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ABSTRACT: People with schizophrenia are more likely to smoke, and to smoke more frequently, than those without schizophrenia. Furthermore, inpatients smoke even more frequently compared with those living in the community. In light of this, we implemented and assessed a smoking reduction intervention using a wide array of behavioral group techniques and methods in chronic hospitalized schizophrenic clients. Using a controlled design, we randomly assigned chronic schizophrenic clients to either a five-session smoking reduction intervention (n = 35) or a waiting list (WL; n = 18). We assessed self-reported smoking behavior, clinical status (Positive and Negative Syndrome Scale, Hamilton Rating Scale for Depression; Clinical Global Impression Scale for Psychosis), subjective quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire-abbreviated version), and weight before and 3 months after the intervention. The intervention successfully reduced the number of cigarettes smoked compared with nonintervention. No clinical worsening or weight gain was observed. Behavioral group-oriented smoking reduction interventions can significantly reduce smoking behavior in hospitalized chronic clients with schizophrenia. [ABSTRACT FROM AUTHOR]

The authors evaluated the impact of a 'training the trainers' course for helping Sri Lankan tsunami-survivor children on education and mental health disaster volunteers. Sixty-two disaster volunteers were randomly assigned to either a school-based (ERASE Stress) 'training the trainers' course or to an alternative 'befriending' program that served as a control group. Participants in the ERASE Stress course significantly improved their perception of self-efficacy as tsunami survivors' helpers (Disaster-Helper Self-Efficacy Scale), self-mastery (Mastery scale), and optimism about their personal future (item from the Children's Future Orientation Scale). In addition, the perceived ability to use cognitive coping strategies (Cognitive Emotion Regulation Questionnaire) such as refocusing on planning, positive reappraisal, and putting the trauma into perspective was enhanced. The ERASE Stress course may be an effective method for strengthening local community capacity to deal with trauma survivors in developing countries. [ABSTRACT FROM AUTHOR]

The concept of Mental Homelessness is presented and developed. This paper will provide a historical review of the connection between mental illness and housing and the changing approaches toward institutionalization and de-institutionalization over several centuries. Case illustrations from practice in Israel will be presented to highlight the theme of home, or rather the theme of lacking a home as an element which may be inherent to a mental illness. More specifically, the paper argues that homelessness is a state of flection of. If so, even if a mental patient does initially own a home, he or she is at high risk to lose it somehow. This work is a primary attempt at developing a new idea, stemming originally from the field of mental health, with an attempt to widen its theoretical scope to populations not usually defined as mentally ill. Clinical characteristics are presented, as well as an attempt at a theoretical formulation of this concept permitting the development of therapeutic implications. These are presented in relation to existing psychodynamic concepts and therapeutic approaches related to the phenomenon of homelessness. [ABSTRACT FROM AUTHOR]

This study addressed the following questions for patients after 1 year of methadone maintenance treatment (MMT); (1) What are the demographic features and past history of drug use of benzodiazepine (BZD) abusers? (2) Do BZD abusers abuse more heroin, cocaine and/or cannabis and do they receive a higher methadone dosage level? (3) Do BZD abusers suffer more from hepatitis C (HCV) and do they have more HIV/HCV risk-taking behaviors than non-abusers? (4) Do BZD abusers have more psychopathology and more emotional distress than non-abusers? All 148 patients who completed 1 year of MMT underwent random and twice-weekly observed urine analysis for various drugs of abuse, responded to self-report questionnaires (SCL-90-R; POMS; HIV/HCV risk-taking behaviors), interviews (ASI) and underwent testing for hepatitis C. Abuse in this study is defined as any use during the 12th month of treatment. After 1 year of MMT, more BZD abusers (n = 63) were single, had spent time in prison, were unemployed and had at least one parent with an addiction problem or mental illness in comparison to non-abusers (n = 85). They had started using heroin and cocaine earlier and currently abused more cocaine, heroin and cannabis. They had significantly more psychopathology and negative mood. They had significantly more HCV and reported more HIV/HCV risk-taking behavior. We suggest that this group of patients is in need of more intensive pharmacological and psychological treatment. [ABSTRACT FROM AUTHOR]

Abstract 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.

Daily-life stressors and food cravings are dynamic and vary within and across persons. Some evidence suggests interpersonal stressors increase appetite. However, little is known about the association of food craving with different types of stressors at the momentary level in the general population. We aimed to explore the momentary relationships between daily-life stressful events and food craving in a non-clinical community sample, and to compare the associations with food craving when the most stressful event was perceived as interpersonal versus non-interpersonal. We used ecological momentary assessment (EMA) to collect reports on the most stressful event, perceived stressor type, stressor appraisal, and food craving from 123 adults three times a day scheduled at fixed intervals over 10 days. Mixed effects random intercepts and slopes models examined the within- and between-person associations. Experiencing a stressor was significantly positively associated with within-person food craving at the same measurement. No differences in momentary food craving were found when the most stressful event was perceived as interpersonal or non-interpersonal (within-person level). However, frequently reporting the most stressful event as interpersonal (vs. non-interpersonal) was positively associated with food craving across the study (between-person level), particularly when the stressor was appraised as more unpleasant. Daily-life stressors were associated with momentary food craving. Individuals who generally perceived interpersonal stressors as their most stressful event tended to experience food cravings. Future research could further investigate the role of interpersonal stressors as a factor for overeating in daily life and the potential benefits of stress management in interventions., (© 2024 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Psychiatric rehabilitation for people with severe mental illness (SMI) has many documented benefits, but less is known about cultural related aspects. To date, no comparison of psychiatric rehabilitation outcomes between Israeli Jews and Israeli Arabs has been carried out. Thus, the purpose of the present study was to compare the outcome measures of Israeli Arabs and Israeli Jews consuming psychiatric rehabilitation services. As part of the Israeli Psychiatric Rehabilitation Reported Outcome Measurement project (PR-ROM), a cross-sectional study comparing different ethnic-religious groups was performed. Data is based on 6,751 pairs of psychiatric rehabilitation consumers and their service providers. The consumers filled questionnaires on quality of life (QoL) and functioning, and their providers completed mirroring instruments. The findings revealed that QoL and functioning ratings were lower among Muslim Arabs compared to Jews on both consumers' and providers' ratings. Among Muslim Arabs, differences in outcomes according to the service's location were indicated. The observed differences between Israeli Arabs and Israeli Jews with SMI in the PR-ROM point to the need for culturally adapted rehabilitation services that take into account how cultural differences may affect the benefits of such services., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The high rates of psychiatric re-hospitalizations (also termed "revolving door") presents a "wicked problem" which requires a systematic and holistic approach to its resolution. Israel's mental-health rehabilitation law provides a comprehensive set of services intended to support the ability of persons with severe mental illness to rely on community rather than in-patient facilities for their ongoing care needs. Guided by the Health Behavior Model, we examined the relationship between psychiatric re-hospitalizations and the three Health Behavior Model factors (predisposing factor: socio-demographic characteristics and health beliefs; enabling factor: personal and social/vocational relationships facilitated by rehabilitation interventions and services; and need factor: outcomes including symptoms, and mental health and functional status) among persons with severe mental illness receiving rehabilitation services., Methods: Logistic regression models were used to measure the association between re-hospitalization within a year and variables comprising the three Health Behavior Model factors on the sample of consumers utilizing psychiatric services (n = 7,165). The area under the curve for the model was calculated for each factor separately and for all three factors combined., Results: A total of 846 (11.8%) consumers were hospitalized within a year after the study began. Although multivariable analyses showed significant associations between re-hospitalization and all three Health Behavior Model factors, the magnitude of the model's area under the curve differed: 0.61 (CI = 0.59-0.64), 0.56 (CI = 0.54-0.58), 0.78 (CI = 0.77-0.80) and 0.78 (CI = 0.76-0.80) for predisposing, enabling, need and the full three-factor Health Behavior Model, respectively., Conclusion: Findings revealed that among the three Health Behavior Model factors, the need factor best predicted re-hospitalization. The enabling factor, comprised of personal relationships and social/vocational activities facilitated by interventions and services representing many of psychiatric rehabilitation's key goals, had the weakest association with reduced rates of re-hospitalization. Possible explanations may be inaccurate assessments of consumers' personal relationships and social/vocational activities by the mental healthcare professionals, problematic provider-consumer communication on the consumers' involvement in social/vocational activities, or ineffective methods of facilitating consumer participation in these activities. Clearly to reduce the wicked "revolving-door" phenomenon, there is a need for targeted interventions and a review of current psychiatric rehabilitation policies to promote the comprehensive integration of community rehabilitation services by decreasing the fragmentation of care, facilitating continuity of care with other healthcare services, and utilizing effective personal reported outcomes and experiences of consumers with severe mental illness., (© 2024. The Author(s).)

Individuals with a psychiatric diagnosis and those with a history of trauma are at high risk for depression and posttraumatic stress symptoms (PTSS) following exposure to new traumatic events. Nevertheless, research is scarce on how having both a psychiatric diagnosis and a trauma history affect reactions to new traumatic events, and how different trauma types may affect individuals with a psychiatric diagnosis. We thus examined whether different stressful contexts (War and COVID-19) affected individuals with and without a psychiatric diagnosis differentially and whether results might be explained by prior trauma exposure. In the same cohort, we assessed depression and PTSS during wartime (2014), routine time (2016), and during the COVID-19 pandemic (2020) in a sample with (n = 89) and without (n = 104) a self-reported psychiatric diagnosis. This cohort was recruited during the 2014 Israel-Gaza War using social media, snowballing and outreach to mental health rehabilitation centres. We used a linear mixed modelling approach on data from the entire sample, as well as on the two study groups separately. We found that trauma history predicted PTSS and depression whereas a history of psychiatric diagnosis did not. Regarding trauma types, we found that individuals in the psychiatric diagnosis group relative to themselves had more symptoms during COVID-19 compared to war and routine time, while those without diagnosis had more PTSS and depression symptoms during wartime compared to routine time and COVID-19. In conclusion, a traumatic past may have an important influence on reactions to different types of traumatic events. Distinct traumatic events may affect individuals with or without a psychiatric diagnosis differentially., (© 2023 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Research indicates that stress increased across the globe after the outbreak of the COVID-19 pandemic. Community resilience has been suggested as a central protective factor for stress related to disasters and emergency crises. This study examined the contribution of community resilience reported three years prior to the onset of the COVID-19 pandemic, together with related worries and personal risk factors, to perceived stress among Israeli adults following the first wave of COVID-19 in Israel. We performed a two-period 3-year longitudinal study (Period 1 [P1]: July-September 2017; Period 2: [P2] May-June 2020). The final sample included 578 participants. Participants completed a community resilience self-report questionnaire during P1 as well as measures regarding perceived stress and COVID-19 worries during P2. Using linear hierarchical regression, we tested the additional explanatory effect of community resilience and found it to be negatively associated with perceived stress. While health-related worries were not significantly associated with perceived stress, worries related to the functioning of governmental and health institutions regarding the COVID-19 pandemic were significantly associated with perceived stress. Additionally, being single, living in a smaller residence and income reduction during the pandemic predicted higher perceived stress. The current study highlights the potential buffering role of community resilience in protecting against COVID-19 stress. Assessing community resilience may help identify vulnerable groups, and focusing on community building may be an effective strategy to mitigate stress in future disasters., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Elsevier Ltd. All rights reserved.)

Research indicates that mental health problems increased across the globe after the outbreak of the COVID-19 pandemic. However, there is a need for research examining specific risk factors for mental health problems, while accounting for symptoms before the pandemic. This study examined risk factors for depression and anxiety symptoms among Israeli adults following the first wave of the COVID-19 pandemic in Israel, above and beyond depression and anxiety symptoms reported 3 years before the pandemic. We performed a two-wave 3-year longitudinal study (W1 July-September 2017; W2 May-June 2020). The final sample included 578 participants who completed anxiety and depression self-report questionnaires at both waves. The W2 assessment additionally included being considered high-risk for COVID-19, and measures regarding loneliness, perceived stress, and COVID-19 worries. Both anxiety and depression symptoms were significantly higher at W2 during the pandemic. Worries related to COVID-19, perceived stress, loneliness, and prior mental health symptoms predicted depression and anxiety in W2. Additionally, being younger was associated with W2 anxiety. The current study highlights risk factors for psychological distress in light of the COVID-19 pandemic. Attention of clinicians and policy makers should be given to the important role of loneliness when screening and treating people during this pandemic., (© 2022 John Wiley & Sons Ltd.)

Objective: Motor vehicle collisions (MVCs) are a common source of traumatic stress, which could lead to the development of posttraumatic stress disorder. However, the natural course of symptom development is still poorly understood. The current study aimed to prospectively examine the expression of traumatic stress symptoms in mild-moderate injured MVC survivors, using a novel daily life repeated measurement approach., Method: Participants ( N = 70) were screened and recruited upon hospital arrival. Daily assessments of traumatic stress symptoms were conducted via mobile phones, and the data during days 2-6 (acute phase) and 27-31 (1-month phase) following the MVC were used for the current study., Results: Latent growth curve analyses showed that at the acute phase, traumatic stress symptoms followed a reducing trajectory, with significant intercept and negative slope factors. At the 1-month phase, traumatic stress symptoms followed a low-stable trajectory, with a lower intercept and a nonsignificant slope factor. The acute-phase intercept and slope were both positively associated with 1-month symptomatology, such that higher initial symptoms and slower recovery rates were associated with greater traumatic stress symptoms at 1-month post-MVC. Trauma history and peritraumatic perceived life threat were indirectly associated with the 5-days end-of-the-month traumatic stress symptoms, through the mediation of the acute-phase intercept., Conclusions: An early screen of traumatic stress symptoms in the first few days following trauma exposure, together with trauma history and perceived peritraumatic life threat, may assist in identifying individuals at risk for subsequent posttraumatic psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: Being a member of the dental profession is often associated with stress and high levels of burnout. Stress coping strategies may significantly help mediate burnout. The present cross-sectional study sought to examine the role of stress coping strategies on burnout, secondary traumatic stress, and compassion satisfaction amongst Israeli dentists., Methods: The study was carried out amongst Israeli dentists with the use of the following questionnaires: (1) the Professional Quality of Life Scale 5 (ProQOL), referring to burnout, compassion satisfaction, and level of secondary traumatic stress; (2) the Coping Inventory for Stressful Situations-Situation Specific Coping Inventory (CISS-SSC), referring to coping strategies (task-focused, emotion-focused, or avoidance-focused coping); and (3) demographic and professional variables (eg, specialisation, workload). Participants included 243 Israeli dentists. Univariate analyses and linear regressions were conducted to evaluate the relationships amongst coping strategies and burnout, secondary traumatic stress, and compassion satisfaction., Results: Female dentists had higher emotion-focused and avoidance coping scores than male dentists. Burnout could be explained by higher emotion-focused coping scores and lower task-focused and avoidance-focused coping. Secondary traumatic stress could be explained by higher emotion-focused scores, having fewer years of professional experience, and younger ages. Compassion satisfaction could be explained by lower emotion-focused coping as well as by higher task-focused coping and workload scores, specialisation, and gender., Conclusions: The findings suggest that emotional coping may cause dentists to be vulnerable to burnout and to secondary traumatic stress., Competing Interests: Conflict of interest None disclosed., (Copyright © 2021. Published by Elsevier Inc.)

Abstract: Based on the theory of planned behavior (TPB), this study aimed to examine factors influencing therapist uptake of digital mental health interventions in Israel. Two hundred twenty-nine mental health professionals recruited through a convenience sample completed a background and demographic questionnaire, as well as the TPB-based electronic-therapy attitudes and process questionnaire. Regressions were used to examine the contribution of attitudes, perceived behavioral control, subjective norms, and behavioral intentions. Intention to use and use of digital interventions were significantly predicted by attitudes, subjective norms, and perceived behavioral control, as suggested by the TPB. The use of cognitive behavioral therapy (CBT) and higher perceived behavioral control increased the likelihood of using digital interventions. Having a positive attitude, having expectations/social pressure from one's professional environment, and having a sense of control over the process were found to predict the intent to use, as well as the actual use of, digital interventions., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

While it is recognized that research priorities should reflect and integrate the perspectives and needs of patients along with those of health professionals and researchers, it remains challenging to actualize such priorities into tangible research projects. Targeted dissemination is required to catalyze research on these priorities. To create awareness of and inspire action toward actualizing the top 10 retinoblastoma research priorities in Canada, Canadian Retinoblastoma Research Advisory Board (CRRAB) members developed a wide range of dissemination tools and processes. These resources, co-produced with patients, were instrumental to CRRAB sharing the top 10 priorities internationally to mobilize action toward solving them., (Copyright © 2022 Longwoods Publishing.)

Background: Evidence from various sources suggests that females with schizophrenia tend to report lower quality of life than males with schizophrenia despite having a less severe course of the disorder. However, studies have not examined this directly., Aims: To examine gender differences in the association between quality of life and the risk of subsequent psychiatric hospital admissions in a national sample with schizophrenia., Method: The sample consisted of 989 (60.90%) males and 635 (39.10%) females with an ICD-10 diagnosis of schizophrenia. Quality of life was assessed and scored using the Manchester Short Assessment of Quality of Life. The course of schizophrenia was assessed from the number of psychiatric hospital admissions. Participants completed the quality of life assessment and were then followed up for 18-months for subsequent psychiatric admissions. Hazard ratios (HR) from Cox proportional hazards regression models were estimated unadjusted and adjusted for covariates (age at schizophrenia onset and birth year). Analyses were computed for males and females separately, as well as for the entire cohort., Results: A subsample of 93 males and 55 females was admitted to a psychiatric hospital during follow-up. Higher quality of life scores were significantly (P < 0.05) associated with a reduced risk of subsequent admissions among males (unadjusted: HR = 0.96, 95% CI 0.93-0.99; adjusted HR = 0.96, 95% CI 0.93-0.99) but not among females (unadjusted: HR = 0.97, 95% CI 0.93-1.02; adjusted HR = 0.97, 95% CI 0.93-1.02)., Conclusions: Quality of life in schizophrenia is a gender-specific construct and should be considered as such in clinical practice and future research.

Posttraumatic stress disorder assessments typically require individuals to provide an aggregate report on the frequency or severity of symptoms they have experienced over a particular time period. Yet retrospective aggregate assessments are susceptible to memory recall and retrieval difficulties. This study examined the correspondence between a month of real-time experience sampling methodology (ESM) reports of traumatic stress symptoms and a retrospective assessment of past-month traumatic stress symptoms for that same period. Participants were a convenience community sample (n=96) from Southern and Central Israel exposed to rocket fire during the Israel-Gaza July-Aug 2014 conflict. Participants provided ESM reports on traumatic stress symptoms twice a day for 30 days via smartphone. Average ESM scores, rather than peak or most recent reports, were most highly correlated with retrospective assessments. For individual symptoms, concentration difficulties had the highest correspondence between ESM and retrospective reports, while amnesia had the lowest correspondence. Regression analysis found that average ESM scores and younger age significantly predicted past-month retrospective assessments of PTSD symptoms. Additionally, previously experiencing more types of trauma predicted PTSD symptoms, but did not moderate the relationship between ESM and retrospective assessments. These findings have implications for assessment., (Copyright © 2021 Elsevier B.V. All rights reserved.)

While peritraumatic negative emotions have been associated with subsequent posttraumatic stress and depression, the predictive role of real-time emotional reactions to specific stressors during prolonged stress exposure is still unclear, particularly that of positive emotions. The current study uses experience sampling methodology to examine individual general levels of negative and positive emotions, and emotional reactivity to specific stressors during war, as prospective predictors of posttraumatic stress and depression. Ninety-six civilians exposed to rocket fire during the 2014 Israel-Gaza war reported exposure to rocket warning sirens and levels of ten negative and six positive emotions twice a day for 30 days. Symptoms of posttraumatic stress and depression were then assessed two months post-war. Participants reported higher negative emotions and lower positive emotions during assessment windows with sirens. Over time, negative emotions decreased and positive emotions increased. Higher levels of overall negative emotions predicted posttraumatic stress symptoms and depression symptoms two months later. Levels of positive emotions, and negative and positive emotional reactivity to sirens, were not associated with subsequent symptomatology. Our results indicate the stronger role of overall negative emotions as predictors of symptomatology compared with momentary emotional reactivity, and the stronger predictive role of negative compared with positive emotions., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: This study examined whether personal characteristics of consumers with serious mental illness (SMI), including being an immigrant, explained the lack of concordance in quality-of-life (QOL) ratings reported by consumers versus those reported by staff caring for consumers. Method: In a sample of consumers with SMI ( n = 4,956), including nonimmigrants and immigrants from Ethiopia and countries comprising the former Soviet Union (FSU), we examined consumer-reported and staff-reported QOL ratings. Regression models measured the contributions of covariates to QOL ratings made by both groups. Results: Staff-reported QOL ratings were consistently lower than consumer-reported QOL ratings. Consumer-reported QOL ratings made by FSU immigrants were lower than consumer-reported QOL ratings made by Ethiopian immigrants or by nonimmigrants ( p < .01). Conversely, staff-reported QOL ratings on Ethiopian immigrants were lower than staff-reported QOL ratings on FSU immigrants or nonimmigrants ( p < .05). While consumer-reported QOL ratings were associated with the covariates of gender ( p < .01), disability level ( p < .001), and health status ( p < .001), staff-reported QOL ratings were associated with the covariates of single marital status ( p < .05), education ( p < .001), and disability level ( p < .001). Conclusions and Implications for Practice: Among consumers with SMI, FSU immigrants reported the lowest QOL ratings, yet staff rated the QOL of Ethiopian immigrants as the lowest. Bias is a potential explanation for this discrepancy. An educational program focusing on cultural awareness, sensitivity, and competency might help staff better understand consumers' needs, thereby contributing to better service and potentially improving staff's ability to make assessments of consumers' functioning and QOL. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

This study aimed to examine the contribution of ethnic group status and social support to posttraumatic growth (PTG) among widows after sudden spousal loss. Participants included 184 widows from three ethnic groups: 59 (32.3%) Jewish, 58 (31.7%) Muslim, and 66 (36%) Druze. Information was gathered via a demographic questionnaire, PTG Inventory, and Multidimensional Scale of Perceived Social Support. Analysis of covariance was used to test ethnic group status differences in social support, controlling for demographic variables. Hierarchical linear models were used to assess groups differences in the study outcome variables. The results showed that the PTG total score was higher for Jewish widows than for Muslim and Druze widows, with a null difference between the latter two, and social support contributed to increased PTG among Jewish widows more than among Muslim and Druze widows, with no significant association between social support and PTG among Druze widows. The highest PTG levels were observed among widows from modern individualistic cultural backgrounds, compared with traditional collectivist, cultural backgrounds after sudden spousal death. The social support system may be a pathway to enhance PTG among widows in traditional collectivist societies., (© 2021 Wiley Periodicals LLC.)

Objective: Vocational rehabilitation for people with severe mental illness (SMI) has many benefits. Among the existing models, supported employment has consistently shown to have better impact on vocational outcomes while the findings on non-vocational outcomes are inconsistent. One source of variation with regard to non-vocational outcomes could be related to differences between consumers' self-reports and the providers' point of view., Design: A cross-sectional study of people with SMI consuming three different vocational services and their service providers., Setting: Data were collected as part of the Israeli Psychiatric Rehabilitation Patient Reported Outcome Measurement project., Participants: The current data is based on 3666 pairs of people with SMI consuming vocational services and their service providers., Interventions: Vocational services included supported employment, sheltered workshops and vocational support centers., Main Outcome Measures: The consumers-filled self-report questionnaires, which consisted of the following patient-reported outcome measurements (PROMs): quality of life, functioning and illness management. Primary professional providers were given instruments that mirrored the ones designed for self-report., Results: According to providers' ratings, supported employment was associated with higher functioning (F = 78.6, P < 0.001) and illness management (F = 33.0, P < 0.001) compared to other vocational services. PROMs revealed that supported employment was associated with higher functioning only (F = 31.5, P < 0.001). Consumers rated themselves higher compared to providers on all measures., Conclusions: This study provides a deeper insight into non-vocational outcomes of people with SMI participating in vocational services and suggests differences in perspectives between consumers and providers with regard to outcome measures., (© Crown copyright 2020.)

Purpose: To review and integrate the literature on mental-health-related patient-reported outcome measures (PROMs) and routine outcome measures (ROMs), namely in the domains of goals, characteristics, implementation, settings, measurements and barriers. PROM/ROM aims mainly to ascertain treatment impact in routine clinical practice through systematic service users' health assessment using standardized self-report, caretaker and/or provider assessment., Data Sources: Psych INFO and PubMed including Medline, Biomed Central, EMBASE Psychiatry and Elsevier Science's Direct., Study Selection: Systemized review of literature (2000-2018) on implementation and sustainability of PROMs/ROMs in adult mental health settings (MHS)., Data Extraction and Synthesis: Systemized review of literature (2000-2018) on numerous aspects of PROM/ROM implementation and sustainability in adult MHS worldwide., Results: Based on 103 articles, PROMs/ROMs were implemented mostly in outpatient settings for people with assorted mental health disorders receiving a diversity of services. Frequency of assessments and completion rates varied: one-third of projects had provider assessments; about half had both provider and self-assessments. Barriers to implementation: perceptions that PROM/ROM is intrusive to clinical practice, lack of infrastructure, fear that results may be used for cost containment and service eligibility instead of service quality improvement, difficulties with measures, ethical and confidentiality regulations and web security data management regulations., Conclusion: Improving data input systems, sufficient training, regular feedback, measures to increase administrative and logistic support to improve implementation, acceptability, feasibility and sustainability, follow-up assessments and client attrition rate reduction efforts are only some measures needed to enhance PROM/ROM efficiency and efficacy., (© The Author(s) 2020. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: To review and integrate the vast amount of literature yielded by recent growing interest in patient-reported outcome measurement and routine outcome measures (PROMs/ROMs), in order to suggest options and improvements for implementation. PROMs are the systematic assessment of service users' health using standardized self-report measures. Specifically, for ROMs, it includes routine provider or caretaker assessment measures. Both are administered to ascertain routinely, the impact of treatment in mental health settings and to improve care. A review is needed because of the large differences in setting, conceptualization, practice and implementation. Here, we examine the different major projects worldwide., Data Sources: Psych INFO and PubMed including Medline, Biomed Central, EMBASE Psychiatry and Elsevier Science's Direct., Study Selection: We conducted a systematized review of the literature published from 2000 to 2018 on the implementation and sustainability of PROMs and ROMs in mental health services for adults., Data Extraction, Synthesis and Results: We described and characterized the programs in different countries worldwide. We identified 103 articles that met the inclusion criteria, representing over 80 PROMs/ROMs initiatives in 15 countries. National policy and structure of mental health services were found to be major factors in implementation. We discuss the great variability in PROMs/ROMs models in different countries, making suggestions for their streamlining and improvement., Conclusion: We extracted valuable information on the different characteristics of the numerous PROMs/ROMs initiatives worldwide. However, in the absence of a strong nationwide policy effort and support, implementation seems scattered and irregular. Thus, development of the implementation of PROMs/ROMs is left to groups of enthusiastic clinicians and researchers, making sustainability problematic., (© The Author(s) 2019. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Persons with serious mental illnesses are at increased risk for co-occurring physical comorbidities. Patient-reported outcome measures are increasingly used in routine assessments of persons with serious mental illnesses, yet the relation of patient-reported outcome measures to physical health outcomes has not been comprehensively investigated. We examined the association between patient-reported outcome measures and self-reported physical health at 1-year follow-up., Design: A retrospective cohort study., Setting: Data were collected as part of the Israeli Psychiatric Rehabilitation Patient-Reported Outcome Measurement program in Israel., Participants: A total of 2581 psychiatric rehabilitation service users assessed between April 2013 and January 2016., Main Outcome Measures: Self-reports on two consecutive years of physical health dichotomized as poor versus good., Results: More than one-third of participants reported having poor physical health. Multivariate regression analysis showed that quality of life (odds ratio [OR] = 0.71; 95% confidence interval [CI]: 0.60-0.84) and lack of effect of symptoms on functioning (OR = 0.81; 95%CI: 0.74-0.89) predict subsequent physical health, controlling for all other factors. Compared to a multivariate model with personal characteristics and self-reports on physical health at baseline (Model A), the model which also included patient-reported outcome measures (Model B) showed slightly better discrimination (c-statistic: 0.74 vs. 0.76, respectively)., Conclusions: These results suggest that patient-reported outcome measures contribute to the prediction of poor physical health and thus can be useful as an early screening tool for people with serious mental illnesses living in the community, who are at risk of physical health problems., (© The Author(s) 2020. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Several studies have raised doubts about the effectiveness of posttraumatic growth (PTG) as a mechanism that promotes functioning. This study explored this issue in several directions: First, it examined whether functioning is negatively associated with posttraumatic symptoms (PTS), dissociation, and depression. Second, it determined whether PTG is positively associated with functioning. Finally, the study investigated whether PTG moderates the relationship between functioning and PTS, as well as between functioning and dissociation and depression., Method: The participants were 301 residents of an area exposed to the 2006 war in northern Israel. A structured questionnaire assessing posttraumatic stress disorder, depression, dissociation, PTG, and functioning was used 6 years following the war., Results: Functioning was found to be negatively associated with PTS, dissociation, and depression. PTG was found to be positively associated with functioning. In addition, PTG was found to moderate the relationship between functioning and PTS, as well as between functioning and dissociation and depression., Conclusions: Contrary to the approach that considers PTG to be an illusion, and possibly even a mechanism that may hinder a return to efficient functioning, the findings of this research suggest that PTG may reflect a growth phenomenon that includes functioning, thus implying a characteristic of the individual's relation to the world. Therefore, it may be concluded that PTG is not an illusion-a process that occurs only in one's head-but rather reflects actual functioning. The theoretical and practical implications of these findings are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

There is a lack of knowledge regarding real-time emotional reactivity to high-intensity stressors, particularly in people with mental illness, a potentially vulnerable population. The current study aimed to examine negative emotional reactions to recurring high-intensity stressors within a continuous war situation, in people with different psychiatric diagnosis types. Experience sampling method was used to examine emotional reactions among 143 civilians exposed to rockets during the 2014 Israel-Gaza war, of them 18.2% with psychosis, 14.7% with anxiety or depression and 67.1% without mental illness. Participants reported exposure to rocket warning sirens and the levels of 10 negative emotions twice a day for 30 days. Negative emotional levels were higher on most emotions following high-intensity stressors (sirens), that is, emotional reactivity was demonstrated in real-time during war. Overall, no difference in reactivity was found among the three study groups. Moreover, people with anxiety/depression were less reactive than people without mental illness on sadness and being overwhelmed. The findings indicate similar and sometimes lower emotional reactivity to high-intensity stressors in people with mental illness compared to the general population. Nevertheless, people with mental illness seem to have significant emotional needs during war, to be addressed in prevention and intervention efforts., (© 2020 John Wiley & Sons Ltd.)

Objective: We aimed to assess whether peritraumatic threat experienced during a period of armed conflict predicted subsequent depression symptoms., Method: Ninety-six Israeli civilians provided real-time reports of exposure to rocket warning sirens and subjective sense of threat, twice daily for 30 days, during the 2014 Israel-Gaza conflict. Depression symptoms were reported 2 months after the conflict. Mixed-effects models were used to estimate peritraumatic threat levels and peritraumatic threat reactivity (within-person elevations in threat following siren exposure). These were then assessed as predictors of depression symptoms at 2 months in an adjusted regression model., Results: Individual peritraumatic threat level, but not peritraumatic threat reactivity, was a significant predictor of 2 months depression symptoms, even after controlling for baseline depression symptoms., Conclusions: The findings imply that in situations of ongoing exposure, screening for perceived levels of peritraumatic threat might be useful in identifying those at risk for developing subsequent depression symptoms., (© 2020 Wiley Periodicals, Inc.)

Investigating dynamic associations between specific negative emotions and PTSD symptom clusters may provide novel insights into the ways in which PTSD symptoms interact with, emerge from, or are reinforced by negative emotions. The present study estimated the associations among negative emotions and the four DSM-5 PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and arousal) in a sample of Israeli civilians (n = 96) during the Israel-Gaza War of July-August 2014. Data were collected using experience sampling methodology, with participants queried via smartphone about PTSD symptoms and negative emotions twice a day for 30 days. We used a multilevel vector auto-regression model to estimate temporal and contemporaneous temporal networks. Contrary to our hypothesis, in the temporal network, PTSD symptom clusters were more predictive of negative emotions than vice versa, with arousal emerging as the strongest predictor that negative emotions would be reported at the next measurement point; fear and sadness were also strong predictors of PTSD symptom clusters. In the contemporaneous network, negative emotions exhibited the strongest associations with the NACM and arousal PTSD symptom clusters. The negative emotions of sadness, stress, fear, and loneliness had the strongest associations to the PTSD symptom clusters. Our findings suggest that arousal has strong associations to both PTSD symptoms and negative emotions during ongoing trauma and highlights the potentially relevant role of arousal for future investigations in primary or early interventions., (© 2019 International Society for Traumatic Stress Studies.)

Aim: Dentistry is a stressful and exhausting profession with high levels of burnout. Sensory processing sensitivity (SPS) is a basic personality trait characterised by a gradient of sensitivity to both internal and external stimuli, including social and emotional cues. In this study, the influence of SPS on burnout and professional quality of life among Israeli dentists was analysed., Methods: Two-hundred and forty-three Israeli dentists responded to questionnaires that collected information on their SPS and professional quality of life (burnout, satisfaction at work and level of secondary traumatic stress), as well demographic variables, professional specialisation and workload., Results: Linear regression analyses showed that burnout can be predicted by the three aspects of SPS (ease of excitation, low sensory threshold and aesthetic sensitivity; 32% of the variance). Additionally, the same three aspects of SPS also predicted dentists' satisfaction at work (24% of the variance). Ease of excitation and low sensory threshold, but not aesthetic sensitivity, predicted dentists' reaction to their patients' stress and trauma (23% of the variance)., Conclusions: Sensory processing sensitivity can serve as a tool to identify dentists who are prone to develop burnout and whose professional quality of life can be adversely affected by their profession., (© 2019 FDI World Dental Federation.)

Objective: Research has shown high rates of exposure to trauma among people with serious mental illness (SMI). In addition, studies suggest that psychosis and mental illness-related experiences can be extremely traumatic and may lead to significant symptomatology. Indeed, overwhelming traumatic experiences may shatter people's core beliefs about themselves, the world, and others. However, coping with adversity may also foster a unique outcome; namely posttraumatic growth (PTG). The experience of PTG is contingent on people's ability to reexamine their core beliefs after trauma. Little is known about whether and how such core-belief reexamination is related to PTG among people with SMI and psychosis, specifically people who experience positive, negative, and general psychopathological symptoms (PANSS)., Method: For the purpose of this study, 121 participants were recruited from community mental health rehabilitation centers and administered trauma- and psychiatry-oriented questionnaires., Results: In addition to high levels of traumatic exposure, we observed that people with SMI can experience PTG, which is mediated by reexamination of core beliefs, contingent on low levels of illness-related psychopathological symptoms., Conclusion: The ability to challenge one's world assumptions and reestablish a functional set of assumptions is critical to the development of PTG. In light of the high levels of posttraumatic comorbidity found in this population, psychiatric facilities should place greater emphasis on treating the traumatic aspects of SMI and on teaching and practicing effective strategies to reevaluate life after trauma. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Objectives: The current study examined whether peritraumatic threat predicted posttraumatic growth (PTG), and whether the relationship between peritraumatic threat and PTG was mediated by post-traumatic stress (PTS) symptoms. Design: A prospective experience sampling study. Methods: 96 Israeli civilians provided smartphone reports of their rocket warning siren exposure and peritraumatic threat, twice daily for 30 days, during the 2014 Israel-Gaza conflict. PTS symptoms data were collected one month after entry to the study, PTG data were collected five months after entry to the study. PTG predictors were assessed using a hierarchical multivariate regression model. A mediation analysis was conducted to assess the indirect effect of peritraumatic threat on PTG via PTS symptoms. Results: One month PTS symptoms and level of exposure to the conflict were both significant PTG predictors. After controlling for potential covariates, the relationship between peritraumatic threat and PTG scores was fully mediated by PTS symptoms. Conclusions: PTS symptoms mediated the relationship between peritraumatic threat and subsequent PTG. Screening trauma survivors for levels of threat and PTS symptoms may be helpful in tailoring therapeutic approaches that will aid in alleviating stress symptoms on one hand and increase the likelihood of growth and better health outcomes on the other.

The associations among peritraumatic posttraumatic stress symptoms (P-PTSS) in the immediate aftermath of trauma exposure, including those in the posttraumatic stress disorder clusters of intrusions, avoidance, negative cognitions and mood (NCM), and arousal, might indicate mechanisms through which enduring PTSD develops. During a period of war, exposed participants (N = 181) were sent twice-daily questionnaires for 30 days via smartphone. We repeatedly assessed the predictive associations between the P-PTSS clusters over time. We performed a multilevel pathway analysis built of multiple triple sequence responses (6,221 cases) on each of the four P-PTSS clusters at a mean time lag of 12 hr (Model A) and 24 hr (Model B) for 181 participants, 85 of whom had been diagnosed with a serious mental illness. Arousal predicted intrusion in Models A and B, b A = 0.08, 95% CI [0.03, 0.12], p < .001 and b B = 0.03, 95% CI [0.00, 0.07], p = .051, respectively; and NCM in Models A and B, b A = 0.09, 95% CI [0.05, 0.12], p < .001 and b B = 0.06, 95% CI [0.03, 0.09], p < .001, respectively. Intrusion predicted arousal in Model B, b B = 0.05, 95% CI [0.01, 0.08], p = .010. NCM predicted arousal, b A = 0.10, 95% CI [0.05, 0.14], p < .001, and avoidance b A = 0.05, 95% CI [0.00, 0.11], p = .052, in Model A. Avoidance did not predict any other cluster. Arousal seemed to be acting as a hub, strengthening feedback loops to and from NCM and intrusion., (© 2019 International Society for Traumatic Stress Studies.)