Biomedical subjects

Zahava Solomon

Publications and source records attributed to Zahava Solomon.

At least 19 recordsLinked to original sources

PubMed2006

Mental health and resiliency following 44 months of terrorism: a survey of an Israeli national representative sample.

BACKGROUND: Israeli citizens have been exposed to intense and ongoing terrorism since September 2000. We previously studied the mental health impact of terrorism on the Israeli population (Bleich et al., 2002), however the long-term impact of ongoing terrorism has not yet been examined. The present study evaluated the psychological sequelae of 44 months of terrorism in Israel, and sought to identify factors that may contribute to vulnerability and resilience. METHODS: This was a telephone survey using strata sampling of 828 households, which reached a representative sample of 702 adult Israeli residents (84.8% contact rate). In total, 501 people (60.5%) agreed to participate. The methodology was similar to that of our previous study. Exposure to terrorism and other traumatic events, number of traumatic stress-related symptoms (TSRS), percentage of respondents with symptom criteria for post-traumatic stress disorder (PTSD), traumatic stress (TS) resiliency and feelings of depression, anxiety, optimism, sense of safety, and help-seeking were the main outcome measures. RESULTS: In total, 56 participants (11.2%) were directly exposed to a terrorist incident, and 101 (20.2%) had family members or friends exposed. Respondents reported a mean +/- SD of 5.0 +/- 4.5 TSRS; 45 (9%) met symptom criteria for PTSD; and 72 (14.4%) were TS-resilient. There were 147 participants (29.5%) who felt depressed, 50 (10.4%) felt anxious, and almost half (235; 47%) felt life-threatening danger; 48 (9.7%) felt the need for professional help. Women and people of Arab ethnicity had more TSRS, more PTSD, and less TS resiliency. Injury following a life-threatening experience, a major stressful life event, and a major loss of income were associated with PTSD. Immigrant status, lower education, low sense of safety, low sense of social support, high societal distress, and injury following life-threatening experiences were associated with TSRS. TSRS did not increase with exposure severity. This study revealed less depression and functional impairment, similar rates of PTSD, increased help-seeking and poorer TSRS and TS resiliency than our initial study, 2 years previously. DISCUSSION: The response of people in Israel to 4 years of terrorism is heterogeneous. Vulnerability factors change over time; Arab ethnicity, immigrant status and less education, not found to be risk factors in our previous study, were found in the present study to contribute to trauma-related distress. Prior experience of highly stressful events increases vulnerability to adverse psychological effects of terror.

Adaptation, Psychological↗

PubMed2006

Secondary traumatization among wives of Israeli POWs: the role of POWs' distress.

BACKGROUND: The aim of the study is to examine secondary traumatization of wives of former prisoners of war (POWs) as manifested in posttraumatic stress disorder (PTSD) symptoms, additional psychiatric symptoms, and marital adjustment. In addition, it assessed the role of several contributors to the wives' secondary traumatization: the husband's PTSD, the level of his verbal and physical aggression, and the wife's level of self-disclosure. METHODS: The study compared three groups of Israeli wives: wives of POWs with PTSD (N=18), wives of POWs without PTSD, (N=64), and a control group of wives of veterans without PTSD (N=72). RESULTS: The highest level of distress in all measures was endorsed by the wives of POWs with PTSD. Moreover, in addition to husband's PTSD and captivity, both the man's aggression and the wife's self-disclosure played a role in the wife's level of distress. CONCLUSIONS: The findings show that the husbands' PTSD was more strongly associated with the wives' secondary traumatization than their captivity.

Adult↗

PubMed2006

Marital relations among former prisoners of war: contribution of posttraumatic stress disorder, aggression, and sexual satisfaction.

In this study, the authors examined the marital adjustment, spousal aggression, and sexual satisfaction of prisoners of war (POWs) 3 decades after their release. More specifically, the authors examined the extent to which impaired marital relations among former POWs are an outcome of their captivity or of the posttraumatic stress disorder (PTSD) that some of them developed. The authors compared 25 former POWs with PTSD, 85 former POWs without PTSD, and 104 control veterans. The findings reveal that the marital problems of former POWs are more related to PTSD than to their captivity. PTSD is related to decreased marital satisfaction, increased verbal aggression, and heightened sexual dissatisfaction among former POWs.

Adaptation, Psychological↗

PubMed2006

Reactions to combat stress in Israeli veterans twenty years after the 1982 Lebanon war.

During the war or shortly thereafter, the most common manifestation of combat induced psychopathology is combat stress reaction (CSR). The long-term consequences of CSR have so far received little scientific attention. The aim of this study was to examine whether CSR is a marker for long-term PTSD and other psychiatric comorbidities. Two groups of veterans from the 1982 Lebanon war were assessed 20 years after the war: one comprised 286 CSR casualties and the other comprised 218 matched non-CSR soldiers. Participants were assessed for PTSD, psychiatric symptomatology, social functioning, physical health, and postwar life events. Twenty years after the war, veterans with antecedent CSR reported more PTSD, psychiatric symptomatology and distress, social dysfunction, and health problems than did non-CSR veterans. We conclude that CSR should be seen as a marker for long-term psychiatric distress and impairment. In addition, the implications of combat-related trauma are broad and varied, and go beyond the narrow scope of PTSD.

Aging, Premature↗

PubMed2006

Longitudinal study of acute stress disorder, posttraumatic stress disorder and dissociation following myocardial infarction.

Since dissociation has been recognized as a marker of posttraumatic processes, this study examines the chronological relations between dissociation and stress reactions (acute stress disorder, ASD, and posttraumatic stress disorder, PTSD) following myocardial infarction (MI). One hundred sixteen MI patients were examined twice: within 1 week of the trauma (time 1) and 7 months later (time 2). Sixty-seven matched controls were studied in a parallel interval. ASD was assessed at time 1, PTSD at time 2, and dissociative tendencies at both times. ASD and PTSD were moderately associated with levels of dissociation. In addition, while the MI patients did not differ from the controls in level of dissociation, both in time 1 and time 2, among the MI group, PTSD was associated with an increase in dissociation. These findings may reflect either the development of two comorbid entities, or a presentation of a dissociative subtype of PTSD.

Adult↗

PubMed2006

Trajectories of PTSD: a 20-year longitudinal study.

OBJECTIVE: This study assessed the psychopathological effects of combat in veterans with and without combat stress reaction. METHOD: Veterans (N=214) from the 1982 Lebanon War were assessed in a prospective longitudinal design: 131 suffered from combat stress reaction during the war, and 83 did not. They were evaluated 1, 2, 3, and 20 years after the war. RESULTS: Combat stress reaction is an important vulnerability marker. Veterans with combat stress reaction were 6.6 times more likely to endorse posttraumatic stress disorder (PTSD) at all four measurements, their PTSD was more severe, and they were at increased risk for exacerbation/reactivation. A qualitative analysis of the profile of PTSD symptoms revealed some time-related changes in the symptom configuration of veterans who did not suffer from combat stress reaction. In both groups, the course fluctuated; PTSD rates dropped 3 years postwar and rose again 17 years later; 23% of veterans without combat stress reaction reported delayed PTSD. CONCLUSIONS: These findings suggest that the detrimental effects of combat are deep and enduring and follow a complex course, especially in combat stress reaction casualties. The implications of aging and ongoing terror in impeding recovery from the psychological wounds of war are discussed.

Adolescent↗

PubMed2005

Is terror gender-blind? Gender differences in reaction to terror events.

OBJECTIVE: This study examines gender differences in posttraumatic vulnerability in the face of the terror attacks that occurred during the Al-Aqsa Intifada. In addition, the contribution of level of exposure, sense of safety, self-efficacy, and coping strategies is assessed. METHOD: Participants were 250 men and 262 women, who constitute a representative sample of Israel's adult population. Data were collected via a structured questionnaire consisting of 51 items that were drawn from several questionnaires widely used in the study of trauma. RESULTS: The findings indicate that women endorsed posttraumatic and depressive symptoms more than men and that, generally, their odds of developing posttraumatic stress symptoms are six times higher than those of men. Results also revealed that women's sense of safety and self-efficacy are lower than men's and that there are gender differences in coping strategies in the face of terror. CONCLUSIONS: Gender differences in vulnerability to terror may be attributable to a number of factors, among these are women's higher sense of threat and lower self-efficacy, as well as their tendency to use less effective coping strategies than men. Level of exposure to terror was ruled out as a possible explanation for the gender differences in vulnerability.

Adaptation, Psychological↗

PubMed2005

Combat stress reactions, posttraumatic stress disorder, cumulative life stress, and physical health among Israeli veterans twenty years after exposure to combat.

This study examined the association of initial combat stress reaction (CSR), chronic post-traumatic stress disorder (PTSD) and cumulative life stress on physical health 20 years after the 1982 war with Lebanon, in a sample of 504 Israeli veterans of the war. Two groups were assessed: male veterans who fought and suffered from CSR and a matched group of male veterans from the same units who did not exhibit such reactions. Twenty years following the war, participants were asked to rate their general physical health status, report health complaints and risk behaviors, and were screened for PTSD. CSR and, to a greater extent, PTSD, were found to be associated with general self-rated health, chronic diseases and physical symptoms, and greater engagement in risk behaviors. CSR and PTSD were also related to greater cumulative life stress since the war. Both negative and positive life events were independently related to most of the physical health measures but did not account for the associations of CSR and PTSD with poorer health. Tests of the interactions between CSR, PTSD and life stress in their association with physical health and risk behaviors showed that PTSD suppressed the effects of additional life stress (negative life events had a weaker effect on health among participants with PTSD).

Adult↗

PubMed2005

Social, psychological, and psychiatric interventions following terrorist attacks: recommendations for practice and research.

The terrorist attacks of September 11, 2001, and the constant threat of imminent terrorist activity have brought into the forefront the urgent need to prepare for the consequences of such attacks. Such preparation entails utilization of existing knowledge, identification of crucial gaps in our scientific knowledge, and taking steps to acquire this knowledge. At present, there is little empirical knowledge about interventions following terrorism and absolutely no available empirical knowledge about interventions following bioterrorism. Therefore, this paper reviews knowledge about (1) reactions following the September 11 terrorist attacks in New York City and other places, (2) the practical experiences accumulated in recent years in countries (eg, Israel) that have had to cope with the threat of bioterrorism and the reality of terrorism, and (3) interventions for acute and chronic stress reactions following other types of traumatic events (eg, rape, war, accidents). Our review found several treatments efficacious in treating individuals for acute and chronic post-traumatic stress disorder (PTSD) related to other traumatic events that will likely be efficacious in treating PTSD related to terrorist attacks. However, there were significant gaps in our knowledge about how to prepare populations and individuals for the possibility of a terrorist attack and what interventions to apply in the immediate aftermath of such an attack. Accordingly, we conclude the paper with several questions designed to guide future research.

Health Planning Guidelines↗

PubMed2005

Israeli youth in the Second Intifada: PTSD and future orientation.

OBJECTIVE: To examine the relationship between exposure to political violence and posttraumatic symptoms, future orientation, and attitudes toward peace. METHOD: A total of 740 boys and girls aged 11.5-15 years from Jerusalem, Gilo, and the Jewish settlements in the disputed territories were assessed in the summer of 2001 using an exposure to terror questionnaire, Child Posttraumatic Stress Reaction Index, Children's Future Orientation Scale, and a question regarding the future of peace talks. RESULTS: A substantially higher percentage of youths in the settlements (27.6%) than in Jerusalem (12.4%) or Gilo (11.2%) reported moderate to very severe levels of posttraumatic symptoms. Children's Future Orientation responses were moderately optimistic. About two thirds of the adolescents in the settlements rejected the idea of peace talks at any time, whereas around half of the youths in Jerusalem and Gilo supported the continuation of peace talks. Exposure was related to both PTSD symptoms and attitudes toward peace but not to future orientation. CONCLUSIONS: Our findings present the complex interrelationship of political violence, posttraumatic stress disorder, and attitudes toward peace and raise the need for a combined mental health and peace education intervention to prevent the often overlooked vicious cycle of violence and traumatization.

Adaptation, Psychological↗

PubMed2005

Palestinian youth of the Intifada: PTSD and future orientation.

OBJECTIVE: To assess the nature of chronic exposure to terror and its psychological and cognitive toll on Palestinian youths, as is reflected in posttraumatic symptoms, future orientation, and attitudes toward peace. METHOD: In the summer of 2001, 245 Palestinian and 300 Israeli-Palestinian adolescents in the sixth to ninth grades were assessed with self-report questionnaires that measured level of exposure to terror, posttraumatic stress disorder, anxiety, depression, anger, dissociation, future orientation, and attitudes toward peace. RESULTS: Palestinians experienced significantly more traumatic events than Israeli Palestinians; the groups did not differ, however, in their subjective perception of the threat. Palestinians also reported higher levels of posttraumatic symptoms, more pessimistic future orientation, and less favorable attitudes toward peace negotiations than the Israeli Palestinians. The groups did not differ in reported psychological symptoms related to chronic exposure to stress. In both groups, subjective perceptions of the threat were implicated in the pathogenic sequelae of exposure to terror-induced trauma. CONCLUSIONS: Chronic or repeated exposure to terror may be related to complex posttraumatic symptoms beyond those specified in DSM-IV or ICD-10, including negative personal and national future orientation. The role of subjective appraisal deserves professional attention.

Adaptation, Psychological↗

PubMed2005

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

OBJECTIVE: Since September 2000, continuous terrorist attacks have exposed Israeli society to trauma, and the impact of these events on the mental health of the elderly Israeli population remains unclear. The authors sought to assess the prevalence of posttraumatic stress-related symptoms of distress, depression, optimism, self-efficacy, and sense of safety of the young-old and old-old Jewish population after 19 months of intense terrorism in Israel, in order to identify correlates of the psychological sequelae and compare symptoms and coping methods of these populations with those of younger adults. METHODS: Authors did a telephone survey using stratified sampling with a national sample of young-old (65-74 years old), old-old (>74 years old) and a comparison group of younger adults (18-64 years old). RESULTS: No difference was found in the level of exposure, traumatic stress symptoms, including probable PTSD, except for a nonsignificant tendency toward more depersonalization and emotional numbness in the elderly group, a tendency toward more sleeplessness, more re-experiencing of unwanted thoughts, hyperarousal, fewer avoidance symptoms, and less disengagement-coping in the old-old group. Younger adults were found to be significantly more optimistic. Young-old and old-old people used cigarettes/alcohol and tranquilizers more often to cope with the situation, and old-old people who used disengagement-coping felt less helped by it. CONCLUSIONS: Young-old and old-old people do not differ significantly from the younger adult population with regard to their response to 19 months of intense and recurrent terrorism.

Adaptation, Psychological↗

PubMed2005

Frontline treatment of combat stress reaction: a 20-year longitudinal evaluation study.

OBJECTIVE: The purpose of the study was to evaluate the long-term (20-year) effectiveness of frontline treatment provided to combat stress reaction casualties. METHOD: A longitudinal quasi-experimental design was employed. Participants were combat stress reaction casualties of the 1982 Lebanon War who received frontline treatment (N=79), comparable combat stress reaction casualties who did not receive frontline treatment (N=156), and matched soldiers who did not experience combat stress reaction (N=194). Subjects were asked which of the frontline treatment principles (proximity, immediacy, expectancy) were applied in their treatment, whether or not they returned to their unit after frontline treatment, and if so, whether they returned before or after they felt completely recovered. Outcome assessments included measures of posttraumatic and psychiatric symptoms and of social functioning. RESULTS: Twenty years after the war, traumatized soldiers who received frontline treatment had lower rates of posttraumatic and psychiatric symptoms, experienced less loneliness, and reported better social functioning than similarly traumatized soldiers who did not receive frontline treatment. In addition, a cumulative effect of application of frontline treatment principles was documented: the more principles applied, the stronger the effect on psychiatric outcomes. CONCLUSIONS: Frontline treatment is associated with improved outcomes even two decades after its application. This treatment may also be effective for nonmilitary precursors of posttraumatic stress disorder.

Adaptation, Psychological↗

PubMed2005

Trapped in captivity: marital perceptions of wives of former prisoners of war.

Knowledge on the experience of prisoners of war's (POWs) wives is sparse, and mostly concentrates on the first decade after captivity. The present qualitative study examined the marital perceptions of seven wives of POWs after three decades. Participants were recruited through therapists who worked with families of POWs. Data were collected by a semi-structured, in-depth focus group interview. The findings of the study shed light on: (1) The place of captivity in the life of the family over time and (2) the women's perception of their role and place in the marital relation as being responsible mainly for the husband's well being and the couple's relationship, while struggling to preserve their personal needs. The meaning of the results is discussed together with implications for practice.

Adult↗

PubMed2005

Posttraumatic stress disorder among Israeli ex-prisoners of war 18 and 30 years after release.

BACKGROUND: The psychological responses to captivity were measured in a sample of former prisoners of war (POWs) 18 and 30 years after release from captivity. METHOD: 209 Israeli veterans of the 1973 Yom Kippur War (103 ex-POWs and 106 controls) who had taken part in a previous study conducted in 1991 participated in the current study conducted in 2003. The study assessed current rates of posttraumatic stress disorder (PTSD), changes in PTSD over time, and the contribution of captivity severity (objective and subjective), sociode-mographic variables, and psychological appraisal and coping with captivity to predicting PTSD using standardized self-report questionnaires. RESULTS: Twenty-three percent of the ex-POWs met PTSD criteria and were 10 times more likely than controls to experience deterioration in their psychological condition in the 12-year interval between the 2 assessments. Almost 20% of ex-POWs who did not meet PTSD criteria in 1991 met criteria in the current assessment, in comparison to almost 1% of the controls. Current PTSD was predicted by younger age at the time of captivity, by loss of emotional control and higher subjective appraisal of suffering in captivity, and by a greater number of PTSD symptoms in the 1991 assessment. CONCLUSION: It is important to follow up and offer treatment to former POWs. Special attention should be paid to those who lost emotional control in captivity and to those who felt that the conditions of their captivity were severe.

Adaptation, Psychological↗

PubMed2005

The psychological effects of Intifada Al Aqsa: acute stress disorder and distress in Palestinian-Israeli students.

The study assesses the effects of exposure to nationality-related and personal stressful events, threat appraisal and coping strategies on level of distress of Palestinian Israeli students. One hundred forty-eight Palestinian Israeli students filled out a battery of questionnaires that tapped their exposure to stressful life events, terrorism and political related violence, their primary and secondary appraisals, and coping strategies. Level of distress was evaluated by (1) acute stress disorder, and (2) psychiatric symptomatology. Results reveal relatively low exposure to terrorism-related traumatic events, yet considerable exposure (35.8%) to nationality-related stressful events during the last two years. Twenty-five percent of the students suffered from acute stress disorder, and their levels of psychiatric symptomatology exceeded norms for the general population. Primary appraisal processes and emotion-focused coping strategies made unique contribution to the respondents' level of (1) acute stress disorder and (2) psychiatric symptomatology. The implications of these findings are discussed.

Adult↗

PubMed2005

In the shadow of schizophrenia: a study of siblings' perceptions.

BACKGROUND: The study assesses the impact of schizophrenia on non-schizophrenic siblings with regard to objective and subjective burden, feelings and degree of closeness with sibling, social interaction, coping and sense of meaning in life. METHOD: 100 subjects, 52 siblings of schizophrenic patients and 48 comparable controls participated in the study and filled out self report questionnaires. RESULTS: Findings show that siblings of patients with schizophrenia report more intense negative feelings, elevated levels of objective and subjective burden, less closeness and more shame than the subjects in the control group. LIMITATIONS: The 48 controls did not have a sibling with any sickness, so that the findings are not necessarily specific to schizophrenia, and may be relevant to siblings of those who suffer from various chronic diseases. Further study separating these issues is recommended. CONCLUSIONS: In light of the findings that show that some siblings of patients with schizophrenia become "secondary victims,' we recommend that siblings of the mentally ill receive more professional attention. Information about the illness can help in reducing the sense of anxiety and guilt, and somewhat alleviate the sense of shame and stigma.

Adaptation, Psychological↗

PubMed2005

The EUNOMIA project on coercion in psychiatry: study design and preliminary data.

Previous national research has shown significant variation in several aspects of coercive treatment measures in psychiatry. The EUNOMIA project, an international study funded by the European Commission, aims to assess the clinical practice of these measures and their outcomes. Its naturalistic and epidemiological design is being implemented at 13 centres in 12 European countries. This article describes the design of the study and provides preliminary data on the catchment areas, staff, available facilities and modalities of care at the participating centres.

Journal Article↗