Bereavement Responses among Palestinian Widows, Daughters and Sons Following the Hebron Massacre

In February 1994, an Israeli settler shot Muslim worshippers at the Ibrahime Mosque at Hebron, West Bank. Fifty-three people were killed, and 200 injured. The Derogatis Symptom Checklist-Revised (SCL-90-R), a 90-item 5-point self-administered discomfort scale was administered to all surviving widows ( n=23), daughters ( n=12), and sons ( n=26). Statistically significant different results occurred in 3 of 9 subscales. Widows scored higher somatization than the daughters, who scored higher than the sons. Daughters scored higher phobia than the widows, who scored higher than the sons. Widows scored higher anxiety than the daughters, who scored higher than the sons. Culturally-and-religiously-proscribed gender and familial roles appear to contribute to the different bereavement response patterns. No respondents sought professional mental health counseling.

Depression impairs learning, whereas the selective serotonin reuptake inhibitor, paroxetine, impairs generalization in patients with major depressive disorder

To better understand how medication status and task demands affect cognition in major depressive disorder (MDD), we evaluated medication-naïve patients with MDD, medicated patients with MDD receiving the selective serotonin reuptake inhibitors (SSRI) paroxetine, and healthy controls. All three groups were administered a computer-based cognitive task with two phases, an initial phase in which a sequence is learned through reward-based feedback (which our prior studies suggest is striatal-dependent), followed by a generalization phase that involves a change in the context where learned rules are to be applied (which our prior studies suggest is hippocampal-region dependent). Medication-naïve MDD patients were slow to learn the initial sequence but were normal on subsequent generalization of that learning. In contrast, medicated patients learned the initial sequence normally, but were impaired at the generalization phase. We argue that these data suggest (i) an MDD-related impairment in striatal-dependent sequence learning which can be remediated by SSRIs and (ii) an SSRI-induced impairment in hippocampal-dependent generalization of past learning to novel contexts, not otherwise seen in the medication-naïve MDD group. Thus, SSRIs might have a beneficial effect on striatal function required for sequence learning, but a detrimental effect on the hippocampus and other medial temporal lobe structures is critical for generalization.

Learning from negative feedback in patients with major depressive disorder is attenuated by SSRI antidepressants

One barrier to interpreting past studies of cognition and major depressive disorder (MDD) has been the failure in many studies to adequately dissociate the effects of MDD from the potential cognitive side effects of selective serotonin reuptake inhibitors (SSRIs) use. To better understand how remediation of depressive symptoms affects cognitive function in MDD, we evaluated three groups of subjects: medication-naïve patients with MDD, medicated patients with MDD receiving the SSRI paroxetine, and healthy control (HC) subjects. All were administered a category-learning task that allows for dissociation between learning from positive feedback (reward) vs. learning from negative feedback (punishment). Healthy subjects learned significantly better from positive feedback than medication-naïve and medicated MDD groups, whose learning accuracy did not differ significantly. In contrast, medicated patients with MDD learned significantly less from negative feedback than medication-naïve patients with MDD and healthy subjects, whose learning accuracy was comparable. A comparison of subject’s relative sensitivity to positive vs. negative feedback showed that both the medicated MDD and HC groups conform to Kahneman and Tversky’s (1979) Prospect Theory, which expects losses (negative feedback) to loom psychologically slightly larger than gains (positive feedback). However, medicated MDD and HC profiles are not similar, which indicates that the state of medicated MDD is not “normal” when compared to HC, but rather balanced with less learning from both positive and negative feedback. On the other hand, medication-naïve patients with MDD violate Prospect Theory by having significantly exaggerated learning from negative feedback. This suggests that SSRI antidepressants impair learning from negative feedback, while having negligible effect on learning from positive feedback. Overall, these findings shed light on the importance of dissociating the cognitive consequences of MDD from those of SSRI treatment, and from cognitive evaluation of MDD subjects in a medication-naïve state before the administration of antidepressants. Future research is needed to correlate the mood-elevating effects and the cognitive balance between reward- and punishment-based learning related to SSRIs.

Tomorrow's players under occupation: an analysis of the association of political violent with psychological functioning and domestic violence, among Palestinian youth

A 2005 survey of 2,328 youth (ages 12 to 18) in the West Bank, Palestine, revealed an association between exposure to politically violent events, domestic violence, and school violence and with psychological symptomatology. Results also found associations between family violence, family economic status, and psychological symptomatology. Respondents reported low levels of family functioning. Data revealed some geographic variability in experiences of politically violent events, domestic violence, school violence, and psychological symptomatology. Implications for practice are discussed.

Psychological symptomatology among Palestinian male and female adolescents living under political violence 2004-2005

The aim of the study was to investigate gender differences in relation to exposure to domestic violence, political violence, family relations and psychological symptomatology in Palestinian adolescents. The sample consisted of 1766 adolescents, males (54.1%) and females (45.9%), residents of West Bank cities subjected to violent political conflict. Participants completed a self-report questionnaire consisting of the following measures: demographic variables, domestic violence, political violence events, the McMaster Family Assessment Device, and the Brief Symptom Inventory (BSI) psychological symptomatology. Results indicated that whereas there was no significant difference in the level of exposure to political violence between boys and girls, female adolescents exhibited higher levels of psychological symptoms compared to their male counterparts. Girls also reported higher levels of exposure to domestic violence and lower levels of family function than boys.