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Limited research exists regarding the impact of the Ukrainian War on mental distress among refugees or the presentation of post-traumatic stress disorder (PTSD) as a co-morbidity. This study analyzes the mental distress experienced by displaced Ukrainian refugees, including exposure to war-related trauma, PTSD, psychological distress based on socio-demographic factors, prevalence of concurrent mental illnesses, and associated risk factors. Ukrainian refugees in Israel were included in the study shortly after their arrival. Participants completed questionnaires on socio-demographic information, exposure to war-related events, presence of PTSD, depression, anxiety, and current life satisfaction. The 128 participants reported an average of 6.4 traumatic events (SD = 2.97). Among them, 69.5% (n = 89) met the criteria for probable PTSD, 36.7% (N = 47) for depression, and 53.1% (N = 68) for anxiety. The "comorbidity" cohort, consisting of refugees with PTSD and depression/anxiety or both, included 65 participants (53.3%), the "only PTSD" group was 24 participants (19.7%), and 33 (27%) had "no probability". Women and those who had left family members behind were 2.9 and 3.2 times more likely to experience comorbidity, respectively. Refugees with comorbidity reported higher distress and functional impairments compared to the "only PTSD" group, and lower life satisfaction than those with "no probability". This study highlights the significant traumatology experienced by Ukrainian refugees, with attention to the unique impact of comorbidity on functional and subjective well-being among refugees. Therefore, a comprehensive approach is necessary to appropriately diagnose and support refugees, considering the interconnected impact of PTSD, anxiety, and depression. [ABSTRACT FROM AUTHOR]

The evidence regarding the intergenerational effects of the Holocaust points to a heightened sensitivity to traumatic and stressful events, as well as to threats. These effects were found across at least three generations: the survivors themselves, their children, and their grandchildren. More specifically, this sensitivity is manifested in increased psychological reactions to adverse circumstances, especially when such situations trigger associations with the Holocaust. During 2023 Israel has experienced unprecedented civil unrest and protests following the government's plan to promote a judicial overhaul. Many expressed fears for Israeli democracy and the integrity of the social fabric in Israel. The current study examined how Holocaust descendants (i.e., children and grandchildren of Holocaust survivors) experienced this prolonged social unrest. A web‐based random sample of 706 Israeli Jews born after World War II completed questionnaires several months before the unrest began (Wave 1, 2022) and seven months into the unrest (Wave 2, 2023). Supporting most of our hypotheses, Holocaust descendants reported higher civil unrest salience (i.e., more preoccupation with the political and social upheaval) relative to comparison descendants (i.e., children and grandchildren of those not directly exposed to the Holocaust). Relative to comparison descendants, Holocaust descendants were also at a greater risk of reporting exacerbation in anxiety since the judicial overhaul was introduced, but not in depression or somatisation symptoms. Results remained significant after controlling Wave 1 distress level, background characteristics, level of engagement in civil unrest, and participants' viewpoint on the judicial overhaul. The findings further corroborate unique reactions to stress among Holocaust descendants, this time by highlighting increased preoccupation and increased exacerbation in anxiety during a period of prolonged political and social turmoil. [ABSTRACT FROM AUTHOR]

Ageist attitudes have been associated with various aspects of psychological functioning in older adults. According to Terror Management Theory, older adults may be seen as a reminder of human demise and death, and research has demonstrated links between ageist attitudes and compromised abilities to seek and maintain close personal relationships, which ward off awareness of one's mortality. Accordingly, the current work examined whether reflective functioning, or the ability to comprehend one's own and others' mental states, mitigates the negative psychological manifestations of ageist attitudes in older adults. Data was collected from 686 participants aged 60–94 (Mage = 72.64, SD = 6.28), who completed scales assessing ageist attitudes, reflective functioning, and psychological distress, as well as relevant socio‐demographic information. Results indicated that ageist attitudes were linked with low levels of reflective functioning and enhanced psychological distress. Moreover, reflective functioning moderated the ageist attitudes‐distress link, which was not significant in individuals reporting high levels of reflective functioning. This study provides insight into how the ability to comprehend others' mental states mitigates the adverse psychological effects of ageist attitudes and highlights the importance of examining relationship‐enhancing personal factors within the context of negative ageing perceptions and psychological distress. [ABSTRACT FROM AUTHOR]

Hiring migrant live-in caregivers to take care of older adults with dementia, chronic disease or frailty has become more common in Europe, North America, the Middle East, and Asia. When older couples hire a non-relative to provide live-in caregiver services for a family member, the attendant household transformation – from couple to triad – gives rise to social and psychological challenges. Although live-in caregivers can be indispensable, living together can be very stressful for older adults and live-in caregiver. This article describes the emotional distress of two older adult wives in their eighties, and the therapeutic methods used to reduce it, including empathic understanding, legitimation of emotions, promotion of open communication, and formulation of a household 'management strategy,' establishing specific expectations concerning the parties' roles and a daily activity schedule. Involvement of older couples' children was found helpful, and was aided through psychoeducation. Gerontologists, therapists, educators, and social workers who serve the needs of older adults can effectively assist this population in the evolution of their perceptions of their new situation, the regaining of a sense of equilibrium, mastery and control over their lives, and the development of greater tolerance and understanding of migrant live-in caregivers' work burden, native culture, and individual practices. Professionals should actively screen for risks of burden, stress, depression, and anxiety in households in which live-in caregiver services may be considered. Psychoeducation and preparation of both the older adults and their live-in caregivers entering the new relationship may lessen the incidence of potential stressors. Implications: Clinical and Practical implications: Professionals need to triage and diagnose the difficulties and stressors that arise when older couples or their children invite a paid live-in caregiver into the home, changing the day-to-day routine and relationship dynamics of the household. Professionals should actively screen for risk of burden, stress, depression, and anxiety among healthier older spouses, who may feel discomfort and frustration when their independence and privacy are compromised and their primary role seems to be eclipsed by the activity of a paid live-in caregiver. Older adults, their family members, and paid live-in caregivers can benefit from psychoeducation to understand and address emotional difficulties inherent in situations where serious health decline leads to the hiring of a paid live-in caregiver. Following the clinical implications, this paper suggest some practical implications when proving therapy to older adults. It includes outreach and work with the spouses, and if possible with the children of the frail older adult. While frail older adults are usually the primary object of physical and emotional support, their healthier older spouses also require significant emotional support, especially in the early period after a paid live-in caregiver is hired. The children of older adults can be a very useful resource in promoting early intervention and providing continuing support for parents coping with the addition of a paid live-in caregiver to their parents' household. [ABSTRACT FROM AUTHOR]

Objectives: Existing research on romantic breakups focused on the predictors of breakup, or on its emotional and behavioral sequelae. The current study examines the longitudinal correlates of a breakup experience over a period of eight years, and questions whether breakup experiences may also have negative and positive outcomes. Methods: Data were collected from 124 Israeli emerging adults (mean age 20.22 years; 79 females). Participants were approached again at ages 23, 25, and 28. Breakup distress was assessed at each wave. At age 28, participants' well-being, as well as their romantic capacities, were evaluated. Results: The intensity of breakup distress at age 20 was not found to be associated with future well-being. However, increased accumulating distress explained a greater number of depressive and anxiety symptoms, and reports of feeling insecure about a partner's availability and responsiveness, at age 28. In-depth interviews with participants about their romantic relationships at age 28 showed that breakup distress at age 20 was associated with greater romantic competence at age 28, explaining better capacity to learn from past romantic experiences and draw lessons for future behavior. In addition, earlier breakup distress was associated with more coherent accounts of romantic relationships at age 28. Conclusions: Findings suggest that young adults are likely to experience a number of breakup events during their twenties, and the accumulating breakup experiences can affect future well-being. The experience of a breakup might not necessarily associate with negative future outcomes, while an earlier breakup experience could also serve as a positive learning arena for future relationships. Social policy: Perception of romantic dissolution in a comprehensive manner could be helpful for understanding that breakups are probably part of the normative development of romantic relationships among young adults, and should not be perceived only from a deficit perspective. [ABSTRACT FROM AUTHOR]

Simple Summary: This research is suggested to address the significant psychological distress that cancer patients often experience during diagnosis and treatment, which can adversely affect their outcomes and care. Despite advancements in cancer treatments extending survival rates, the emergence of depression and anxiety as common comorbidities underscores the need for targeted interventions to improve patient well-being. The study aims to investigate the prevalence of depression and anxiety among cancer patients and identify some of the associated risk factors. Advancements in cancer treatment and early detection have extended survival rates, transforming many cancers into chronic conditions. However, cancer diagnosis and treatment can trigger significant psychological distress, including depression and anxiety, impacting patient outcomes and care. This study aimed to examine the prevalence of and identify the risk factors for depression and anxiety among cancer patients. A cross-sectional study was conducted, including patients under the care of the oncology department at a tertiary medical center between June 2021 and October 2023. Depression and anxiety were assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) short forms. Logistic regression analysis identified risk factors for depression and anxiety. The study population included 159 patients, with 40.3% reporting worsening mental health, but only about half of them received therapy. Among the study participants, 22.6% experienced symptoms of depression and 30.2% experienced symptoms of anxiety. Single-cancer patients and those with metastases were at increased risk for depression, while those with a disease duration of more than a year and patients with female-specific cancer were more likely to experience anxiety. Given the high prevalence of mental health deterioration in cancer patients, closer monitoring and validated assessment tools are essential to improve depression and anxiety diagnosis and facilitate early interventions. [ABSTRACT FROM AUTHOR]

At any given moment, a notable proportion of parents worldwide have at least one child serving in the military. The aim of this study is to assess the prevalence of depression, anxiety, and stress in the sample of parents of Israeli soldiers and to assess the difference in this prevalence by type of service (combat vs. non‐combat) and other demographic characteristics of parents and soldiers. A cross‐sectional study of a convenience sample of 202 Israeli parents who were interviewed during January‐September 2023. Depression Anxiety Stress Scale (DASS‐21) was used to measure the emotional states of depression, anxiety, and stress (with cut‐off points of ≥5, ≥4, and ≥8, respectively). Having depression, anxiety, or stress was defined as psychological distress. Parents' demographics and child's service characteristics were included in the multivariable logistic regression model, with psychological distress as a dependent variable. Almost a quarter (22.8%) of parents experienced distress, defined as having high depression, anxiety, or stress score. In a multivariable model, combat service (vs. non‐combat) was significantly associated with distress: parents of combat soldiers were four times more likely to report distress than parents of non‐combat soldiers (OR = 3.9; 95% CI: 1.3–11.8). Highly classified service preventing the child from sharing information with the parents was significantly associated with distress (OR = 2.6; 95% CI: 1.2–5.3). Most distressed parents (78.3%) did not seek professional help, with the vast majority of those seeking assistance were female. Given the substantial proportion of parents suffering from mental distress found in this study, especially parents of combat soldiers and those serving in highly classified positions, healthcare professionals should be aware of parents' difficulties, be proactive in gathering information about their mental well‐being, and be prepared to provide professional help. [ABSTRACT FROM AUTHOR]

Background: Childhood maltreatment (CM) is considered a traumatic experience with long-term adverse effects on the quality of adult intimate relationships. Research on the mechanisms underlying this phenomenon among Arab societies is scarce. Objective: This study investigated the impact of childhood physical abuse (PA) and emotional abuse (EA) on the quality of marital relationships. Additionally, it examined the mediating roles of two dimensions of insecure adult attachment (i.e., avoidant and anxious) to a romantic partner and psychological distress within gender-specific models. Method: A cross-sectional survey was conducted among a representative sample of 604 married Arab adults (M age = 33.5, SD = 6.52; 50.1% women) in Israel using a self-administered questionnaire. Results: Childhood PA was significantly related to low levels of relationship quality among men and women. For men, childhood PA was positively related to psychological distress and both patterns of romantic attachment styles, which in turn were negatively associated with relationship quality. For women, childhood PA was positively associated with psychological distress and avoidant attachment, correlating with low levels of relationship quality. Conclusion: A retrospective assessment of childhood PA is associated with decreased levels of marital relationship quality for men and women. This association is mediated by psychological distress and romantic attachment styles. Implications: Implementing interventions focused on improving mental health and promoting a secure romantic attachment style can enhance the quality of marital relationships for adults with CM experiences. [ABSTRACT FROM AUTHOR]

The present review aimed to synthesize the empirical evidence regarding the association between problematic pornography use (PPU) and mental health. A comprehensive literature search using keywords and subject headings was performed with three electronic databases, resulting in 20 studies that met the inclusion criteria. The patterns of association between PPU and mental health were examined, and the limitations of these studies were discussed. The overall findings suggest the relationship between PPU and mental health outcomes is not clear-cut, and it is often mediated by other factors such as loneliness, anxiety, and self-esteem. Further studies are required to evaluate the prevalence of PPU and both risk and protective factors which are associated with exposure to online pornography. Most studies relied on homogenous samples which have limited the generalizability of findings. The use of representative samples, including both males and females with different sexual orientations and from diverse cultural and ethnic backgrounds, would strengthen our understanding of PPU and go further to expound on its controversies. Clinical recommendations and future directions are also discussed. [ABSTRACT FROM AUTHOR]

Proposal: This systematic review aims to comprehensively examine all existing knowledge on psychosocial interventions for family caregivers for ALS patients. Also, the study will present the gaps in knowledge, recommendations for future research, and guidelines for psychosocial interventions that are focused and adapted to the needs of family caregivers of ALS patients. Materials and methods: The systematic review was conducted according to the PRISMA guidelines and identified studies on psychosocial intervention for family caregivers of ALS patients, using five electronic databases: PsychNET, PubMed, EBSCO, PRIMO, and PROQUEST. Seven articles met the criteria and were included in the review. A thematic analysis was conducted to extract major themes. Results: Three major themes emerged from the data: (1) Personal benefits; (2) Interpersonal benefits; and (3) Charting challenges and pathways to improve psychosocial interventions. Conclusions: Based on the findings, practical guidelines were formulated that focus on the group's composition, the facilitator's role, the contents, the relationships within the group, and the opportunities and limitations of online interventions. [ABSTRACT FROM AUTHOR]

The current study examined the role of interpersonal vulnerability, that is, self-perceived threats to one's interpersonal domain, in the mental health of bereaved parents. Israeli bereaved parents in older adulthood (N = 105, aged 48–88, M = 64.06, SD = 9.93) were pair-matched with equivalent 105 non-bereaved parents. Participants completed questionnaires assessing interpersonal vulnerability, satisfaction with life, and depressive symptoms. The results showed higher levels of interpersonal vulnerability among bereaved parents compared to their non-bereaved counterparts. Additionally, parental bereavement and interpersonal vulnerability were associated with worse mental health. Finally, interpersonal vulnerability mediated the association of parental bereavement with worse mental health. This study reveals interpersonal vulnerability as an important vulnerability factor among a significant minority in older adulthood. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has been associated with increased existential concerns, as well as with significant changes in the work force. The current study examined the availability of meaning in work and belonging to a work group as personal resources which may mitigate psychological distress associated with feeling close to death. Data were collected from 450 working Israelis, and results indicated that the connection between feeling close to death and distress was not significant for individuals reporting high levels of belonging and meaning. Implications are discussed from the perspective of Terror Management Theory. [ABSTRACT FROM AUTHOR]

Nonprofit organizations operating in civil society have become the main channel for social service provision in most neoliberal welfare economies. Social service nonprofits (SSNs) deliver essential services mainly to vulnerable and marginalized populations. Since the outbreak of COVID-19, SSNs have been at the frontline of dealing with its socioeconomic consequences. This paper focuses on the activities and responses to the crisis of SSNs in Israel. Interviews with SSN directors (N = 17) show that they dealt with growing demands for services due to the social implications of the pandemic, along with operational difficulties, such as deterioration in clients' condition, disruption in service continuity, and reduced funding and staff. Next to these difficulties, the findings highlighted the social innovations adopted by SSNs to maintain service provision, such as implementing remote service technologies, forming collaborations, and recruiting volunteers. Implications for the social services and policies are presented and discussed. [ABSTRACT FROM AUTHOR]

Background: Mental health challenges are widespread among adolescents undergoing significant physical, emotional, social, and academic changes. However, rates of formal help-seeking remain low, particularly among those from ethnic minorities. Aims: This study investigated the determinants of intentions to seek formal mental health help among Palestinian adolescents in Israel, focusing on mental health literacy (MHL) and trust in formal sources of information. Methods: A total of 178 adolescents (Mage = 16.24 ± 1.24 years, 61.8% female) completed measures assessing intention for formal help-seeking, psychological distress, MHL, trust in formal sources of information, sociodemographic, and clinical characteristics. Results: Findings revealed low levels of intention to seek formal help and psychological distress, alongside average or above-average levels on all MHL dimensions and trust in formal sources for information. Our analysis identified socioeconomic status (β =.17, p <.05), psychological distress (β =.18, p <.05), trust in formal sources of information (β =.28, p <.001), and two MHL dimensions: knowledge of where to seek information (β =.25, p <.01) and attitudes that promote recognition or appropriate help-seeking behavior (β =.16, p <.05) – as the main determinants of intention for formal help-seeking. Conclusions: This study underscores the critical role of trust in formal sources of information and MHL in seeking formal help among adolescents from ethnic minorities. Interventions aiming to improve access to mental health-related information, address and enhance attitudes, and foster trust in formal professionals and institutions may contribute to an increased tendency for formal mental health help-seeking among this population and others. [ABSTRACT FROM AUTHOR]

Background: Mental health literacy (MHL) has been related to health behaviors and outcomes. However, studies examining MHL as a barrier and facilitator to service use are limited, especially among minority groups. Aims: This study examined MHL as a barrier and facilitator to mental health service use among the Palestinian Bedouin minority in Israel. Methods: Twenty-five Bedouins (15 women) from southern Israel participated in semi-structured, in-depth interviews. The participants were recruited by publishing an ad on social media about the study, then through a snowball technique. The data were analyzed thematically using ATLAS.ti.9, and the intercoder reliability was 92%. Results: We identified four major themes in the interviews: (1) MHL as a barrier to service use, due to lack of knowledge about professionals in the field, mental health services, or reasons and risk factors for mental health problems; (2) traditional attitudes that acted as barriers to service use, including a preference for informal treatment, a lack of faith in mental health treatment, aversion to discussing private feelings, and the perception that mental health is a luxury; (3) MHL as a facilitator to service use by enabling accurate identification of mental distress and suggesting practical avenues for seeking help; and (4) ways to improve MHL that should be culturally sensitive and under the government agencies' responsibility. Conclusions: Interventions aimed at increasing the use of mental health services among Bedouins and reducing racial/ethnic disparities should increase knowledge in culturally adapted ways, especially regarding professionals and services, and change negative attitudes such as mental health treatment as ineffective or bonus. [ABSTRACT FROM AUTHOR]

The October 7th, 2023, terror attacks in Israel were characterized by a scope and magnitude not previously known to Israeli citizens. The aim of this study was to examine the prevalence and correlates of posttraumatic stress disorder (PTSD), emotional distress and use of addictive substances among Israeli adults, approximately one month following the attacks. PTSD was assessed with the Posttraumatic Stress Disorder Checklist (PCL-5) and emotional distress was assessed with a brief version of the Hopkins Symptom Checklist (HSCL-25). Participants also ranked the degree of change in their frequency of use of six addictive substances. The final sample consisted of 415 Jewish and Arab Israeli adults. Results indicate that one month following the attacks, 31.4% of the total sample qualified for positive screening of PTSD. An increase in the use of tobacco, alcohol, tranquilizers and sleep medications was reported by 16.5%, 10.1%, 11.1% and 10.6% of the sample, respectively. Being at a younger age, of female sex and with increased exposure to the attacks was associated with increased levels of PTSD (β = -0.24, p < 0.001; β = 0.19, p < 0.001 and β = 0.29, p < 0.001, respectively) and increased distress (β = -0.22, p < 0.001, β = 0.26, p < 0.001 and β = 0.19, p < 0.001, respectively). Being male was significantly associated with increased use of cannabis (Adjusted Odds Ratio (AOR) = 4.73, 95% Confidence Interval (CI) = 1.70–13.13, p = 0.003), and level of exposure to traumatic events was significantly associated with increased use of tranquilizers (AOR = 1.58, 95% CI = 1.17–2.13, p = 0.003). The high magnitude of symptomatic response should alert other countries as they prepare for national disasters. [ABSTRACT FROM AUTHOR]

Contemporary understanding of combat trauma's psychological effects emphasizes the interpersonal ways survivors process their experiences. Yet cases of incongruence between survivors who want to share their traumatic experience and close others who are not ready to take part in this challenging task are common. Hence, many trauma survivors are compelled to cope with the posttraumatic consequences mostly alone. The present study followed the interpretive phenomenological approach to examine the experience of loneliness, as described by 15 male combat veterans dealing with posttraumatic stress. Participants completed semistructured qualitative interviews in which they shared their knowledge regarding postservice distress, loneliness, coping, and growth. Two main themes emerged: "The Loneliness Complex," highlighting this phenomenon's multifaceted, layered, and cyclical nature; and "Emotional Growth after Loneliness," presenting the positive potential of loneliness. These findings emphasize the importance of interpersonal relations in trauma survivors' recovery process. Participants described how experiences with peers can serve as a pivotal point for coping with postservice distress and how internalization of positive interpersonal interactions seems to be a crucial psychological resource for further rehabilitation and growth. Being a multilayered and cyclical condition, loneliness might serve trauma survivors in their search of safety, while also bearing the potential to motivate them to act upon their condition and promote emotional growth. Clinicians should acknowledge the risks trauma survivors take by leaving their lonely yet safe place, as they are encouraged to process their traumatic experiences and share their inner world with others. [ABSTRACT FROM AUTHOR]

The Palestinian minority in Israel has endured sociopolitical stressors (e.g., ethnonational racism, discrimination, oppression, and political violence) throughout the decades, which have adverse psychological and behavioral outcomes. In this study, we examine the association between interpersonal racism (IPR) among Palestinian parents in Israel and their child neglect, the mediating role of psychological distress on this relationship, and the moderating role of perceived social support (PSS) on the mediated effect of psychological distress on this relationship. A systematic sample of 770 parents (500 mothers and 270 fathers) aged 21–66 was recruited to fill out a self-administered questionnaire composed of several instruments. The results indicate that parents' IPR experiences are associated with an increased risk of child neglect, and this relationship is mediated by psychological distress. Results also show that in low or medium levels of PSS, psychological distress reports in relation to racism exposure are the highest. Yet, surprisingly, this effect strengthens at high levels of PSS. In comparison, the positive effect of psychological distress on child neglect strengthens in lower levels of PSS, showing a protective role of PSS. Finally, PSS moderates the mediation model's indirect effect; IPR is related to increased psychological distress, and in turn, to a greater risk of child neglect when perceiving low or medium levels of social support. The study underlines the negative consequences of IPR on child neglect and contributes new knowledge to the literature. Longitudinal research is needed to confirm and extend these findings, which could have important clinical implications for treating parents facing racism and potential child neglect. Highlights: Racism is a sociopolitical problem for the Palestinian minority in Israel. The study emphasizes its adverse psychological and behavioral outcomes on parents and children. Parents who experienced ethnonational racism and perceived having lowered levels of social support were at high risk of psychological distress and child neglect. Practitioners should provide programs that contain different sources of social support (instrumental and psychosocial support) when dealing with people exposed to racism. It is essential that policymakers reconsider combating current policies and rules as well as social exclusions to reduce disparities and barriers to services among minorities. [ABSTRACT FROM AUTHOR]

Introduction: Mothers faced an increased risk of adverse mental health outcomes during the COVID-19 pandemic compared to other populations. However, there is little data on the factors that placed mothers at increased risk of distress. Aims: The present study explored a range of individual, familial, and environmental factors associated with psychological distress in mothers during the COVID-19 pandemic. Method: This repeated cross-sectional study was composed of a convenience sample of mothers who completed an online survey that included a demographic questionnaire, an emotion regulation questionnaire, and the Depression, Anxiety, and Stress scale. The survey was administered during the second and third lockdowns in Israel in 2020–2021. Results: The study included 575 mothers (M age = 39). The findings of a hierarchical regression indicated that individual-level factors, composed of age and emotion regulation tendencies predicted psychological distress. The family-level factors of household income and number of children in the family also predicted distress. In terms of environmental-level factors, COVID-19-related media consumption and school status (open or closed) were also significant predictors of psychological distress. Importantly, the results showed that the most important predictors of psychological distress in mothers during the COVID-19 outbreak were school closures, household income, and the use of adaptive and maladaptive emotion regulation strategies. Conclusions: The findings highlight the intersection of individual, familial, and environmental factors in mothers' mental health during crises. [ABSTRACT FROM AUTHOR]

The current study focused on the associations between the cause of a loved one's death, mourner's emotional distress, mourner's ongoing relationship with the deceased, and posttraumatic growth (PTG). The sample comprised 91 Israeli mourners following death due to traffic accident, military service, or prolonged illness. Participants completed questionnaires assessing psychological distress, ongoing relationship with the deceased, and PTG. Findings showed that in traffic-accident deaths, mourners reported higher psychological distress and preoccupation with the deceased compared to that reported by the other mourner groups. Moreover, psychological distress mediated the association between the cause of death and PTG. The findings emphasize the differences between the mourner groups. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate family leadership in family centres for families of children with disabilities in Israel amid the 2019 coronavirus disease (COVID‐19) pandemic. The study focuses on mapping family leadership activities within these family centres during the COVID‐19 pandemic and explores potential associations between participation in family leadership groups and family outcomes. Thirty‐five parents who were involved in family leadership groups and 42 parents of a control group completed an online survey. The survey included the Family Leadership Activity Measure, the Sense of Community Index, the Emergency Families Centre Services Index, the Sense of Sharing Index, the Brief Family Distress Scale and the Beach Center Family Quality of Life Scale. Significant differences were found among groups with regard to barriers to services usage, family centre services usage, family's satisfaction with services, sense of community with the family centre and sense of sharing. Parents who were involved in family leadership groups demonstrated favourable outcomes. No significant differences were found between the groups in family quality of life and distress. It is determined that in times of local or national crises, family leadership may promote more family‐centred supports. [ABSTRACT FROM AUTHOR]

In two studies, we examined the utility of intrinsic (i.e., self) versus extrinsic (i.e., other) reappraisal training for distress reduction during two consecutive COVID-19 lockdowns in Israel. In both Study 1 (n = 104) and Study 2 (n = 181), participants practiced the use of reappraisal for eight sessions across three weeks. Participants were trained to reappraise either a personal event (self-reappraisal group) or an incident presumably written by another participant (other-reappraisal group). Study 2 also included an untrained control group. Outcome measures were daily negative mood and psychological distress immediately at post-training and at a two-month follow-up. The results demonstrate a benefit for training compared to no training in lowering immediate post-training distress and daily negative emotions. However, this advantage disappeared at the two-month follow-up. In both studies, intrinsic reappraisal was associated with lower post-training distress than extrinsic reappraisal. Findings suggest reappraising negative experiences may lower distress at times of major contextual stress. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate emotional distress, suicidality, and help-seeking among Israeli transgender and gender diverse (TGD) persons. Methods: TGD (n=139) and cisgender (n=275) participants reported on suicidal thoughts and behavior (STB), help-seeking behavior, and emotional distress (General Health Questionnaire [GHQ-12]) in an online survey. Results: GHQ-12 and STB were significantly higher among TGD compared with cisgender participants. More TGD participants reported seeking help. Conclusion: TGD persons reported high levels of emotional distress and STB, suggesting that their needs for mental health care are not met by the Israeli health services. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this research was to explore a proposed moderation model that suggests the presence of internalized transphobia as a factor that moderates the relationship between internal and external resilience resources (including personal resilience and coping strategies utilized during distress, and social and family support) on the one side, and psychological distress on the other. Method: Information was gathered from a sample of 119 Israeli adults who self-identified as transgender via an online survey. We modified existing scales to assess the variables of interest. Pearson correlations, t-tests, multiple linear hierarchical regression, and a simple slopes analysis were applied to test our hypotheses. Results: The findings supported the argument that a lack of internal and external resilience resources is associated with higher levels of psychological distress experienced by transgender individuals. The moderation model showed that internalized transphobia moderated the correlation between social support and reported levels of psychological distress, as well as between the use of coping strategies and reported levels of distress. However, internalized transphobia did not moderate the relationship between personal resilience and psychological distress. Conclusions: It is imperative to prioritize raising awareness and providing support to this unique population, considering the associations observed between the study variables. Behavioral interventions are necessary to enhance awareness among policymakers in the domains of education, therapy, and health. In adition, given that young Israelis are obligated to join the army at 18, it becomes even more crucial to implement effective interventions that actively address and combat any discriminatory practices against sexual minorities within the Israeli military. Promoting inclusivity and equity within the armed forces is of utmost importance to ensure fair and respectful treatment of all individuals. [ABSTRACT FROM AUTHOR]

Background: Limited research has examined parental quality of life (QoL) for caregivers of children with special needs, mostly comparing parents of children with autism spectrum disorder (ASD) to those with typical development. This study examines QoL and related variables during the COVID‐19 pandemic among two comparable groups: parents of children with ASD and parents of children with other diagnoses (non‐ASD). Method: The sample included 175 Israeli parents (ASD = 101; non‐ASD = 74). The parents were surveyed about the pandemic's effects on family life, child's function, and their own psychological distress, resilience, and QoL. Results: Parents in both groups reported deterioration in their child's academic, emotional, social, and functioning performance. However, higher psychological distress and more deterioration in child behaviour were reported in the ASD group. In both groups, QoL was positively associated with the introduction of distance learning and parental resilience and negatively associated with psychological distress, deterioration in the child's behaviour and functioning, and increased time spent with the child at home. An interaction analysis indicated that deterioration in a child's behaviour was linked to QoL solely within the ASD group, while home atmosphere was associated with QoL in the non‐ASD group. Conclusion: While the COVID‐19 pandemic imposed similar challenges on both parental groups, there is evidence that it may have been more challenging for the ASD group. This calls for further examination concerning parents with special needs children, and accordingly, tailoring targeted and specific help for them. [ABSTRACT FROM AUTHOR]

This study examines family distress and quality of life among families of children with disabilities during the first wave of the COVID-19 pandemic in Israel. It considers the role of family resources, a sense of community, and the services provided by the Israeli family-centered program (IFCP). One hundred eighty-two parents of children with disabilities participated in this study through an online survey. Structural equation modeling showed that extensive family resources, better operation of the IFCP, and a sense of community were associated with a better quality of life. Lack of family resources was associated with family distress. A regression-based path analysis indicated that this association was moderated by components of the IFCP. Family-centered services were associated with a family's quality of life and experience of distress in times of national crisis. The results highlight the importance of the partnership between parents of children with disabilities and service providers. [ABSTRACT FROM AUTHOR]

During the Israel-Hamas war, researchers conducted a study on the physiological effects of repeated bombings on reptiles. The study focused on the elegant short-fingered gecko and found that their metabolic rates were 2.3 times higher immediately after explosions compared to before. The increased metabolic costs indicate an acute stress response, which could deplete energy stores and negatively impact fitness. The study highlights the far-reaching effects of armed conflicts on biodiversity conservation and calls for armed forces to consider conservation issues during training. [Extracted from the article]

Background: In 2021, the annual rate of pediatric-onset multiple sclerosis (POMS) in Israel among children was 1.5, and 4.5% among youth aged 14–18, out of a total of 5,000 multiple sclerosis cases nationwide. Children diagnosed with POMS often display various deficiencies across psychological, cognitive, sensory, and physical areas. As such, POMS poses significant challenges for parents’ well-being, with heightened emotional, financial, and physical strains linked to both the immediate and long-term care requirements of their children. In this preliminary study, we examined changes over three time-points in two measures of well-being: satisfaction with life and psychological distress. In addition, the role of perceived social support (PSS) and coping flexibility was examined through a multilevel causal mediation model which suggested that PSS 1 month post-diagnosis would predict coping flexibility at 6 months postdiagnosis, which in turn would predict parents’ life satisfaction and psychological distress at 12 months post-diagnosis. Methods: The research was conducted at a tertiary university-affiliated children’s hospital in central Israel. Preliminary data were obtained from 36 parents at three times-points. Participants provided demographic information and filled out the following standardized self-report questionnaires: the Diener’s Satisfaction with Life Scale, Kessler’s inventory for measuring psychological distress (K6), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Perceived Ability to Cope with Trauma Scale (PACT) for measuring coping flexibility. Results: Over time (12 months), parents reported stable levels of PSS, coping flexibility, satisfaction with life, and psychological distress. In addition, mothers reported significantly greater PSS from friends than did fathers. Regarding the causal mediation model, greater PSS from friends at T1 was significantly associated with an increase in coping flexibility from T1 to T2. In turn, an increase in coping flexibility was associated with a decrease in psychological distress from T1 to T3 (after controlling for PSS). Yet the causal mediation path via coping flexibility to satisfaction with life was not significant. Conclusion: This preliminary study emphasizes the important role of both PSS and coping flexibility for the well-being of parents whose children are affected by POMS, a subject that merits heightened consideration among healthcare professionals dealing with long-term chronic diseases. [ABSTRACT FROM AUTHOR]

Objective: This study examined students' perceived levels of coping and need for help, and the relationship with their risks and protective factors during the early stages of the COVID-19 pandemic in Israel. Participants: A sample of 4,710 university students responded anonymously to an online questionnaire. Methods: The risk and protective factors assessed were: specific COVID-related functional difficulties, levels of social support, and trust in the university authorities and the government in handling the crisis. Results: The most frequent COVID-19 related difficulties were: worry for the health of family members (64.4%) and difficulties with online learning (63.2%). Almost half of the students (47.3%) reported that they needed at least a little help. Hierarchical regression analyses for coping and need for help showed that COVID-related difficulties predicted lower levels of perceived coping and a higher need for help. Conclusions: Universities need to build specific services for students to provide concrete support throughout this continuous health crisis. [ABSTRACT FROM AUTHOR]

This study explored the relationship between war-related stressors and sexual well-being among a civilian population during the 2023 Israel–Hamas War, emphasizing a comprehensive assessment of sexual satisfaction, function, and distress. We aimed to investigate how direct exposure, media exposure, and acute stress symptoms during the war contribute to various dimensions of sexual well-being using a quasi-longitudinal online survey method. An online survey with a convenience sample of 1033 Israeli adults, utilizing measures of direct and media exposure to war stress, acute stress symptoms, and various aspects of sexual well-being, both pre-war and present was distributed. Data analysis involved Pearson correlations and hierarchical regression. There were significant associations between stress-related variables and sexual well-being, highlighting the differential contribution of direct exposure, media exposure, and acute stress symptoms. Direct exposure to stress was uniquely associated with sexual dysfunction, while media exposure and acute stress symptoms contributed significantly to predicting various aspects of sexual well-being. Recognizing the multifaceted impact of stress during wartime on sexual well-being is crucial for developing comprehensive mental health interventions that address individual and societal factors. This study contributes valuable insights into the relationships between stress-related variables and sexual well-being during wartime, emphasizing the need for holistic approaches in addressing the intimate challenges individuals face during times of conflict. [ABSTRACT FROM AUTHOR]

Objective: The prolonged and continuous conflict of the Palestinian minority in Israel with the Jewish majority and its cumulative sociopolitical stress (e.g., national incongruity, racism, community, and political violence) may put this minority at risk for psychological distress. This experience may lead to maladaptive behaviors, such as perpetrating violence, including intimate partner violence (IPV). This study examined the relationship between exposure to sociopolitical stressors (i.e., interpersonal racism, collective racism, and national minority stress) and psychological and physical IPV perpetration among Palestinians in Israel. It also examined cognitive appraisals of stress and psychological distress as serial mediators in this relationship. Method: A self-administered questionnaire was completed by a systematic sample of 770 Palestinian adults (64.9% were women and 35.1% were men), aged 21–66 (M = 38.7, SD = 7.84). Participants were sampled from urban, rural, and Bedouin areas in Israel. A serial mediation model was conducted using path analysis. Results: Interpersonal racism directly predicts IPV perpetration. Minority stress and interpersonal racism, however, indirectly predict IPV perpetration via psychological distress. Further, each chain of cognitive appraisals of sociopolitical stress (i.e., uncontrollable and challenge) with psychological distress serially mediates the relationship between sociopolitical stress and IPV perpetration. Conclusions: Exposure to sociopolitical stressors directly impacts the dynamics among Palestinian men and women, but also likely indirectly, through psychological distress and serially through cognitive appraisals and psychological distress. Cognitive appraisals of sociopolitical stress may be important psychological resources or risk factors that practitioners can consider to combat psychological distress and IPV. [ABSTRACT FROM AUTHOR]

Aims: (1) Exploring nurses' perceptions of issues that impacted the quality of patient care and their own performance on COVID‐19 wards; (2) examining nurses' perceptions of how these issues impacted their psychological state and level of performance; and (3) presenting recommendations for improving healthcare policies. Background: Nurses played a critical role in caring for hospitalized COVID‐19 patients and managing the disease. Methods: Semistructured interviews were conducted with 50 nurses (32 females), aged 31–58 years, 6–37 years' tenure, from eight hospitals across Israel. Prior to working in COVID‐19 wards, they worked in internal medicine, emergency rooms, or intensive care units. Based on the COREQ checklist, these interviews were recorded and transcribed, and categorized into themes and subthemes. Findings: The findings indicate that the unpreparedness of healthcare systems for the pandemic outbreak rendered nurses paying a high price at the personal and professional levels, which in turn may have impacted the levels of care that they provided. Conclusion: The rich, qualitative data source revealed important interactions between clinical, personal, social, and familial factors in determining distress levels and performance impairment. A nuanced understanding of the link between these stressors is key to developing and implementing policies that could mitigate deficiencies in the management of epidemics and pandemics in the future. Implications for nursing and health policies: Changes should be made to government directives and healthcare policies, with an emphasis on increasing the nursing workforce, providing emotional support, ensuring availability of equipment and beds, optimizing work practices, developing transparent means of communication within teams, and clearly defining the areas of responsibility of nurses—in times of routine and crises. [ABSTRACT FROM AUTHOR]

The DUET program (a group intervention) aims to enhance parental reflective functioning (PRF). We examined whether pretreatment levels of key outcomes as well as individual parental and family-environment characteristics predicted improvement after intervention with the DUET program. One hundred forty-two parents (native Israelis; mean age = 34.84 years) of preschool children (n = 107; mean child age = 4.3 years; 53% female) were assessed before, after, and 6 months following the intervention. Results indicated significant associations between lower levels of key outcomes at the pretreatment assessment and greater improvement after treatment in PRF, child self-regulation, and child self-distraction strategies. Furthermore, two subgroups of families were uncovered based on individual parental and family-environment characteristics: low-distress and high-distress parents. Following intervention, the high-distress group showed greater improvement in parental sensitivity and child problem behavior, whereas the low-distress group reported greater improvement in locus of control. Clinical and future directions are discussed. [ABSTRACT FROM AUTHOR]

This study sought to investigate a positive dimension of coping with the COVID‐19 pandemic, that of post‐traumatic growth (PTG). This study investigated coping difficulties and PTG amongst parent and nonparent students in Israeli Universities. A total of 4022 parents (3648 Jews and 374 Palestinian‐Arab Citizens [PACs]) and 14,651 nonparents (12,010 Jews and 2641 PACs) completed measures of coping, social support and PTG. Parents demonstrated significantly higher levels of coping and PTG. Amongst parents, fathers coped slightly better than mothers; however, while Jewish mothers demonstrated greater PTG than Jewish fathers, PAC fathers had significantly greater PTG than both PAC mothers and Jewish parents. These findings, while specific to COVID‐19, indicate that PTG should be studied in greater depth in different ethnic and minority groups in order to develop enhanced understanding and facilitate promotion of post‐traumatic growth, in addition to the prevention of COVID‐19‐related distress. [ABSTRACT FROM AUTHOR]

The measures taken to stop the spread of COVID-19 pandemic may have severe economic, family and health consequences for socially vulnerable populations, such as single mothers. We assessed COVID-19 stressors (employment and economic changes and child-related worries) among a convenience sample of single mothers (n = 325), and examined their association with the mothers' self-rated health (SRH) and psychological distress (symptoms of depression and anxiety). A high proportion of the mothers experienced substantive impact on their employment, income and child-related worries since the COVID-19 outbreak; close to 25% reported low levels of SRH; and the mean scores for symptoms of depression and anxiety were high, around the cutoff point for probable symptomatology. Multivariate analyses using hierarchical linear regression models revealed that changes since the pandemic outbreak – worries about employment, reduction in income and children – contributed significantly to SRH and to symptoms of depression and anxiety: the greater the worries, the poorer the SRH and the higher the levels of psychological distress. Single mothers require assistance to safeguard their employment and prevent reduction in income, as well as practical help with childcare, to reduce the impact of COVID-19 on health and on symptoms of depression and anxiety. [ABSTRACT FROM AUTHOR]

Background: Government actions and participating in protracted-duration protests against it affect protesters' mental health, leading to high distress levels, such as posttraumatic and depressive symptoms. Aside from exposure to violence and other issues, protest participation can pose unique challenges to the protesters as they may be exposed to potentially morally injurious events (PMIEs), such as the betrayal of leaders they once trusted. This study's primary objective was to examine the extent of psychological difficulties among civilians participating in long-duration protests in Israel. More specifically, the study aimed to understand the contribution of exposure to protest-related PMIEs to psychological difficulties such as posttraumatic and depressive symptoms. Method: Participants comprised 4036 Israelis who were actively involved in the unfolding civil protest movement against the government-led judicial overhaul between January 2023 and August 2023. The protesters completed validated self-report questionnaires that included measures of PMIE exposure, PTSD and depressive symptoms. Results: About half (44.3%) of the sample met the criteria for self-report diagnosis of major depression and 10.6% for PTSD. Most of the protesters indicated their exposure to at least one moral injury event, with 63.9% reporting exposure to PMIE-Betrayal. Protesters exposed to PMIEs reported significantly higher levels of both PTSD and depression than non-PMIE-exposed protesters. Hierarchical regression analyses revealed that, beyond demographics and protest-related characteristics such as exposure to violence, PMIE dimensions significantly contributed to both PTSD and depression levels. Conclusions: The findings highlight the mental burden of protesters during the civil protests against the judicial overhaul in Israel. More central to the present research, the findings highlight the critical contribution of PMIEs exposure to this burden. Clinicians treating protesters coping with depression and PTSD following the civil actions should attend to their exposure to PMIEs, which may relate to the deleterious psychological effects among protesters. Participation in protests have high mental burden as about half of the sample met the criteria for self-report diagnosis of major depression and 10.6% for PTSD. Protesters exposed to protest-related PMIEs reported significantly higher levels of both PTSS and depression than non-PMIE-exposed protesters. The findings highlight the critical contribution of PMIE-betrayal exposure to both PTSS and depressive symptoms, above and beyond demographic and protest-related characteristics. [ABSTRACT FROM AUTHOR]

Informed by socio-ecological psychology and the conservation of resources model, the present study proposes an integrative perspective on the association between psychological distress and a constellation of factors, during the COVID-19 outbreak in Israel. Our sample, comprised of 991 adult participants, was measured for psychological distress, locus of control (internal/ external), resilience, loneliness, social support, dimensions of citizens' trust in government organizations (perceived competence, benevolence, and integrity), and demographic characteristics. The findings showed that women, non-religious people, and the unemployed reported higher levels of psychological distress. Internal locus of control, resilience, social support, and the extent to which citizens perceive government organizations as benevolent were negatively associated with psychological distress. Self-reported loneliness and external locus of control positively predicted the level of respondent psychological distress. No association was detected between age, competence and integrity and psychological distress. An overview of the research findings indicates that individuals with greater resources were less likely to suffer from psychological distress during the COVID-19 outbreak. These findings call upon mental health care practitioners to help as well as to enable clients to attain resources in order to lower their levels of psychological distress. Policies developed by policymakers during periods of acute crisis should consider the specific needs and vulnerabilities of certain population groups, including women and the unemployed who may be more susceptible to psychological distress. It is also important for policymakers to be aware that the perception of democratic governments as benevolent can serve as a buffer against psychological distress during times of crisis. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had devastating emotional consequences. The present study aimed to examine the relationships between personal resources and emotional distress while accounting for COVID-19–related variables. Seven hundred and seventy-seven (N = 777) participants completed demographic, mastery, forgiveness, optimism, resilience, PTSD, and anxiety questionnaires. A stepped hierarchical multiple regression revealed that mastery, forgiveness, cultural group, age, acquaintance with a person who died of COVID-19, and having been infected with COVID-19 contributed significantly to the explained variance in PTSD symptoms. Mastery, forgiveness, optimism, age, and acquaintance with a person who died of COVID-19 contributed significantly to the explained variance in anxiety. However, resilience was not found to significantly contribute to the explained variance in PTSD symptoms or anxiety. This study demonstrates the importance of being aware of both PTSD symptoms and anxiety associated with COVID-19. Thus, it is suggested that therapy programs should pay special attention to mastery and forgiveness as coping resources. In addition, among medical and mental-health personnel awareness should be given to individuals who have been in close acquaintance with those who died of COVID-19, those with COVID-19 risk factors, and those who have been infected. Special attention should also be paid to minority groups as they might tend to experience more emotional distress and trauma symptoms. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the relationship between work)family system stressors and mental distress among traditional sectors (Orthodox and Arab) and the modern sector (non-Orthodox Jews) of Israeli society. The work-family system stressors included objective load, subjective load at work, and role conflict between family and work. The research sample comprised 817 participants, and data was collected through an online link from the member database of the Panels Research Institute. The study was based on the assumption that in traditional collectivist cultural sectors, the impact of work-family system stressors on individual well-being would be lower than in cultural sectors with a modern-individualist orientation. The findings indicated differences between the sectors and genders in the experience of work-family system stressors. Ultra-Orthodox men experienced higher levels of family-work role conflict than ultra-Orthodox women, and Arab men experienced higher levels of mental distress than Arab women. These differences were also found in the relationship between work-family system stressors and mental distress: weaker relationships were found among women from the traditional sectors (especially from the Arab sector) between role conflict and mental distress compared to men. The study concludes that work-family system stressors negatively affect the mental well-being of all sectors in Israel, although Arab women in particular show resilience to such stressors, as do ultra-Orthodox women to a certain extent. Contrary to the conventional belief that women are the main victims of work-family system stressors, the findings show that men in traditional sectors, especially Arab men, are at the highest risk of experiencing mental distress. Recommendations for practice include the adoption of family)friendly policies by labor organizations, and the development of intervention methods that are compatible with sector and gender. [ABSTRACT FROM AUTHOR]

Introduction: Civilians constitute a significant wartime target, and trauma accounts for most of their injuries. Air raid sirens have long been used to alert civilians of incoming attacks and have since expanded to warn from natural disasters. Sirens are known to cause significant emotional distress and physiological changes. Injuries inflicted from trauma while moving for shelter have yet to be described in the medical literature.Methods: During the recent Israel-Gaza conflict of May 2021, most of Israel's population experienced rocket warning sirens. We collected all adult (18<) patients arriving at a major tertiary medical center emergency department (ED), attesting to having suffered their injury while rushing for shelter. Clinical and demographic data were retrieved and analyzed.Results: A total of 48 patients were identified, with a mean age of 59.6 ± 20.0. Ten (21%) patients were admitted, and their mean length of stay was 4.4 ± 3.7 days. Women had a higher probability of being hospitalized (42.9% vs. 5.9%, P = .04), and those hospitalized tended to be older (68.8 ± 16.4 vs. 54.8 ± 20.8, P = .06). Elderly patients (65<) had a higher risk of injury. Extremity injuries were most common (50%), before head trauma (29%) and torso injuries (25%). Most patients (38/48, 79.2%) were discharged from the ED, and the rest were hospitalized for observation or surgery. One patient died from a head injury.Conclusions: This study implies that injuries while moving for shelter were a prevalent cause of physical injury to Israeli civilians during the Israel-Gaza 2021 conflict. Warning sirens injuries should be given appropriate attention-from prevention by directed media campaigns to post-conflict reimbursement. [ABSTRACT FROM AUTHOR]

Introduction: Lesbian women, gay men, and bisexual (LGB) individuals often have adverse mental health outcomes connected to their sexual minority status. We hypothesized that distress in LGB emerging adults may be connected to specific relational attitudes in their connection with their parents. We examined whether sense of relational entitlement and authenticity in relationships mediated the association between sexual orientation and mental health outcomes. Methods: Participants were 152 women and 69 men aged 18–21, 105 (47.5%) of whom identified as heterosexual and the others as LGB. They completed questionnaires online in 2020–2021 assessing inflated and restricted sense of entitlement, relational authenticity, psychological distress, well-being, and life satisfaction. Results: LGB participants reported more inflated and restricted sense of entitlement and psychological distress than heterosexual participants, and less relational authenticity and life satisfaction. Mediation models showed that inflated and restricted entitlement fully mediated the association between sexual orientation and psychological distress and that inflated entitlement and authenticity in relationships fully mediated the association between sexual orientation and life satisfaction. Gender was not a moderator in these models. Conclusions: LGB individuals' negative mental health outcomes may be connected to imbalanced relational entitlement and low authenticity in their relationships with their parents. Policy Implications: Our findings show the need for supportive services for LGB youth and their parents, encouraging mutuality, openness, and authenticity. This is particularly true in Israel, where traditional masculine roles reign and the Orthodox Jewish law condemns sexual minorities. Policymakers should work to decrease disparities between heterosexual and LGB individuals. [ABSTRACT FROM AUTHOR]

In the context of sexual minorities and the distress they may experience, recent years have witnessed a trend emphasizing the idea that protective factors may curb risk behaviors, while stressing that not all sexual minorities do experience distress. However, protective factors have been studied less frequently than have risk factors. To the extent that protective factors are identified among those at risk for psychological distress and risk behaviors, strategies can seek to address risk by enhancing these protective factors. The current study aimed to expand the knowledge in this area by simultaneously examining protective and risk factors as well as by examining the association between sexual orientation, psychological distress, sense of coherence (SOC), social support (e.g., parental and peer relationships), and alcohol and cannabis use among Israeli young adults. A self-reported questionnaire was distributed to 496 young adults: 254 heterosexual participants and 242 homosexual participants. As hypothesized, participants with a same-sex orientation reported higher psychological distress, lower SOC, a weaker relationship with their parents, and a greater use of alcohol and cannabis than did heterosexual participants. Regression analyses indicated that low SOC, low family support, and low peer support predicted higher psychological distress. However, sexual orientation was not found to predict distress levels among young adults in Israel. Similarly, no associations were found between alcohol and cannabis use and psychological distress. The results are discussed within the framework of resilience factors that can serve as a barrier to distress and to the use of psychoactive substances among young adults in general and sexual minorities in particular. [ABSTRACT FROM AUTHOR]

Exposure to potentially morally injurious events (PMIEs) during military service is associated with mental health problems. However, knowledge about these associations and possible mechanisms of effect among female combat veterans is sparse. This study examines associations between PMIEs, posttraumatic stress disorder (PTSD), complex PTSD, depression and anxiety symptoms among female veterans, as well as the mediating role of disruption in assumptive world and moral injury (MI) symptoms. A volunteer sample of Israeli female combat veterans (n = 885) and non‐combat veterans (n = 728) responded to self‐report questionnaires in a cross‐sectional design study. Results show that combat veterans reported higher levels of PMIEs, PTSD and MI symptoms, but not CPTSD, depression and anxiety symptoms, as compared to non‐combat veterans. Importantly, PMIEs was indirectly associated with PTSD, complex PTSD, depression and anxiety symptoms through serial mediators of disruption in assumptive world and MI symptoms. This study emphasized the exposure to PMIEs and its posttraumatic sequelae among female combat veterans as compared to non‐combat veterans. Our findings also suggest that future longitudinal studies should examine the mediating role of disruption in assumptive world and MI symptoms for the deleterious effects of exposure to PMIEs during military service. [ABSTRACT FROM AUTHOR]

The current study aimed to explore the associations between intimate partner violence (IPV), psychological distress, health and financial concerns, function and support during the COVID‐19 outbreak in Israel. Data were collected from 333 Israeli adults (50.8% men and 49.2% women) via an online survey during the third lockdown in Israel. Existing scales were adapted to measure psychological distress, function, and support. Chi‐square tests, t‐tests, Chi‐square tests Z ratios, multiple regressions and a series of process models were employed to examine the research hypotheses. The main findings show that IPV, especially verbal violence, was directly associated with higher levels of distress and lower levels of functioning, a link that could be indirectly mitigated by health and financial concerns as well as lack of family and community support. In addition, low rates of physical violence, with no gender differences and with higher levels of verbal violence reported by women, were found. Finally, women reported higher levels of concerns and psychological distress and lower levels of functioning than men. The results might help identify the needs of families and couples in order to design counselling or training programs for stress and conflict reduction. In addition, the response to the pandemic cannot be a homogeneous response. Different assistive measures must be applied to various segments of the population and groups that are already at risk and, therefore, remain more vulnerable, with targeted assistance given to all of these different groups. [ABSTRACT FROM AUTHOR]

Whereas the desire for revenge for an unjust deed is considered natural, its use within the therapeutic setting is scarce, specifically in sexually victimized children. The study aimed to find how experiencing sexual molestation during childhood and the revenge fantasy is reflected in drawings and narratives of sexually victimized children. Following ethical approval and signing a consent form, 14 children who experienced sexual abuse and were psychologically treated (ages 11–18) were recruited. They were asked to draw two drawings: "draw an unjust event that had happened to you" and "draw what you would have liked to happen to the person that unjustly treated you." At completion, participants were asked to give a narrative to each drawing. Phenomenological analysis of the drawings and narratives indicated that most participants refrained from using more than two colours, did not draw the perpetrator and drew schematic figures. The main themes that emerged in the drawings and the narratives were feeling of loneliness, aloneness, and the desire for role reversal. [ABSTRACT FROM AUTHOR]

Differences in economic, social, and environmental circumstances lead to systematic and unfair health inequalities. Yet, this inequality is modifiable. Drawing on the social determinants approach to health this study explored: (a) the association between economic, social-relational, and environmental stressors with psychological distress (PD) among a representative sample of young adults in Israel (N = 2,407); (b) the collective impact of these multiple stressors on PD and the extent to which the co-occurrence of stressors demonstrated a stepped relationship with PD. Social determinants included subjective poverty, perceived income adequacy, material deprivation indices, social trust, trust in institutions, perceived discrimination, loneliness, and indicators for the quality of the neighborhood environment. Bivariate analysis was used to assess associations between economic, social-relational, and environmental stressors with PD. Hierarchical linear regressions, estimated to predict PD, showed that the social determinants shaped PD in young adulthood, with each stressor domain making a distinct contribution to explaining PD. Subjective poverty, material deprivation, and loneliness were particularly detrimental. Social determinants were additive, constituting cumulative stressors that convey increased risk for young adults' mental well-being. The findings suggest that health inequality can be reduced by directly addressing its social determinants. Although important, improved access to social and mental health services alone is unlikely to relieve the burden of PD and its adverse consequences both for individual suffering and at the national level. Broader and combined policy measures are required to combat poverty and deprivation, discrimination, lack of trust, and loneliness. Public Policy Relevance Statement: Psychological distress in young adulthood is shaped by economic, social-relational, and neighborhood environment stressors. The co-occurrence of stressors is extremely harmful for young adults, resulting in progressively declining well-being. Disparities in psychological distress can be greatly reduced by addressing its social determinants. Combined policy measures should be taken, giving priority to those aimed at combating poverty and material deprivation along with programs and intervention to alleviate loneliness. The eradication of discrimination against any background and enhancement of both social trust and trust in institutions are important steps for narrowing health inequalities and promoting social justice. Finally, decreasing environmental stressors in terms of noise level and air pollution will also help. These require action beyond the health sector and should involve the education, labor, environment, housing, and welfare sectors. To address the health divide, policy makers must adopt the broader perspective of considering individuals' position within multiple levels of the social context in which they are embedded. [ABSTRACT FROM AUTHOR]

Introduction: Academic distress has been frequently reported following the COVID-19 pandemic. This study estimates academic distress among undergraduate students, characterizes its nature in relation to economic, social, and health indicators, and examines the level of request for help following mental distress. Students with higher levels of academic distress were expected to show lower socio-economic status, lower social connections, and lower wellbeing indices. Methods: A cross-sectional study based on a structured anonymous questionnaire was delivered online to more than 1,400 undergraduate students from one university in Israel (women, 66.7%). Results: Academic distress was reported by 27.1% of the sample. Students who reported academic distress were more likely to report stress, negative psychosomatic symptoms, changes in weight since COVID-19, low self-esteem, depressive symptoms, higher COVID-19 concerns, and higher security situation concerns. A hierarchic logistic regression model showed that the probability of reporting academic distress was 2.567 times higher (p < 0.001 95% CI [1.702, 3.871]) for those who reported lower family economic status before COVID-19 and 2.141 times higher (p = 0.004 95% CI [1.284, 3.572]) for those who highly reported depressive symptoms. In contrast, only 15.6% of those who reported academic distress sought help from academic authorities. Discussion: The significant associations of academic distress with health indices indicate that the self-reported distress was real and highly related to adverse health measures. A comprehensive, collaborative model that integrates psychological, economic, and social aspects of intervention is required in times of crisis within academic institutions. [ABSTRACT FROM AUTHOR]

This paper reports findings on associations between four subscales of social alienation and psychological distress and sleep problems, and the moderating effects of ethnic pride and shame on these relationships. The study employed a cross-sectional survey design. Participants were 1008 Israeli Palestinian and Jewish adolescents recruited via public schools that allowed access. The questionnaires were administered in adolescents' native language (Hebrew or Arabic) in their homeroom classes. As hypothesized, findings showed that adolescents who have more trust in procedural justice and prefer their own ethnic group reported fewer sleep problems and that adolescents who were less committed to the law and more alienated reported more sleep problems. The findings also showed negative association between psychological distress and believing in procedural justice and positive association with alienation. However, of sixteen moderating effects tested only ethnic pride reached statistical significance and moderated the effect of alienation on sleep problems. Findings also showed that gender, ethnicity and SES were partially linked to both outcomes variables. Psychological distress and sleep problems were associated with female gender, Palestinian-Israeli ethnic affiliation and low SES. Several possible explanations are offered for the findings. Directions for future research, and potential implications are discussed. [ABSTRACT FROM AUTHOR]

While it is known that fibromyalgia patients often suffer from depression and stress symptoms, there is inconclusive evidence as to why these symptoms occur. The aim of this study is to examine the role of emotion regulation in mental health symptoms among treatment-seeking individuals with fibromyalgia. Ninety-three (93) participants (mean age = 47.25, SD = 12.4) were recruited from one of Israel's largest community healthcare providers. They were administered self-report questionnaires assessing fibromyalgia (FIQR), perceived stress (PSS), major depression (PHQ-9), and difficulties in emotion regulation (DERS). Associations were found between measures of fibromyalgia symptoms, psychological distress, and emotion regulation. Several sub-indices of emotion regulation showed significant correlations with psychological distress, with non-acceptance of emotional responses showing the strongest associations. Moreover, non-acceptance of emotion responses mediated the association between fibromyalgia symptoms and psychological distress. Our findings show that the connection between fibromyalgia symptoms and psychological distress is partially explained by difficulties in emotion regulation. Moreover, we show that specific emotion regulation strategies play a differential role in fibromyalgia patients' distress, thereby highlighting the importance of identifying unique psychotherapeutic targets. Specifically, regulating emotions through acceptance of emotional responses seems to be particularly important for fibromyalgia patients, as they cope with stigma and a lack of validation. [ABSTRACT FROM AUTHOR]

Social workers often rely on non-professional community figures to identify and refer at-risk populations. One such figure is the Jewish "balanit" (plural: balaniyot), who assists women at the mikveh, a religious bathhouse for monthly purification. Mental health symptoms can come to light in this unique situation. This quantitative study drew on the feminist perspective and concept of the "moral third" to explore factors contributing to balaniyot's role perception regarding distressed women. Israeli balaniyot (N = 166) completed self-report questionnaires assessing the role perception of aiding distressed women, and independent variables relating to commitment and connectedness to the victims (organizational commitment, years of experience, workdays), and acknowledgment of suffering (knowledge of distress situations, beliefs about violence toward women). Hierarchical regression showed that more weekly workdays, higher community belonging, and greater knowledge of distress situations contributed to role perception. Moreover, among participants with low community belonging, organizational commitment was associated with lower role perception. The findings suggest that organizational commitment may conflict with community belonging, requiring balaniyot to choose between them. The study indicates the need for specialized training to increase balaniyot's knowledge of distress situations and ensure that their organizational commitment is not strengthened at the expense of their crucial capability to aid distressed women. [ABSTRACT FROM AUTHOR]