The effect of pre-pandemic PTSD and depression symptoms on mental distress among older adults during COVID-19.

OBJECTIVES: To explore the extent that pre-COVID-19 comorbid PTSD-depression symptoms prospectively predict mental distress among older adults during COVID-19. METHODS: We used the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel), and focused on older adults who participated in 2015 and 2020 and were aged 60 years old or above in 2020 (N = 754). Mental distress was measured via symptoms of depression, feeling anxious\nervous, and loneliness. RESULTS: Older adults who suffered from PTSD-depression comorbidity prior to the pandemic showed the highest risk of feeling more depressed, anxious\nervous, and lonelier than those with no pre-pandemic symptoms. CONCLUSIONS: This study suggests that it would be beneficial to prioritize those older adults with a comorbid PTSD-depression diagnosis for interventions, as they are at the highest risk for mental distress in the event of a new stressor.

Caregiver burden among adults caring for their Holocaust-survivor parents during the COVID-19 pandemic.

This study aimed to examine the caregiver burden among offspring of Holocaust survivors (OHS) caring for their parents during the COVID-19 pandemic, hypothesizing that caregivers whose parents suffer from posttraumatic stress disorder (PTSD) would report an increased burden. The sample consisted of 109 caregivers with older adult care recipient parents (average caregivers' age = 57.67, SD = 8.49). Caregivers were divided into three groups: 20 OHS who reported that at least one care recipient had PTSD, 60 OHS who reported that their care recipients did not have PTSD, and 29 comparison caregivers (whose care recipients did not undergo the Holocaust). Caregivers completed questionnaires about SARS-CoV-2 exposure, COVID-19 concerns, helping their care recipients, their experiences of caregiver burden, and perceived changes to their caregiver burden during the pandemic. The caregivers also reported PTSD symptoms-in themselves as well as in their care recipients. Relative to comparisons, OHS with parental PTSD reported higher caregiver burden in four aspects: time-dependent burden, developmental burden, physical burden, and social burden. Furthermore, OHS reported a greater perceived increase in caregiver burden during the pandemic than the comparisons. The study findings illuminate the difficulties OHS caregivers, especially those whose care recipients have PTSD, face during the COVID-19 pandemic. This group of caregivers is at risk of experiencing more distress and may need help and support. Further research is needed to determine whether people taking care of their posttraumatic parents following other massive traumatic events also feel a heavier caregiver burden-both in general and specifically during the current pandemic.

Activity engagement and psychological distress among Holocaust survivors during the COVID-19 pandemic.

OBJECTIVES: The COVID-19 pandemic may pose a specific threat for Holocaust survivors, as such threats may be linked with increased psychological distress. Moreover, research has demonstrated that engaging in planful problem-solving activities is associated with reduced distress. Accordingly, we aimed to examine the link between engaging in activities during COVID-19 and psychological distress among Holocaust survivors with varying levels of post-traumatic symptoms (PTS) and comparisons (not directly exposed to the Holocaust). DESIGN: A cross-sectional design composed of Holocaust survivors and a comparison group. SETTING: Participants were interviewed face-to-face, over the telephone, or filled the scales online at their leisure. PARTICIPANTS: Data were collected from 131 older Jewish Israelis (age range 76-94, M = 82.73, SD = 4.09), who were divided into three groups (comparisons; low-PTS survivors; high-PTS survivors). MEASUREMENTS: Participants completed scales assessing PTS, activity engagement, and psychological distress and provided additional sociodemographic, medical, and COVID-19-related information. RESULTS: When activity engagement was low, high-PTS survivors reported extremely high levels of psychological distress relative to low-PTS survivors and comparisons. However, when activity engagement was high, these group differences were considerably reduced, as the psychological distress of high-PTS survivors was significantly lower. CONCLUSIONS: The study highlights the importance of daily planning and activity engagement for Holocaust survivors with high PTS levels in reducing psychological distress. Clinicians are urged to take this factor into account when dealing with the psychological effects of COVID-19 on survivors and on traumatized older adults in general.

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.

Parental PTSD and psychological reactions during the COVID-19 pandemic among offspring of Holocaust survivors.

OBJECTIVE: Previous evidence suggests heightened sensitivity to life-threatening challenges among offspring of Holocaust survivors (OHS). Therefore, this study examined the psychological reactions of aging OHS during the COVID-19 pandemic. METHOD: A convenience sample (N = 297, mean age = 66.85) of North American Jews rated posttraumatic stress disorder (PTSD) symptoms for their parents and for themselves. They further rated their psychological distress, COVID-19-related worries, loneliness, and social support. Respondents were divided into four groups: OHS with two parents with probable PTSD, with one such parent, with no such parent, and comparisons whose parents did not undergo the Holocaust. RESULTS: OHS with two parents with PTSD reported the highest levels of PTSD symptoms. Controlling for respondents' own PTSD, OHS with two parents with PTSD reported higher psychological distress relative to comparisons. Moreover, OHS with parental PTSD reported higher loneliness relative to OHS without parental PTSD or comparisons. The groups did not differ in COVID-19-related worries or social support. CONCLUSIONS: The distress experienced by OHS with parental PTSD seems more general, and is possibly related to the multiple coalescing crises that occurred since the pandemic began, rather than to the health risk associated directly with COVID-19. Moreover, while OHS acknowledge having good social support, some of them nevertheless feel lonely. This possibly reflects unique interpersonal difficulties characteristic in Holocaust survivor families. These findings suggest that OHS with parental PTSD (especially when both parents had symptoms) represent a group of older adults who are relatively susceptible to negative psychological effects of the current pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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.

COVID-19 health worries and anxiety symptoms among older adults: the moderating role of ageism.

A prominent feature of anxiety in late life is concerns regarding physical health. Anxiety symptoms among older adults have been connected with various psychological outcomes, including social isolation and loneliness. During the coronavirus disease 2019 (COVID-19) pandemic, many societies have demonstrated increased ageist attitudes, encouraging older adults to distance themselves from society. Accordingly, the current study examined the moderating role of COVID-19-related ageism in the connection between COVID-19 health worries and anxiety symptoms among older adults. Data were collected from 243 older adults (age range 60-92; M = 69.75, SD = 6.69), who completed scales assessing COVID-19-related health worries and ageism, as well as anxiety symptoms. The results demonstrated that both health worries and ageism were positively associated with anxiety symptoms. Moreover, the connection between health worries and anxiety symptoms was more pronounced among older adults with high ageism levels. The study highlights the vulnerability of older adults in general, and ageist older adults in particular, to the negative consequences of COVID-19-related health worries, and emphasizes the role of the increased ageist stance of society during the pandemic in this regard.

COVID-19-Related Loneliness and Psychiatric Symptoms Among Older Adults: The Buffering Role of Subjective Age.

OBJECTIVE: The study examined whether subjective age moderated the relationship between loneliness due to the COVID-19 pandemic and psychiatric symptoms. METHODS: A convenience sample of older adult Israelis (N = 277, mean age = 69.58 ± 6.72) completed web-based questionnaires comprising loneliness, anxiety, depressive, and peritraumatic distress symptoms. They also reported how old they felt. RESULTS: The positive relationship between loneliness due to the COVID-19 pandemic and psychiatric symptoms was weak among those who felt younger than their age while this very same relationship was robust among those feeling older. CONCLUSIONS: Young subjective age may weaken the loneliness-symptom association among older adults during the COVID-19 pandemic. Older adults holding an older age identity are more susceptible to the adverse effects of loneliness. Although preliminary, the findings may inform screening and interventions. Subjective age may help identify those at high risk in suffering from loneliness, and suggest interventions aimed at ameliorating both loneliness and older subjective ages.