COVID-19 Booster Vaccination Bellwethers: Factors Predictive of Older Adults' Adoption of the Second Booster COVID-19 Vaccine in Israel: A Longitudinal Study.

Israel became the first country to offer the second COVID-19 booster vaccination. The study tested for the first time, the predictive role of booster-related sense of control (SOC_B), trust and vaccination hesitancy (VH) on adoption of the second-booster among older adults, 7 months later. Four hundred Israelis (≥60 years-old), eligible for the first booster, responded online, two weeks into the first booster campaign. They completed demographics, self-reports, and first booster vaccination status (early-adopters or not). Second booster vaccination status was collected for 280 eligible responders: early- and late-adopters, vaccinated four and 75 days into the second booster campaign, respectively, versus non-adopters. Multinomial logistic regression was conducted with pseudo R2 = .385. Higher SOC_B, and first booster early-adoption were predictive of second booster early-vs.-non-adoption, 1.934 [1.148-3.257], 4.861 [1.847-12.791]; and late-vs.-non-adoption, 2.031 [1.294-3.188], 2.092 [0.979-4.472]. Higher trust was only predictive of late-vs.-non-adoption (1.981 [1.03-3.81]), whereas VH was non-predictive. We suggest that older-adult bellwethers, second booster early-adopters, could be predicted by higher SOC_B, and first booster early-adoption, 7 months earlier.

Vaccine hesitancy prospectively predicts nocebo side-effects following COVID-19 vaccination.

The directionality between vaccine hesitancy and COVID-19 vaccine side-effects has not been hitherto examined. We hypothesized a nocebo effect, whereby vaccine hesitancy towards the second Pfizer vaccination dose predicts subsequent side-effects for a booster dose, beyond other effects. We expected these nocebo effects to be driven by (mis)information in males and prior experience in females. A representative sample of older adults (n = 756, mean age = 68.9 ± 3.43) were questioned in a typical cross-lagged design (wave 1 following a second Pfizer dose, wave 2 after their booster). As hypothesized, earlier vaccine hesitancy predicted subsequent booster side-effects for females (ß = 0.10 p = 0.025, f 2 = 0.02) and males (ß = 0.34, p < 0.001, f 2 = 0.16); effects were stronger in males (χ2Δ (1) = 4.34, p = 0.03). The (W1-to-W2) side-effect autoregression was stronger in females (ß = .34, p < 0.001; males ß = 0.18, p < 0.001), χ2Δ (1) = 26.86, p < 0.001. Results show that a quantifiable and meaningful portion of COVID-19 vaccine side-effects is predicted by vaccine hesitancy, demonstrating that side-effects comprise a psychosomatic nocebo component in vaccinated individuals. The data reveal distinct risk levels for future side-effects, suggesting the need to tailor public health messaging.

The experience of aging before one's time during the coronavirus pandemic among war veterans in Israel.

Subjective age, the personal sense of how old one feels, is an important concomitant of posttraumatic outcomes in the second half of life. The present study aims to disentangle the interrelationships between posttraumatic stress disorder symptoms (PTSS) and subjective age, during the COVID-19 pandemic, among a sample of Israeli older adults who are veterans of the 1973 Yom Kippur War. Participants were interviewed in 2015 (T1; N = 259; mean age = 65.23, SD = 5.32) and in 2020, during the COVID-19 outbreak in Israel (T2). We assessed subjective age, PTSS, fear of COVID-19, self-rated health, and COVID-19 related accelerated subjective aging. A cross-lagged path analysis showed that while higher PTSS at T1 were associated with an increase in subjective age from T1 to T2, subjective age at T1 was not associated with PTSS at T2. PTSS at T1, but not subjective age, were associated with higher COVID-19 related accelerated subjective aging at T2. Older adults with continued PTSS due to past traumas, might be susceptible to the stressors of COVID-19 expressed in the personal subjective experience of having aged quickly in a short period of time. Our findings also suggest that in the context of stress and trauma, subjective age is more appropriately conceived as an outcome variable rather than a predictor of PTSS.

COVID-19 Vaccinations and Anxiety in Middle-Aged and Older Jews and Arabs in Israel: The Moderating Roles of Ethnicity and Subjective Age.

Subjective age (i.e., feeling younger/older than one's chronological age) plays a significant role in older minority group members' psychological well-being. In light of the importance of vaccinations for fighting COVID-19, it is unclear whether ethnicity and subjective age moderate the connection between receiving COVID-19 vaccinations and anxiety in Israel. Jewish (n = 198) and Arab older adults (n = 84) provided information regarding COVID-19 vaccinations, subjective age, and anxiety symptoms, as well as additional socio-demographic and COVID-19-related health factors (age range= 40-100, M = 62.5, SD = 12.34). Results demonstrated that feeling older was associated with increased anxiety (p < .001) and that vaccinations were linked to increased anxiety among Jews (p < .05). Moreover, the association between COVID-19 vaccinations and anxiety was significant only among Jewish participants with an older subjective age (p < .05). We stress the importance of examining cultural diversities regarding the contribution of subjective age in the context of COVID-19 and psychological well-being.

"Post-lockdown Depression": Adaptation Difficulties, Depressive Symptoms, and the Role of Positive Solitude When Returning to Routine After the Lifting of Nation-Wide COVID-19 Social Restrictions.

Objectives: The aim of the current study was to identify difficulties in adapting to normal life once COVID-19 lockdown has been lifted. Israel was used as a case study, as COVID-19 social restrictions, including a nation-wide lockdown, were lifted almost completely by mid-April 2021, following a large-scale vaccination operation. Methods: A sample of 293 mid-age and older Israeli adults (M age = 61.6 ± 12.8, range 40-85 years old) reported on return-to-routine adaptation difficulties (on a novel index), depression, positive solitude, and several demographic factors. Results: Of the participants, 40.4% met the criteria of (at least) mild depressive symptoms. Higher levels of adaptation difficulties were related to higher ratios of clinical depressive symptoms. This link was moderated by positive solitude. Namely, the association between return-to-routine adaptation difficulties and depression was mainly indicated for individuals with low positive solitude. Conclusions: The current findings are of special interest to public welfare, as adaptation difficulties were associated with higher chance for clinical depressive symptoms, while positive solitude was found to be as an efficient moderator during this period. The large proportion of depressive symptoms that persist despite lifting of social restrictions should be taken into consideration by policy makers when designing return-to-routine plans.

Vaccine and Psychological Booster: Factors Associated With Older Adults' Compliance to the Booster COVID-19 Vaccine in Israel.

Israel became the first country to offer the booster COVID-19 vaccination. The study tested for the first time the role of sense of control (SOC) due to vaccinations, trust and vaccination hesitancy (VH), and their association with compliance to the booster COVID-19 vaccine among older adults, during the first 2 weeks of the campaign. 400 Israeli citizens (≥ 6 years old), eligible for the booster vaccine, responded online. They completed demographics, self-reports, and booster vaccination status (already vaccinated, booked-a-slot, vaccination intent, and vaccination opposers). Multinomial logistic regression was conducted with pseudo R2 = .498. Higher SOC and lower VH were related to the difference between early and delayed vaccination (booked-a-slot, OR = 0.7 [0.49-0.99]; 2.2 [1.32-3.62], intent OR = 0.6 [0.42-0.98]; 2.7 [1.52-4.86]), as well as to rejection (OR = 0.3 [0.11-0.89]; 8.5 [3.39-21.16]). Increased trust was only related to the difference between early vaccinations and vaccine rejection (OR = 0.3 [0.11-0.89]). We suggest that SOC, as well as low VH, can be used as positive motivators, encouraging earlier vaccinations in older age.

COVID-19 post-vaccination depression in older Israeli adults: the role of negative world assumptions

Background With the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the aging population has been shown to be highly vulnerable. As a result, policy makers and the media urged older adults to restrict social interactions, placing them at greater risk of mental health problems, such as depression. However, there has been a little previous attempt to examine coronavirus disease-2019 (COVID-19) vaccine-related risk factors and depressive symptoms amongst older adults. Methods Participants (938 older adults, Mage = 68.99, s.d. = 3.41, range 65–85) answered an online questionnaire at the start of the COVID-19 vaccination program in Israel. Participants completed measures of background characteristics, world assumptions, COVID-19 vaccine-related variables, and symptoms of depression. Results Univariate logistic regression revealed that more negative world assumptions were linked with clinical depression levels. Conclusions Older adults in our sample were susceptible to unique factors associated with clinical depression influenced by their world assumptions during their COVID-19 vaccination. The high level of depression following vaccination indicates that it may take time to recover from depression associated with pandemic distress. Cognitive interventions that focus on world assumptions are recommended.

COVID-19 post-vaccination depression in older Israeli adults: the role of negative world assumptions.

Background: With the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the aging population has been shown to be highly vulnerable. As a result, policy makers and the media urged older adults to restrict social interactions, placing them at greater risk of mental health problems, such as depression. However, there has been a little previous attempt to examine coronavirus disease-2019 (COVID-19) vaccine-related risk factors and depressive symptoms amongst older adults. Methods: Participants (938 older adults, Mage = 68.99, s.d. = 3.41, range 65-85) answered an online questionnaire at the start of the COVID-19 vaccination program in Israel. Participants completed measures of background characteristics, world assumptions, COVID-19 vaccine-related variables, and symptoms of depression. Results: Univariate logistic regression revealed that more negative world assumptions were linked with clinical depression levels. Conclusions: Older adults in our sample were susceptible to unique factors associated with clinical depression influenced by their world assumptions during their COVID-19 vaccination. The high level of depression following vaccination indicates that it may take time to recover from depression associated with pandemic distress. Cognitive interventions that focus on world assumptions are recommended.

Factors associated with current posttraumatic stress disorder among COVID-19 vaccinated older adults in Israel.

This is the first study to examine COVID-19 vaccine-related stressors in the context of current posttraumatic stress disorder (PTSD) symptoms amongst older adults exposed to traumatic events prior to the COVID-19 outbreak, with particular focus on the associations between ageism, vaccine-related stressors and PTSD. Five hundred and sixty-three participants aged 65 and above reported exposure to at least one traumatic event, their current PTSD level, physical and mental health, ageist attitudes, and vaccine related stressors. Univariate logistic regression revealed that depressive symptoms, ageism, vaccine hesitancy and severity of side effects were the main factors associated with clinical levels of current PTSD. These results suggest that older adults were vulnerable to intensified PTSD symptoms, not only as a result of greater depression, but also as a consequence of other factors, including ageism, vaccination hesitancy and vaccination side effects. Practitioners would benefit from awareness to these factors.

Vaccination anxiety when vaccinations are available: The role of existential concerns.

This study examined how existential fears are related to COVID-19 vaccination anxiety and followed the Terror Management Theory (TMT) by examining the contribution of two existential concerns, subjective nearness-to-death (SNtD) and death anxiety, to COVID-19 vaccination anxiety during the first month of COVID-19 vaccinations. Data were collected during January 2021, when Israel was in lockdown, from a convenience sample of 381 Jewish Israelis (M = 55.39, SD = 17.17). Participants completed questionnaires examining demographics, SNtD, death anxiety and COVID-19 vaccination anxiety. A hierarchical regression analysis examined the connections between these variables and COVID-19 vaccination anxiety while controlling for demographics and for receiving COVID-19 vaccinations. In line with the hypotheses, SNtD and death anxiety were each positively associated with COVID-19 vaccination anxiety, and death anxiety levels moderated the positive connection between SNtD and COVID-19 vaccination anxiety, as this association was not significant for individuals with low death anxiety. The findings of this study provide preliminary evidence concerning the role of death anxiety in moderating the effect that SNtD has on COVID-19 vaccination anxiety. These findings are in line with the TMT and justify further investigation and may be utilized in future research in order to address COVID-19 vaccination anxiety more effectively.

The Moderating Effect of Older Adults' Receptive Arts Engagement on the Association Between Resilience and Anxiety Symptoms During Coronavirus Breakout.

ABSTRACT: In this study, we evaluated whether levels of receptive arts engagement (visiting museums/concerts/the theater/the cinema) during the year preceding the COVID-19 outbreak may have served as a psychological resource for older adults that mitigated the association between resilience levels and COVID-19 anxiety when the pandemic broke out. Data were collected after the enactment of the first emergency regulations (between March 15 and April 1, 2020) via the Qualtrics Survey Software link that was sent out through social media platforms. In total, 205 participants aged 65 to 92 (mean age, 72.32; SD, 5.63) reported general anxiety symptom levels (GAD-7) (Spitzer et al., 2006), resilience (Connor-Davidson Resilience Scale), frequency of receptive arts engagement in the previous year, health status, exposure to risk situations, and behavioral changes due to the pandemic. Our hypothesis that receptive arts would moderate the resilience-COVID-19 anxiety link was examined by a multiple hierarchical regression analysis and with the PROCESS computational tool. Findings show that resilience was associated with COVID-19 anxiety and that this association was moderated by levels of receptive arts engagement. The findings show that high levels of prior art engagement constituted a potent buffer against subsequent COVID-19 anxiety. Policy makers may benefit older adults by encouraging their engagement in arts activities, even during social distancing.

Subjective accelerated aging moderates the association between COVID-19 health worries and peritraumatic distress among older adults.

BACKGROUND: The present study examined whether subjective accelerated aging moderated the relationship between COVID-19 health worries and COVID-19 peritraumatic distress among older adults. METHOD: The sample consisted of 277 older adults (M = 69.58, s.d. = 6.73, range 60-92) who answered an online questionnaire during the outbreak of COVID-19 pandemic in Israel. Participants completed the measures of background characteristics, exposure to COVID-19, COVID-19 health worries, subjective accelerated aging and COVID-19-based peritraumatic distress. RESULTS: Higher levels of COVID-19 health worries were correlated with higher levels of peritraumatic distress symptoms among older adults. Moreover, those reporting accelerated aging also reported a higher level of peritraumatic distress. Finally, the interaction between COVID-19 health worries and subjective accelerated aging predicted peritraumatic distress, suggesting that COVID-19 worries were associated with peritraumatic distress to a stronger degree among older adults who felt they were aging faster. CONCLUSIONS: These findings indicate that negative views of aging may serve as an amplifying factor for traumatic distress during the COVID-19 pandemic. Although preliminary, the findings provide insight for potential screening and interventions of older adults at risk of developing peritraumatic distress symptoms during the global pandemic.

The Moderating Role of the Hostile-World Scenario in the Connections Between COVID-19 Worries, Loneliness, and Anxiety.

The COVID-19 pandemic has had pronounced effects on individuals' psychological well-being around the world. Concerns regarding the consequences of infection, as well as the general uncertainty and governmental regulations have resulted in increased psychological distress among many populations and cultures. In this regard, research has shown that the manner by which individuals perceive such large-scale threats and appraise them significantly contributes to the psychological consequences of such events. According to the Hostile-World Scenario (HWS) model, negative engagement (NE) with such threats weakens one's competence and coping abilities, whereas positive engagement (PE) facilitates resilience and enhances psychological adjustment. Accordingly, the current study examines the moderating role of both NE and PE in the connections of two main features of the current pandemic, COVID-19-related worries and loneliness, with anxiety. Data were collected between March 16 and April 14, 2020, from 1,112 Israelis (age range 17-92, M = 46.90, SD = 16.46), who provided information regarding COVID-19 health worries, loneliness, and anxiety. A special measure assembled items pertinent to the HWS-NE and HWS-PE throughout the survey. Results demonstrated that both HWS-NE and HWS-PE were significant moderators. COVID-19-related health worries/loneliness were linked with anxiety only among individuals with high HWS-NE, and were non-significant among those with low HWS-NE. Moreover, the positive association between loneliness and anxiety was significantly mitigated by high HWS-PE. The discussion highlights the importance of the HWS for understanding the psychological consequences of COVID-19 and offers practical suggestions, which may aid mental health practitioners in providing assistance and support to the general population.

No psychological vaccination: Vaccine hesitancy is associated with negative psychiatric outcomes among Israelis who received COVID-19 vaccination.

BACKGROUND: The widespread COVID-19 vaccination program, issued by the Israel Government, provides a unique opportunity to examine psychiatric morbidity and vaccine attitudes among individuals who have already been vaccinated. Accordingly, the current study examined how vaccine hesitancy contributes to clinical levels of depression, anxiety, and peritraumatic stress among individuals who had received COVID-19 vaccinations. METHODS: We analyzed data obtained from 254 vaccinated individuals, and assessed vaccine hesitancy, depression, anxiety, and peritraumatic distress, as well as several demographic, health, and COVID-19-related factors. RESULTS: Logistic regressions demonstrated that above and beyond socio-demographic, health, and COVID-19-related factors, COVID-19 vaccine hesitancy was the most prominent risk factor for anxiety, depression, and peritraumatic distress. Higher levels of vaccine hesitancy were found to double the risk for depression and peritraumatic stress (ORs > 2), and to triple the risk for anxiety (OR > 3). LIMITATIONS: A cross-sectional design; a preliminary study requiring further investigation CONCLUSIONS: This study points to the importance of vaccine hesitancy among vaccinated populations and provides knowledge regarding its associations with negative psychiatric outcomes. These findings may offer important information for healthcare practitioners and policy makers in their attempt to encourage individuals to receive COVID-19 vaccinations and emphasize the need to further understand the underlying mechanisms of psychiatric morbidity among vaccinated individuals.

The associations between media use, peritraumatic distress, anxiety and resilience during the COVID-19 pandemic.

This study examined the relationship between media use, experiences of media use as having a negative and/or positive impact on coping, peritraumatic distress, anxiety symptoms and resilience during the COVID-19 pandemic. A convenience sample of 902 Israeli adults (mean age = 46.21) completed measures of peritraumatic distress, anxiety symptoms and resilience, and reported on their media use experiences one month following the initial outbreak of the disease in Israel (April 2020). After controlling for COVID-19 related events and demographic covariates, experiencing media use as having a negative impact on coping was related to higher levels of peritraumatic distress and anxiety symptoms and lower levels of resilience. In contrast, experiencing media as having a positive impact was not related to peritraumatic distress, anxiety symptoms or resilience. The findings suggest that those reporting that media use had a negative impact on coping are at greater risk of experiencing higher levels of peritraumatic distress and anxiety symptoms as well as lower resilience. In addition, traditional media use was related to higher resiliency. Developing understanding of how media could be used to optimally support emergency responses is crucial in order to minimize psychopathology. Unified, clear, trustworthy and informative messaging has a special importance during a mass public health crisis. Further research will contribute to guidance of potential risk and resilience aspects of media use during emergencies.

The moderating role of subjective nearness-to-death in the association between health worries and death anxieties from COVID-19.

The purpose of this study was to examine whether subjective nearness-to-death moderated the association between health worries and death anxiety due to the COVID-19 outbreak among older adults in Israel. Using an online survey, 277 participants were recruited and completed self-reported questionnaires, which included background characteristics, exposure to COVID-19 risk experiences, self-rated health, subjective nearness-to-death, health worries regarding COVID-19, and death anxiety. Findings revealed that subjective nearness-to-death moderated the association between health worries and death anxiety. The importance and significance of subjective perceptions concerning the distance from death as far, which may serve as a resilient resource, is discussed.

COVID-19 related loneliness and sleep problems in older adults: Worries and resilience as potential moderators.

OBJECTIVES: Older adults may experience loneliness due to social distancing and isolation during the Coronavirus disease 2019 (COVID-19) pandemic. Loneliness may further catalyze numerous poor health outcomes including impaired sleep. This study aimed to assess COVID-19 related worries and resilience as potential moderators of the loneliness-sleep problems link. METHOD: In the midst of the lock-down period of COVID-19, we collected data using a web-based public platform from 243 Israeli older adults (mean age = 69.76, SD = 6.69, age range = 60-92). Participants completed measures of COVID-19 related loneliness, sleep problems, COVID-related worries, and resilience. RESULTS: COVID-19 related loneliness was related to more sleep problems. The loneliness-sleep association was especially strong among those with more COVID-19 related worries or among those with lower resilience. CONCLUSION: The relationship between COVID-19 related loneliness and sleep problems is not uniform across older adults. The subjective sleep quality of those with more COVID-19 related worries or less resilience (i.e., feeling less being able to adapt to the challenging circumstances) is more susceptible to feeling lonely. Considering these variables may facilitate detection of and intervention for older adults vulnerable to aversive results in the context of COVID-19.