New Article: Schiff et al, PTSD Among Female Methadone Patients Who Were Survivors of Sexual Abuse

Schiff, Miriam, Nitsa Nacasch, Shabtay Levit, Noam Katz, and Edna B. Foa. “Prolonged Exposure for Treating PTSD Among Female Methadone Patients Who Were Survivors of Sexual Abuse in Israel.” Social Work in Health Care 54.8 (2015): 687-707.

 

URL: http://dx.doi.org/10.1080/00981389.2015.1058311

 

Abstract

The aims of this pilot study were: (a) to test the feasibility of prolonged exposure (PE) therapy conducted by a social worker staff on female patients in methadone program clinics who were survivors of child sexual abuse or rape and (b) to examine preliminary outcomes of PE on posttraumatic stress disorder (PTSD), depression, and illicit drug use at pre- and posttreatment, and up to 12-month follow-ups. Twelve female methadone patients who were survivors of child sexual abuse or rape diagnosed with PTSD were enrolled in 13–19 weekly individual PE sessions. Assessments were conducted at pre-, mid-, and posttreatment, as well as at 3, 6, and 12-month follow-ups. The treatment outcomes measures included PTSD symptoms, depressive symptoms, and illicit drug use. Ten of the 12 study patients completed treatment. PTSD and depressive symptoms showed significant reduction. No relapse to illicit drug use was detected. These preliminary results suggest that PE may be delivered by methadone social workers with successful outcomes. Further research should test the efficacy of PE among methadone patients in a randomized control trial with standard care as the control condition.

 

 

New Article: Zerach et al, The Role of Fathers’ Psychopathology in the Intergenerational Transmission of Captivity Trauma

Zerach, Gadi, Yaniv Kanat-Maymon, Roy Aloni, and Zahava Solomon. “The Role of Fathers’ Psychopathology in the Intergenerational Transmission of Captivity Trauma: A Twenty Three-Year Longitudinal Study.” Journal of Affective Disorders 190 (2016): 84-92.

 

URL: http://dx.doi.org/10.1016/j.jad.2015.09.072

 

Abstract

Background

The aversive impact of combat and parents’ combat-induced posttraumatic stress disorder (PTSD) on young children has been examined in a few studies. However, the long-term toll of war captivity on the secondary traumatization (ST) of adult offspring remains unknown. This study aimed to assess the longitudinal associations between former prisoners of war (ex-POWs), PTSD, depressive symptoms and their adult offsprings ST.

Method

A sample of 134 Israeli father-child dyads (80 ex-POWs dyads and a comparison group of 44 veterans’dyads) completed self-report measures. The fathers participated in three waves of measurements following the Yom Kippur War (T1: 1991, T2: 2003, and T3: 2008), while the offspring took part in T4 (2013).

Results

Offspring of ex-POWs with PTSD at T3 reported more ST symptoms than offspring of ex-POWs without PTSD and controls. Ex-POWs’ PTSD hyper-arousal symptom cluster at T3 was positively related to offsprings ST avoidance symptom cluster. Offspring of ex-POWs with chronic and delayed PTSD trajectories reported more ST symptoms than offspring of ex-POWS and controls with resilient trajectories. Ex-POWs’ PTSD and depression symptoms at T1, T2 and T3 mediated the link between war captivity (groups) and offsprings ST in T4.

Limitations

The use of self-report measures that did not cover the entire span of 40 years since the war, might may bias the results.

Conclusions

The intergenerational transmission of captivity related trauma following the Yom Kippur War was exemplified. ST symptoms among ex-POWs’ adult offspring are closely related to their father’ PTSD and related depressive symptom comorbidity.

 

 

 

New Article: Lurie and Nakash, Mental Health and Acculturation Patterns Among Asylum Seekers in Israel

Lurie, Ido, and Ora Nakash. “Exposure to Trauma and Forced Migration: Mental Health and Acculturation Patterns Among Asylum Seekers in Israel.” In Trauma and Migration. Cultural Factors in the Diagnosis and Treatment of Traumatised Immigrants (ed. Meryam Schouler-Ocak; New York: Amsterdam; 2015), 139-56.

 
 

URL: http://dx.doi.org/10.1007%2F978-3-319-17335-1_10

 

Abstract
Immigration is a process of loss and change which entails significant sociopsychological stress and possible effects on the mental health of immigrants. Over the last few decades, the State of Israel has become a target for forced migration. Since 2006 specifically, asylum seekers from East Africa (mainly Eritrea and Sudan) have been arriving in Israel.

In the current chapter, we first outline the phenomenon of forced migration to Israel and the living conditions of migrants once they arrive in Israel. We then describe the relationship between forced migration and mental health, both in adults and adolescents, as well as the connection between acculturation and mental health. Following this, we describe studies conducted with forced migrants in Israel, mainly Eritrean and Sudanese asylum seekers. We carried out three studies; within the population of service users at the Physicians for Human Rights (PHR)-Israel’s Open Clinic, we documented the exposure of Eritrean and Sudanese asylum seekers to traumatic events during their journey to Israel. Our findings indicate that among a sample of adult African asylum seekers who arrived at the Open Clinic, a considerable percentage of men and women reported having witnessed violence and/or having been a victim of violence during migration to Israel.

Next, we examined the relationship between acculturation patterns and mental health symptoms among asylum seekers who arrived at the Open Clinic (N = 118). Assimilated asylum seekers reported higher (or more) depressive symptoms compared to integrated asylum seekers. Acculturation predicted depressive symptoms among adult asylum seekers beyond reports of experiences of traumatic events and the effect of history of detention.

Then, also describe the results of a study examining the role of acculturation, perceived discrimination and self-esteem in predicting mental health symptoms and risk behaviours among 1.5 and second-generation non-Jewish adolescents born to migrant families compared to native-born Jewish Israeli adolescents in Israel. Migrant adolescents across generations reported more severe mental health symptoms compared to native-born Jewish Israelis. However, only the 1.5 generation migrants reported higher engagement in risk behaviours compared to second-generation migrants and native-born Jewish Israelis. Similar to the adult sample, adolescents also showed that acculturation plays an important role in predicting the mental health status of migrant youths; adolescents showing integrated acculturative patterns reported fewer mental health symptoms than those with assimilated acculturation patterns.

The findings regarding the exposure of East African asylum seekers to traumatic events highlight the need to gather information regarding all phases of forced migration, from experiences in the home country through the journey to the host country. Our findings on acculturation draw attention to the paradox of assimilation and the mental health risks it poses for adult asylum seekers and adolescent immigrants wishing to integrate into the new culture at the expense of their original culture. Mental health professionals should be culturally aware of this vulnerability in therapeutic interventions with forced migrants. Policy makers may consider the benefits of the restrictive policies that have characterised many industrial countries in recent years.

 
 
 
 

New Article: Halperin et al, The Influence of Childbirth on PPD: A Comparison between Israeli Jewish and Arab Women

Halperin, Ofra, Orly Sarid, and Julie Cwikel. “The Influence of Childbirth Experiences on Women׳s Postpartum Traumatic Stress Symptoms: A Comparison between Israeli Jewish and Arab Women.” Midwifery 31.6 (2015): 625-32.

 
 

URL: http://dx.doi.org/10.1016/j.midw.2015.02.011

 

Abstract

Background

childbirth is a positive experience for most women yet some women express distress after birth. Traumatic experience can sometimes cause post-traumatic stress disorder (PTSD) in relation to childbirth. Prevalence of traumatic birth experience and PTSD after childbirth differs between cultures.

Objectives

to examine the subjective recall of childbirth experiences and PTSD symptoms of Israeli Jewish and Arab women; to examine comparatively the prevalence of PTSD symptoms six to eight weeks after childbirth and to establish the factors that predict PTSD symptoms.

Methods

a prospective study was conducted in a region characterised by wide variations in ethnocultural groups. The study was comprised of two time points: Time 1 (T1) interviews were conducted at the bedside of the women in the maternity ward of each hospital 24–48 hours after childbirth. Time 2 (T2), all 171 women participating in T1 were interviewed by phone six to eight weeks after childbirth.

Findings

34 women (19.9%) reported their labour as traumatic 24–48 hours after birth (T1), and six to eight weeks later (T2) 67 women (39.2%) assessed their experience as traumatic. More Arab women (69.6%) than Jewish women (56.5%) had a positive memory of childbirth, but this difference only approached statistical significance (p=.09). Results showed rather low frequencies of PTSD symptoms, and no ethnic difference. PTSD symptoms were significantly and positively predicted by subjective recollection of childbirth experience (Time 2). PTSD symptoms were higher for women who did not have a vaginal birth, and more women with PTSD symptoms were not breast feeding.

Conclusions

we found more similarities than differences between Arab and Jewish women׳s experience of their births and no differences between them on the prevalence of PTSD symptoms after birth. The results suggest that non-vaginal birth (instrumental or caesarean section) and negative recollection of the childbirth experience are important factors related to the development of PTSD symptoms after birth, and that women with PTSD symptoms are less likely to breast feed.

New Article: Shelef et al, Risk Factors for Suicide Attempts among IDF Soldiers

Shelef, Leah, Dan Kaminsky, Meytal Carmon, Ron Kedem, Omer Bonne, J. John Mann, and Eyal Fruchter. “Risk Factors for Suicide Attempt among Israeli Defense Forces Soldiers: A Retrospective Case-Control Study.” Journal of Affective Disorders 186 (2015): 232-40.

 

URL: http://dx.doi.org/10.1016/j.jad.2015.07.016

 

Abstract

Background

A major risk factor for suicide is suicide attempts. The aim of the present study was to assess risk factors for nonfatal suicide attempts.

Methods

The study’s cohort consisted of 246,814 soldiers who were divided into two groups: soldiers who made a suicide attempt (n=2310; 0.9%) and a control group of soldiers who did not (n=244,504; 99.1%). Socio-demographic and personal characteristics as well as psychiatric diagnoses were compared.

Results

The strongest risk factors for suicide attempt were serving less than 12 months (RR=7.09) and a history of unauthorized absence from service (RR=5.68). Moderate risk factors were low socioeconomic status (RR=2.17), psychiatric diagnoses at induction (RR=1.94), non-Jewish religion (RR=1.92), low intellectual rating score (RR=1.84), serving in non-combat unit (RR=1.72) and being born in the former Soviet Union (RR=1.61). A weak association was found between male gender and suicide attempt (RR=1.36). Soldiers who met more frequently with a primary care physician (PCP) had a higher risk for suicide attempt, as opposed to a mental health professional (MHCP), where frequent meetings were found to be a protective factor (P<0.0001). The psychiatric diagnoses associated with a suicide attempt were a cluster B personality disorder (RR=3.00), eating disorders (RR=2.78), mood disorders (RR=2.71) and adjustment disorders (RR=2.26).

Limitations

Mild suicidal behavior constitutes a much larger proportion than among civilians and may have secondary gain thus distorting the suicidal behavior data.

Conclusions

Training primary care physicians as gatekeepers and improved monitoring, may reduce the rate of suicide attempts.

New Article: Ayalon et al, Informal Mental Health Help-Seeking Attitudes according to Israeli Arab Women

Ayalon, Liat, Khaled Karkabi, Igor Bleichman, Silvia Fleischmann, and Margalit Goldfracht. “Between Modern and Traditional Values: Informal Mental Health Help-Seeking Attitudes according to Israeli Arab Women, Primary Care Patients and Their Providers.” International Journal of Social Psychiatry 61.4 (2015): 386-93.

 

URL: http://dx.doi.org/10.1177/0020764014549082

 

Abstract

Background: Israeli Arab women under-utilize mental health services.

Objectives: The present study evaluated the use of alternative services for dealing with depression and anxiety among Israeli Arab women and primary care providers.

Material: Four focus groups with primary care patients and two focus groups with primary care providers were conducted. Constant comparisons were employed in order to identify major themes related to informal help-seeking behaviors.

Discussion: Three informal help-seeking behaviors were identified: (a) social support, divided into extended family and neighbors versus nuclear family and close friends; (b) religiosity, divided into inner, direct practices and beliefs versus externally mediated ones; and (c) self-help techniques, such as engagement in activities and distancing oneself from the situation. Both social support and religiosity were viewed with ambivalence by primary care patients and providers.

Conclusion: The findings suggest that the Arab population in Israel might be lacking informal sources of support at times of mental health needs.

New Article: Abu-Kaf and Braun-Lewensohn, Paths to Depression. Comparing Bedouin Arab and Jewish Students

Abu-Kaf, Sarah and Orna Braun-Lewensohn. “Paths to Depression Among Two Different Cultural Contexts. Comparing Bedouin Arab and Jewish Students.” Journal of Cross-Cultural Psychology 46.4 (2015): 612-30.

 

URL: http://jcc.sagepub.com/content/46/4/612

 

Abstract

Over the past two decades, there has been an increase in the number of Bedouin Arab students studying at institutions of higher education in Southern Israel. To date, research on Bedouin students is limited, particularly with regard to their coping and adjustment. The main aim of the current study is to shed more light on potential pathways between vulnerability factors and depression among Bedouin Arab and Jewish students. This study was designed to explore cultural differences in the levels of self-criticism, depression, coping, and social support among Bedouin Arab college/university students and their Jewish peers, and to examine the effects of self-criticism on depression in the two cultural contexts. To that end, we conducted a cross-sectional study of 108 Bedouin students and 109 Jewish students. The participants completed the Depressive Experiences Questionnaire, Medical Outcomes Study Social Support Survey, Orientations to Problems Experienced Inventory, the Center for Epidemiological Studies Depression Scale, and demographic questionnaire. In this work, we observed differences in the levels of self-criticism, depression, avoidant coping, and social support in the different groups. Moreover, among the Jewish participants, self-criticism affected depression directly. However, among the Bedouin Arabs, self-criticism affected depression only indirectly, through avoidant coping. The present study highlights the possibility that specific cultural contexts underscore the role of avoidant coping in the pathways between self-criticism and depression, whereas other cultural contexts underscore the direct effect of self-criticism on depression levels. Furthermore, the current research underscores the importance of cross-cultural perspectives in studies of vulnerability factors and depression.

New Article: Shelef et al, Characteristics of Soldiers with Self-Harm in the IDF

Shelef, Leah Eyal Fruchter, Dror Ortasse Spiegel, Gal Shoval, J. John Mann, and Gil Zalsma. “Characteristics of Soldiers with Self-Harm in the Israeli Defense Forces.” Archives of Suicide Research 18.4 (2014): 410-418.

 

URL: http://www.tandfonline.com/doi/abs/10.1080/13811118.2013.845121

 

Abstract

Suicide is the leading cause of soldier death in the Israeli Defense Forces (IDF) in peace time. Suicide attempt (SA) and non-suicidal self-injury (NSSI) are risk factors for death by suicide in civilian studies and therefore their predictive value needs to be determined in the military. All army screening, psychometric and demographic data on consecutive cases of IDF soldier self-harm during the years 2010–2011 were analyzed. The Columbia Suicide Severity Rating Scale was used retrospectively to classify self-harm as suicidal or NSSI. The Suicide Ideation Scale and the Suicide Intent Scale were scored retrospectively by trained clinical psychologists. A total of 107 soldiers reported self-harm during the study period, comprising 70 SA and 37 with NSSI. The most prevalent diagnosis was personality disorder (n = 48). Soldiers with any mood/anxiety disorders comprised the smallest group (n = 21) and included major depression, dysthymia, anxiety, and posttraumatic stress disorder. Soldiers with NSSI (n = 37) did not differ in any of the characteristics from those who attempted suicide (n = 70). Unlike the well-known female dominance in both SA and NSSI patients in other settings, males dominated this army sample in both groups. Soldiers with self-harm (both SA and NSSI) cannot be easily distinguished by any demographics or specific psychological attributes detectable at induction, and the scales used in suicide research cannot predict an attempt or NSSI. Unlike civilian samples, males dominated attempter and NSSI groups and the reason for this may be multifactorial. These retrospective findings, if replicated, indicate the need for different screening strategies at induction into the military.