suffering from terror-related posttraumatic symptoms and mitigate the negative effects of future traumatic experiences. Furthermore, a school-based universal program such as the ERASE-Stress may potentially serve as an important and effective component of a community mental health policy for communities affected by terrorism.
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Affiliation(s)
- Marc Gelkopf
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
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