Emotional impact of exposure to terrorism among young-old and old-old Israeli citizens

PTSD Symptoms and Sleep Quality of COVID-19 Patients During Hospitalization: An Observational Study from Two Centers

BACKGROUND

The outbreak of COVID-19 has developed into a pandemic. Data are required that specifically address the psychological consequences in COVID-19 confirmed patients. This study mainly aimed to examine posttraumatic stress disorder (PTSD) symptoms and sleep quality among COVID-19 confirmed patients during hospitalization.

METHODS

An observational study was conducted in two designated hospitals in Wuhan, China. Data were collected from 190 patients hospitalized with laboratory-confirmed COVID-19 infection between February 10, 2020 and March 13, 2020.

RESULTS

The mean age of the 190 confirmed patients was 55.7 years (SD = 13.7), of which 96 (50.5%) were female and 88 (46.3%) had family members or acquaintances infected with COVID-19. Lymphocytopenia was presented in 62 (32.6%) patients and 25 (13.2%) patients showed oxygen desaturation. The prevalence of high PTSD symptoms was 22.6% among the 190 patients. The median time from symptom onset to first medical visit and hospitalization was 2 days (IQR, 1-5) and 16 days (IQR, 10-27), respectively. Patients' PTSD symptoms were positively related to the time from symptom onset to first medical visit (r = 0.156, p < 0.05) and hospitalization (r = 0.181, p < 0.01). There were significant correlations between sleep quality and PTSD symptoms (r = 0.312-0.547, p < 0.01).

CONCLUSION

The prevalence of high PTSD symptoms was 22.6% among hospitalized COVID-19 patients. Early diagnosis and treatment of COVID-19 symptoms are beneficial to infected patients both physically and psychologically. With the recovery of physical symptoms, psychological intervention is desired to promote the trauma recovery in COVID-19 patients.

Existential Threat: Uncovering Implicit Affect in Response to Terror Reminders in Soldiers

Psychological science has a hard time assessing affective processes of the individuals that they may not recognize or do not like to report on. Here, the authors used the Implicit Positive and Negative Affect Test (IPANAT; Quirin et al., 2009) to investigate whether reminders of an existential threat induce unpleasant implicit affect in soldiers waiting for their deployment to a country with high levels of terrorist threat, Afghanistan. As expected, relative to reminding participants of a television evening, implicit negative affect was higher and implicit positive affect was lower after reminding participants of terror acts performed in different cities. No significant effects were found in self-reports of negative or positive affect. Our findings suggest that reminders of existential threat can elicit implicit negative affect that individuals may not report on explicitly and thus, validate the IPANAT as an easily applicable measure in emotional contexts.

A comparative study of psychotic and affective symptoms in Rwandan and Kenyan students

AIMS

War and conflict are known to adversely affect mental health, although their effects on risk symptoms for psychosis development in youth in various parts of the world are unclear. The Rwandan genocide of 1994 and Civil War had widespread effects on the population. Despite this, there has been no significant research on psychosis risk in Rwanda. Our goal in the present study was to investigate the potential effects of genocide and war in two ways: by comparing Rwandan youth born before and after the genocide; and by comparing Rwandan and Kenyan adolescents of similar age.

METHODS

A total of 2255 Rwandan students and 2800 Kenyan students were administered the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen. Prevalence, frequency and functional impairment related to affective and psychosis-risk symptoms were compared across groups using univariate and multivariate statistics.

RESULTS

Rwandan students born before the end of the genocide and war in 1994 experienced higher psychotic and affective symptom load (p's < 0.001) with more functional impairment compared with younger Rwandans. 5.35% of older Rwandan students met threshold for clinical high-risk of psychosis by the WERCAP Screen compared with 3.19% of younger Rwandans (χ 2 = 5.36; p = 0.02). Symptom severity comparisons showed significant (p < 0.001) group effects between Rwandan and Kenyan secondary school students on affective and psychotic symptom domains with Rwandans having higher symptom burden compared with Kenyans. Rwandan female students also had higher rates of psychotic symptoms compared with their male counterparts - a unique finding not observed in the Kenyan sample.

CONCLUSIONS

These results suggest extreme conflict and disruption to country from genocide and war can influence the presence and severity of psychopathology in youth decades after initial traumatic events.

Predictors of Posttraumatic Stress Symptoms and Association with Fear of Falling After Hip Fracture

OBJECTIVES

To determine whether fall-related hip fracture, alone or in the presence of Fear of Falling, is likely to induce PTSD in an elderly population.

DESIGN

A longitudinal prospective study of patients admitted for hip fracture.

SETTING

Eight St. Louis, Missouri, area hospitals.

PARTICIPANTS

Individuals aged 60 and older admitted for surgical hip fracture repair after a fall (N = 456).

MEASUREMENTS

Rates of partial and full posttraumatic stress disorder (pPTSD and fPTSD) were compared with rates of FoF. PTSD and FoF were assessed 4 and 12 weeks after surgery. Baseline characteristics including depression, stress, pain, cognitive functioning, and anesthesia type were also analyzed as potential predictors of PTSD symptoms 12 weeks after surgery.

RESULTS

No participants met criteria for fPTSD at 4 or 12 weeks, and rates of pPTSD were low 12 weeks after surgery (7.4%), in contrast to high rates of FoF symptoms at the same time point (58.5%). Higher ratings of stress and depressive symptoms at baseline were associated with higher levels of PTSD symptoms 12 weeks after surgery.

CONCLUSIONS

Hip fracture, despite its considerable morbidity, does not induce fPTSD and infrequently induces pPTSD. Individuals with higher rates of stress and depressive symptoms after hip fracture repair may be more likely to develop PTSD symptoms.

Which category of lifetime adversity accelerates physical impairment among Israeli older adults?

Preliminary evidence suggests that exposure to lifetime cumulative adversity is related to faster increase in physical impairment with time, especially when depressive symptoms are present. Nevertheless, it is still unclear whether different adversity categories accelerate impairment. The current study capitalized on the unique accounts of adversity available in the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel) by focusing on different categories of adversity, while accounting for their interaction with depressive symptoms in predicting trajectories of physical impairment (i.e., chronic medical conditions and disability). Data of 1665 participants (mean age = 63.08, SD = 10.04 at Wave 1) were drawn from the first three waves of SHARE-Israel. Respondents reported exposure to bereavement (e.g., experiencing the death of a spouse), war and terrorism (e.g., being wounded in terrorist attack), and victimization (e.g., being a victim of abuse or assault). Other measures assessed depressive symptoms, chronic medical conditions, and disability. Growth-curve models showed that bereavement and exposure to war and terrorism were related to specific measures of physical impairment. Moreover, three-way interactions showed that clinical level of depressive symptoms coupled with exposure to either bereavement or war and terrorism predicted a faster increase in chronic medical conditions and disability. The findings offer a differentiated outlook on the effect of adversity on age-related increase in physical impairment. Practitioners should consider that older adults previously exposed to bereavement, war and terrorism are at risk for a hastened physical decline, especially when they suffer from depressive symptoms.

Regular drinking may strengthen the beneficial influence of social support on depression: findings from a representative Israeli sample during a period of war and terrorism

BACKGROUND

Social support is consistently associated with reduced risk of depression. Few studies have investigated how this relationship may be modified by alcohol use, the effects of which may be particularly relevant in traumatized populations in which rates of alcohol use are known to be high.

METHODS

In 2008 a representative sample of 1622 Jewish and Palestinian citizens in Israel were interviewed by phone at two time points during a period of ongoing terrorism and war threat. Two multivariable mixed effects regression models were estimated to measure the longitudinal association of social support from family and friends on depression symptoms. Three-way interaction terms between social support, alcohol use and time were entered into the models to test for effect modification.

RESULTS

Findings indicated that increased family social support was associated with less depression symptomatology (p=<.01); this relationship was modified by alcohol use and time (p=<.01). Social support from friends was also associated with fewer depression symptoms (p=<.01) and this relationship was modified by alcohol use and time as well (p=<.01). Stratified analyses in both models revealed that the effect of social support was stronger for those who drank alcohol regularly than those who did not drink or drank rarely.

CONCLUSIONS

These findings suggest that social support is a more important protective factor for depression among regular drinkers than among those who do not drink or drink rarely in the context of political violence. Additional research is warranted to determine whether these findings are stable in other populations and settings.

Greater age-related decline in markers of physical, mental and cognitive health among Israeli older adults exposed to lifetime cumulative adversity

OBJECTIVES

This longitudinal investigation addressed whether and how lifetime cumulative adversity and depressive symptoms moderated age-related decline in markers of physical, mental, and cognitive health.

METHOD

1248 older adults (mean age = 62 at Wave 1) who completed the first two waves of the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel) reported on exposure to potentially traumatic life events, depressive symptoms, and three outcomes - disability, quality of life, and cognitive markers.

RESULTS

Age was related to greater functional decline in outcome measures across the two waves (i.e., increase in disability and decrease in quality of life and cognitive functioning). This age-related decline became stronger as lifetime adversity increased. A three-way interaction showed that the greatest age-related functional decline in outcome measures was especially salient among those with high level of lifetime adversity and high level of depressive symptoms.

CONCLUSION

Lifetime cumulative adversity is associated with a more noticeable process of age-related dysfunction across various markers of health. Although the majority of older adults are resilient to lifetime adversity, prevention and intervention programs should be aimed at mitigating the pronounced senescence observed when adversity accumulated to a large degree, and especially when it is accompanied with high level of distress.

Sense of threat and coping strategies of Israeli older adults during a military operation

To examine what levels of sense of threat functionally disabled older people experience during war and the coping strategies they use to protect themselves; to examine factors that explain their sense of threat and coping strategies. A convenience sample that included 138 respondents who were functionally disabled older adults and received homecare services. Face-to-face interviews were conducted using a structured questionnaire. The majority of respondents stayed in their homes during the military operation and used a shelter during part or all the times when there was rocket shelling. The findings showed that a variety of factors were significantly correlated with sense of threat and coping strategies; gender and education were significant in explaining sense of threat, and living arrangement was significant in explaining use of shelter; while number of children was significant in explaining frequency of staying at home during the military operation. However, Holocaust survivor status, formal and informal support, and functional status were insignificant in explaining any of the dependent variables. Holocaust survivors feel no more threat compared to those who did not experience the Holocaust. Communities should be prepared to provide emergency services to ease the sense of threat of functionally disabled older adults during wartime and to assure their use of shelter, in particular those who live alone.

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.