Yaira Hamama-Raz

Examining the Relationship Between Resilience and Posttraumatic Growth

To extend the literature the present study aims to examine the interrelationships between resilience (defined by a lack of posttraumatic stress disorder following trauma) and posttraumatic growth. Two studies were conducted of Israeli: (a) adolescents exposed to terror (N = 2908), and (b) citizens and army personnel following the second Lebanon War (N = 588). Across studies the results showed that high levels of resilience were associated with the lowest posttraumatic growth scores. The results imply that although growth and resilience are both salutogenic constructs they are inversely related. The theoretical and clinical implications of these findings are discussed.

Posttraumatic growth in adolescence: Examining its components and relationship with PTSD

To address gaps in the literature, this study examined the components of posttraumatic growth, and the relationship between growth and posttraumatic stress disorder (PTSD). Participants were from a pooled sample of 4,054 Israeli adolescents exposed to terror of whom 210 (5.5%) met criteria for PTSD. Measures included the Child Post-Traumatic Stress Reaction Index and Posttraumatic Growth Inventory. Principal components analysis showed two correlated components of outward and intrapersonal growth. Regression modeling showed that the relationship between the growth and PTSD measures was linear and curvilinear (inverted-U). These results replicated accounting for heterogeneity in PTSD, exposure and subsamples. Collectively, the results imply that posttraumatic growth in adolescence is characterized by two robust components, and is greatest at moderate posttraumatic stress levels.

PTSD symptoms, forgiveness, and revenge among Israeli Palestinian and Jewish adolescents

Exposure to political terror and its psychological toll were assessed in 276 Israeli Palestinian and 1,469 Jewish adolescents using self-report questionnaires. Israeli Palestinians displayed more posttraumatic symptoms, higher levels of objective exposure to terror, more negative life events, lower ability to forgive, and a higher need for vengeance than their Jewish counterparts. Although the two groups did not differ in fear levels, Israeli Palestinians expressed more favorable attitudes toward peace. Ethnicity played a major role in explaining the variance of posttraumatic symptomatology. Israeli Palestinians displayed increased vulnerability to mental distress when compared to their Jewish counterparts. The unique roles of subjective fear, attitudes towards peace, forgiveness, and revenge among Israeli Palestinians are discussed.

Does psychological adjustment of melanoma survivors differs between genders

Objective: Survival rates of cancer have significantly increased. However, cancer survivors face physical, psychological and social difficulties, while adjusting to post‐illness status. We examined between‐gender differences in the psychological adjustment (mental well‐being, distress and subjective level of functioning), the putative origin of those differences, and the roles of cognitive appraisal, hardiness and attachment style in the psychological adjustment of melanoma survivors.

Posttraumatic Growth in Breast Cancer Survivors: Constructive and Illusory Aspects.

This study investigated the impact of a building-resilience intervention on coping and posttraumatic growth (PTG) in a convenience sample of 94 breast cancer survivors. PTG was divided into constructive and illusory components, based on the two-sided Janus face model (Maercker & Zoellner, 2004). We operationalized constructive PTG as an improvement in both PTG and coping, and illusory PTG as an improvement in PTG only. An 8-session group intervention was delivered to 49 women (mean age = 51.5 years, SD = 10.7) who completed self-report questionnaires at baseline and at 6 months follow-up; a control group of 45 women only completed questionnaires. More than half the participants (n = 53; 56.38%) reported increased PTG at 6 months (mean change = 0.56, SD = 0.48, η(2) = .58). The increase in both PTG and positive coping was significantly greater in the intervention group than the control group (B = 0.23 for PTG, and B = 0.35 for positive coping). Further, a higher proportion of constructive PTG (vs. illusory PTG) was reported by the participants in the intervention group (89.3%), as compared to the control group (56.3%; z = 2.57). The distinction between constructive and illusory PTG has clinical implications for interventions promoting coping and growth among cancer survivors.

Previous Exposure to the World Trade Center Terrorist Attack and Posttraumatic Symptoms Among Older Adults Following Hurricane Sandy

Objective: The present study tested the maturation and inoculation hypotheses by examining whether age and previous exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack moderated the relationship between degree of exposure to Hurricane Sandy and related posttraumatic stress disorder (PTSD) symptoms. Method: An online sample of 1,000 participants from affected states completed self-report questionnaires one month after Hurricane Sandy hit the East Coast. Participants reported their degree of exposure to the WTC terrorist attack and to Hurricane Sandy, and their posttraumatic stress disorder (PTSD) symptoms following Hurricane Sandy. Results: The positive relationship between degree of exposure to Hurricane Sandy and level of PTSD symptoms was weaker among older adults. An additional significant three-way interaction suggested that both age and previous exposure to the WTC terrorist attack moderated the relationship between degree of exposure to Hurricane Sandy and level of PTSD symptoms. Previous high degree of exposure to the WTC terrorist attack was related to a weaker effect of current exposure to Hurricane Sandy on PTSD symptoms among older adults. However, among younger adults, previous high degree of exposure to the WTC terrorist attack was related to a stronger effect of current exposure on PTSD symptoms. Conclusions: When confronted by a natural disaster, American older adults are generally resilient. Supporting the inoculation hypothesis, resilience of older adults may be partly related to the strength successfully extracted from previous exposure to adverse events.

From Hope to Despair, and Back: Being the Wife of a Patient in a Persistent Vegetative State

In this study we examined the meaning of being the wife of a vegetative patient over time. The research was based on semistructured interviews with 12 wives of husbands who were diagnosed with persistent vegetative state between 1 year 2 months and 10 years prior to the interview. We found that there were two contradicting forces common to all of the wives across time. First, there was a process of finding significance in the situation based on acceptance of the husband’s condition and focusing on positive emotions and values such as love, commitment, and loyalty. Second, the wives described an increase in negative emotions such as sadness, pain, loneliness, loss, and grief. These findings are discussed in the context of research and theoretical literature about coping processes and the meaning of caring for patients in a persistent vegetative state.

In the eye of the storm or the bullseye of the media: Social media use during Hurricane Sandy as a predictor of post-traumatic stress

Social media use during Hurricane Sandy as a predictor of posttraumatic stress. The category 1 storm “Hurricane Sandy”, which affected the Caribbean, Mid-Atlantic and North East United States, struck the New York Metropolitan Area on October 29. The hurricane led to large property damage and more than 100 casualties in the U.S. alone. Unsurprisingly the hurricane attracted extensive media coverage, providing the main headlines for most leading national journals (The New York Times 2012). Recent debates have questioned the extent to which such media coverage helps ‘amplify’ anxieties, maintaining or contributing to post traumatic stress (Bonanno et al., 2010; Marshall et al., 2007). Following the 9/11 terrorist incidents in the US PTSD was higher amongst those who watched more anniversary television a year after the attacks (Bernstein et al., 2007). Media amplification can help explain how those away from the ‘bulls eye’ of a disaster, with little personal direct exposure to traumatic events, may exhibit high rates of traumatic symptoms (Marshall et al., 2007). Some media may be particularly significant for determining stress response. While traditional media may appear to provide relatively ‘objective’ statements about threat, social media has a more direct, personal impact on assessments of risk (Lemyre et al., 2010). Social media can reflect normative appraisals of risk from ‘people like me’ via established social contacts (e.g. networking sites such as Facebook) or through like-minded individuals with similar interests (e.g. via Twitter). Video sharing sites such as Youtube allow users to share dramatic multimedia clips about apparent health risks. Social media therefore offers greater opportunity for the ‘emotional contagion’ related to risk appraisal and stress following traumatic events (Mineka and Zinbarg, 2006). In a representative New York sample collected one month after Hurricane Sandy we compared levels of post-traumatic stress response amongst those learning about the hurricane through only traditional media with those learning about the event through social media. We then assessed social media use alongside demographic variables and personal exposure to the Hurricane in order to predict stress responses.

Fear of Personal Death among Physicians

Many studies have tried to explain why professionals experience difficulty when dealing with, and in treating efficiently, situations connected with death. We studied levels of fear of personal death among physicians and addressed two questions: Does exposure to death on professional and personal levels affect the level of fear of personal death which physicians experience? Is there a relationship between personality variables, represented by the repression-sensitization dimension, and level of fear of personal death? A sample of 233 physicians who specialized in oncology, internal medicine, surgery, psychiatry, and pediatrics was studied. Results revealed no differences in level of fear of personal death of physicians according to specialization, but those who had been exposed to death on the personal level feared less in relation to their own death. With respect to the personality variable, tendency to sensitization, it was found that those who were sensitized exhibited a higher level of fear of their own death compared to those who were repressive. Of the various demographic variables examined, it was found that those with many years of professional experience, who were relatively older, who were nonobservant religiously, and who were in good health had lower levels of personal fear of death.

The Coping Experience of Parents of a Child with Retinoblastoma-Malignant Eye Cancer

The authors explored 12 couples’ coping with their childrens diagnosis and treatment of retinoblastoma using a semistructured interview, with qualitative, descriptive, narrative-interpretative analysis. Findings showed that the parents’ experienced increased distress with the physicians first suspicion that something was seriously wrong. Distress was ameliorated when they arrived at a specialty treatment center but increased as they tackled treatment decisions. Distress decreased again after they consented to enucleation but increased after hospital discharge. The parents’ strength, their ability together and individually, to separate and split between cognition and emotion contributed to coping. Parents need support from a multidisciplinary staff and parents who coped with retinoblastoma.