Michal Mahat-Shamir

The link between death anxiety and post-traumatic symptomatology during terror: Direct links and possible moderators

The current wave of terrorism which is taking place in Israel is characterized by increased arbitrary attacks by individual terrorists, acting independently, with reduced ability to anticipate when and where the next attack will take place. This situation creates an atmosphere of fear and insecurity in the lives of many citizens. Accordingly, the current study aims to establish a connection between death anxiety and PTSD symptom severity, as well as to examine whether major personality characteristics may moderate this connection. Using an online survey, 429 adult participants were recruited, and filled out death anxiety and PTSD symptomatology scales, as well as a short version of the Big Five personality scale. Findings revealed that death anxiety was a significant predictor of posttraumatic symptom severity, as were personality characteristics. Moreover, two personality traits, emotional stability and conscientiousness, moderated the association between death anxiety and PTSD symptomatology. The importance of death anxiety as a factor which is associated with PTSD symptomatology is discussed.

Do previous experience and geographic proximity matter? Possible predictors for diagnosing Adjustment disorder vs. PTSD

The minority of people who have experienced a traumatic event and were diagnosed as either suffering from PTSD or from Adjustment disorder, may suggest that victims of a traumatic event vary in risk factors for the disorders. The current research aimed at examining the association between reports of Adjustment disorder and PTSD symptoms (In accordance with the proposed revisions of the ICD-11) and several vulnerability variables: previous traumatic event, previous stressful event and physical proximity to the terror attack. Using an online survey, 379 adult participants were recruited, and filled out Adjustment disorder, PTSD symptomatology scales, as well as a previous exposure, magnitude of exposure and death anxiety scales. Findings revealed that previous experience of traumatic events was a significant predictor associated with both PTSD and Adjustment disorder symptoms. Previous experience of stressful events was a significant predictor associated with Adjustment disorder alone. Physical proximity to the site of the attack was a significant predictor associated with PTSD symptoms but not Adjustment disorder symptoms. The importance of previous traumatic events, previous stressful events and physical proximity to the terror attack as factors which are associated with Adjustment disorder and PTSD symptomatology is discussed.

A blast from the past: Civilians immediate psychological reactions and associative memory of prior events following exploding bus in Israel

This study examined the association between self-report associative memories of prior traumatic events and psychological distress up to 48h after a terror attack. To date, the number of studies that examined this association is very small and most were conducted weeks or even months post event. For this purpose, we examined the association between self-report associative memories of prior traumatic events beyond factors such as previous exposure to trauma, political shift and sense of safety. The results showed that self-report associative memories of prior traumatic events were significantly associated with psychological distress. These results could be explained by the similarity and recency effects.

Evoked Death-Related Thoughts in the Aftermath of Terror Attack: The Associations Between Mortality Salience Effect and Adjustment Disorder

Abstract ICD-11 has provided a revised definition for adjustment disorder (AjD). The current study examined whether mortality salience effect, a possible consequence of a terror attack, may serve as a significant predictor associated with each of the AjD subscales. Using an online survey, 379 adult participants were recruited and filled out self-reported questionnaires dealing with adjustment disorder symptoms as well as mortality salience effect. Findings revealed that mortality salience effect was a significant predictor of all AjD subscales. The importance of mortality salience effect for AjD is discussed in light of terror management theory.

Mothers’ Continuing Bond With the Baby The Case of Feticide

The nature of the ongoing bond maintained by the bereaved with the deceased has attracted considerable attention, but studies have generally ignored postdeath relationships when loss occurs in utero. The goal of this research was to reach an interpretive understanding of the continuing bond experience among Israeli mothers who underwent feticide, examining the strategies they use in maintaining a postdeath relationship with a child they did not know, whose death they chose and witnessed, within a social context that ignores their loss and forces them to silence their grief. The results highlight two themes: (a) strategies for relinquishing connection with the baby and (b) strategies for maintaining a postdeath relationship. These processes partially correspond with two theoretical views that shed light on interpretation of the results: the dual process of coping with bereavement and relational dialectic theory. Implications of the results to the practice of health providers are outlined.

Factors associated with post-election psychological distress: The case of the 2016 U.S. presidential election

This study, through the lens of Social Cognitive Theory, examined potential risk factors that may intensify election-related psychological distress. Six weeks after the 2016 U.S. election, 772 U.S. adult citizens filled out an online survey that assessed psychological distress along with sociodemographic characteristics, and a set of variables tapping various dimensions of political self-efficacy (i.e., importance of politics in ones life, preferences for different media outlets, political directness, and voting choices). The findings showed that election-related psychological distress was positively associated with young age, greater reliance on new media, greater importance of politics in ones life, higher political directness, and voting for the candidate who did not win the election. Findings should be valuable for health-care providers informing them about potential risk factors intensifying psychological distress in the context of significant political events.

Truck attack: Fear of ISIS and reminder of truck attacks in Europe as associated with psychological distress and PTSD symptoms

Following an ISIS attack, the present study examined the association between psychological distress and severe stress symptoms with vulnerability variables: i.e. Physical proximity to the site of the terror attack, Associative memory of prior events, Danger perception and ISIS anxiety. Using an online survey, 397 adult participants were recruited, Seventy-two hours after an ISIS terror attack, and filled out Psychological distress Patient Health Questionnaire 4 and severe stress symptoms questionnaire as well as physical proximity to the site of the terror attack, associative memory of prior events, danger perception and ISIS anxiety scales. Physical proximity to the site of the terror attack and ISIS anxiety were found to be significantly associated of both psychological distress and severe stress symptoms. Regarding danger perception, only danger perception of terror attacks was associated with both psychological distress and with severe stress symptoms. Lastly, whereas being reminded of the 2014 Jerusalem tractor attack (tapping to association via location) was neither associated with psychological distress nor with severe stress symptom, the reminder of the truck attack in Berlin (tapping into association by recency and similarity) was associated with psychological distress but not with severe stress symptoms. The importance of the findings is discussed.

The family in the view of Israeli adolescents in foster care

Summary This qualitative study explores the unique views about the family system held by adolescents who have spent years in foster care in Israel. This inductive study is among the few to address the unheard views held, and the salient challenges faced, by adolescents who have not grown up in their biological parents’ home, with a focus on their view of the family. Findings Participants’ demonstrated conflicting, polarizing perceptions of the family: (a) family is a genetic system: blood is thicker than water; (b) the family system is constructed and limited by terminology; and (c) communication is essential to family life. Applications While the first two themes highlighted the participants’ family of origin as their “true family” the last theme emphasized on the foster family as their “true” family system. Synthesis between these views could not be achieved as informants embraced the social expectation perceiving the family as one. Raising social and professional awareness about the difficulties these young people face partly because of an exclusive social view of the family lies in the sphere of interest and the social work professional expertise.

Screening of adjustment disorder: Scale based on the ICD-11 and the Adjustment Disorder New Module

In line with ICD-11 new conceptualization of Adjustment disorder (AjD), a self-report Adjustment Disorder-New Module (ADNM) was developed and validated. Nevertheless, the ADNM-20 is a long research tool and potentially problematic in the use in epidemiological and clinical studies. The present study introduces the brief ADNM-8 and the ultra-brief ADNM-4, examines their validity and establishes cut-off scores for their clinical use. The study used a representative national sample of 1003 Israelis who reported on the ICD-11 stress spectrum ranging from AjD, PTSD, complex PTSD and complicated grief. Construct validity was assessed via confirmatory factor analysis and cut-off scores were established through ROC analysis. The original and brief instruments were highly correlated (r > 0.918 or better). Cronbachs Alpha for the Brief ADNM-8 and the Ultra-Brief ADNM-4 were above 0.800. Correlations with stress related conditions indicated a good convergent and construct validity for both instruments as well. The ultra-brief ADNM-4 was found to have a very good fit with the data. These findings indicate that the brief ADNM-8 and the ultra-brief ADNM-4 can serve as a brief screening tools for assessing AjD symptoms according to the ICD-11 definition.

Concern and death anxiety during an ongoing terror wave: the moderating role of direct vs. indirect exposure

ABSTRACT The current study examined whether emotional concern over one’s security situation is connected with death anxiety during an ongoing terror wave, and whether type of exposure (media exposure vs. contact with witnesses) moderates this connection. A total of 345 individuals, aged 18–70, were sampled during an ongoing wave of terror in Israel and filled out scales measuring death anxiety, concern over security situation, and type of exposure. Results indicated that increased concern was connected with enhanced death anxiety. Moreover, this connection was more pronounced among individuals exposed to the events through the media, in comparison with individuals who had first-hand contact with witnesses.