Parents' experience of a shared parent-child stay during the first week of hospitalization in a child psychiatry inpatient ward.

Hospitalization of children in an inpatient psychiatric ward is stressful for both the children and their parents, and separation from the parents during hospitalization is probably one major cause of this stress. We designated one room in a closed inpatient unit to enable a parent to stay with his/her child, including overnight, during the 1st week of hospitalization. We then examined the parents' experience of the shared parent-child stay. Thirty parents of 16 children aged 6-12 years admitted to our inpatient child psychiatry ward completed in-depth semi-structured interviews after that week's experience. The interviews covered the parents' experiences of the 1st week in the larger context of pre-hospitalization period, which also includes the decision to hospitalize the child. The contents of the interviews were analyzed by means of independent coders that identified the following major themes: (1) ambivalence and confusion of the parents as related to their decision to hospitalize their child in the time period just before admission; (2) gradual process of separation from the child during the joint stay at the ward; (3) building confidence and trust toward the staff. Themes 2 and 3 express benefits from the joint hospitalization that may have a strong positive impact on the child's and the parent's recovery. These themes warrant further evaluation of the proposed shared stay during hospitalization in future studies.

Awareness, Incidence and Psychological Wellbeing of Childhood Sexual Abuse as Reported by Ultra-Orthodox Mothers.

The harm caused by child sexual abuse (CSA) is well-documented, calling for more awareness and efforts at prevention. However, CSA in closed religious societies is still tightly under wraps, and therefore underreported and understudied. We chose to use the mother's point of view, in order get an estimate of the prevalence, the reporting rates and their psychological wellbeing. The current study aims at addressing this in the Jewish ultra-Orthodox community, an insular religious one, which may thus serve as a test case for understanding other closed, religious communities. Three hundred forty-seven ultra-Orthodox Israeli women completed self-report questionnaires and reported on their, or their children's exposure to CSA sexual abuse, about their emotional coping, and about considerations regarding disclosing the abuse. About 24% the participants reported that they were victims of sexual abuse. Only 24.3% of cases were reported to the police or official welfare services, with cultural reasons offered by the women to explain it. Lower psychological wellbeing was found among mothers who themselves or their children were victims of child sexual abuse, compared to controls. Interestingly, mothers who reported having undergone psychological treatment suffered a higher degree of distress than those who had not. These findings contribute to the understanding of the dynamics of sexual abuse exposure and disclosure in the ultraorthodox community, and in close societies and highlight the changes required to improve safeguarding of children.

Good Health Practices and Well-Being among Adolescents with Type-1 Diabetes: A Cross-Sectional Study Examining the Role of Satisfaction and Frustration of Basic Psychological Needs.

Type 1 diabetes (T1D) is a chronic disease requiring medical adherence. However, among adolescents, non-adherence rates may reach up to 75%. Satisfaction or frustration with psychological needs is a crucial factor in the motivation and management of health-related behaviors. This study aimed to examine the differences in good health practices and psychological and physical well-being among adolescents with and without T1D and the mediating role of satisfaction and frustration of psychological needs on the association between good health practices and well-being in this population. A total of 94 adolescents (42 with T1D, 52 healthy controls, mean age 14.83 ± 1.82 years) completed questionnaires assessing good health practices, satisfaction or frustration of psychological needs, and well-being. Adolescents with T1D reported lower levels of physical well-being compared to healthy controls. Satisfaction or frustration of psychological needs had an effect on good health practices and psychological and physical well-being among healthy controls. Among adolescents with T1D, satisfaction or frustration of psychological needs was related to psychological well-being and partially related to physical well-being, but not to good health practices. The results demonstrate that the satisfaction or frustration of psychological needs has a unique effect on health behaviors and well-being among adolescents with T1D. This calls for further examination of the underlying mechanisms involved in health-related behaviors and well-being among adolescents with T1D.

Pilot outcomes of a filmmaking intervention designed to enhance treatment entry and social reintegration of veterans.

Military personnel transitioning to civilian life have reported significant challenges in reintegrating into civilian culture. Filmmaking has been used as a therapeutic intervention to enhance the community reintegration of veterans, but there are no published quantitative data documenting its impact. The present study provides outcome data on 40 veterans who participated in the I Was There (IWT) filmmaking workshop. This 3-day (20-hr) group intervention involved veterans working in small teams with a film coach, making short films designed to communicate some aspect of their experience during or after military service, and then creating a screening event to show their films to community members. The sample consisted of community-dwelling veterans who reported at least some mental health symptoms and who were not engaged in mental health treatment for those symptoms. Targeted outcomes included engagement in mental health care, symptoms of posttraumatic stress disorder (PTSD) and depression, and reported perception of community interest in their experience as veterans. Fifty-six percent of participants entered treatment within 4 months of participation. Significant decreases were noted in symptoms of PTSD at 1-month follow-up but not at the 4-month follow-up, while changes in depression were not statistically significant. Participation was related to increased perception of community interest in veterans' experience, and increased interest among community members who viewed the films. These data provide initial support for the conclusion that the IWT film workshop is a potentially effective tool for treatment engagement and for community reintegration among veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

One uncertainty added on top of another: Challenges and resources of mothers of preterm infants during the COVID-19 pandemic.

Aims and objectives: To qualitatively explore COVID-19-related experiences of mothers of preterm infants in the Neonatal Intensive Care Unit (NICU), the main challenges they face, and the resources available for them. Background: The birth of a preterm infant is a stressful event under otherwise normal circumstances. The outbreak of COVID-19, the uncertainty about the virus and how it spreads, and the restrictions imposed, may have exacerbated the stress of caring for a preterm infant. Design: Retrospective interviews. Methods: In-depth interviews with 12 mothers of preterm infants who were hospitalized in the NICU at the time of study. The interview addressed challenges and resources related to coping with the pandemic. The interviews were transcribed and content analyzed, based on Lieblich et al's model for narrative analysis. This research was conducted in accordance with the COREQ checklist. Results: The overarching experience shared by all mothers was accumulative stress caused by a combination of factors related to the infant's health and COVID-19-related stressors. A central theme was the dissonance between the mothers' expectations from the birth and infant, and the reality they encountered. Other themes included fear of infecting the infant, loneliness, and stress caused by the restrictions that disrupted daily routines. Resources included a sense of shared fate regarding the pandemic, improvements in the infant's condition, religious faith, emotional support from the partner, and support from professional staff. Conclusion: Caring for a preterm infant during a pandemic is a challenging experience on many levels. The loss of significant support resources puts mothers of these infants at a higher risk for psychological distress. Relevance to clinical practice: Awareness of mothers' accumulative stress due to the COVID-19 pandemic may assist the staff in developing procedures that can alleviate parental stress, for example by enabling mothers to connect to each other, giving clear information to compensate for physical and social distancing and providing professional mental health support.

The experience of divine struggle following child loss: The Case of Israeli bereaved Modern-Orthodox parents.

Child loss may undermine one's faith. Whereas much is known about religion's role following loss, less is known about the experience of divine struggle-namely, struggling with complex God-related emotions/beliefs-particularly among diverse sociocultural samples. Employing a narrative approach, we interviewed 20 bereaved Modern-Orthodox parents. Analysis revealed three types of divine struggle (explicit, implicit/silenced, none) differentiated by four categories: core emotional experience, response type, significance of faith in the coping process, and the impact of grief-induced divine struggle on parent-God relationship. Findings emphasize the need for culturally-sensitive inquiry of divine struggle, that divine struggle may be silenced, and therapists' awareness is critical.

Internalization and Opposition to Stigmatized Social Discourse among Incest Survivors.

Despite the high prevalence of incest, survivors are reluctant to disclose its existence for reasons such as shame, guilt and the presence of an accusatory and stigmatizing social discourse. The current mixed methods study examined the internal discourses of 13 incest survivors in Israel, reflected in self-reported internal dialogs which emerged during interviews. The qualitative analysis revealed a dialectical tension between two themes - one reflecting an internalization of the social discourse (manifested as quotes taken from social discourse and uttered by the survivors) and the other an agentic discourse (manifested in utterances either resisting the social discourse or showing an empowering advertence to one's own fulcrum). The quantitative analysis showed that for seven participants the internalized social discourse expressions were most frequent, for five the agentic expressions were most frequent, and that for one the discourses were at equilibrium. The ubiquitous sub-themes manifested in the internalized social discourse were: victimhood (feelings of vulnerability and helplessness), survivorship (meaningless existence, despair and hopelessness), negative self-esteem and self-pathology (perception of the self as having pathological psychological problems), and denial/repression of the abuse. The ubiquitous sub-themes manifested in the agentic discourse were: positive self-image and sense of potency, hope, optimism and positive perception of life, and uprising against the parents and institutions that did not give support. The discussion is based on Butler's concept of vulnerability, which suggests how to address the harms inflicted by incest without erasing aspects of the survivors' agency and growth.

Using topic models to identify clients' functioning levels and alliance ruptures in psychotherapy.

Computerized natural language processing techniques can analyze psychotherapy sessions as texts, thus generating information about the therapy process and outcome and supporting the scaling-up of psychotherapy research. We used topic modeling to identify topics discussed in psychotherapy sessions and explored (a) which topics best identified clients' functioning and alliance ruptures and (b) whether changes in these topics were associated with changes in outcome. Transcripts of 873 sessions from 58 clients treated by 52 therapists were analyzed. Before each session, clients self-reported functioning and symptom level. After each session, therapists reported the extent of alliance rupture. Latent Dirichlet allocation was used to extract latent topics from psychotherapy textual data. Then a sparse multinomial logistic regression model was used to predict which topics best identified clients' functioning levels and the occurrence of alliance ruptures in psychotherapy sessions. Finally, we used multilevel growth models to explore the associations between changes in topics and changes in outcome. Session-based processing yielded a list of semantic topics. The model identified the labels above chance (65% to 75% accuracy). Change trajectories in topics were associated with change trajectories in outcome. The results suggest that topic models can exploit rich linguistic data within sessions to identify psychotherapy process and outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Narrative Reconstruction as an Intervention for Posttraumatic Stress Disorder: A Pilot Delayed Intervention Quasi-Randomized Controlled Trial.

Although empirically supported treatments for posttraumatic stress disorder (PTSD) exist, many patients fail to complete therapy, are nonresponsive, or remain symptomatic following treatment. This paper presents the results of a delayed intervention quasi-randomized controlled study that evaluated the efficacy of narrative reconstruction as an integrative intervention for PTSD. During narrative reconstruction, the patient and therapist reconstruct an organized, coherent, and detailed written narrative of the patient's traumatic experience. Additionally, narrative reconstruction focuses on arriving at the subjective meaning of the traumatic experience for the patient as related to their personal history. Thus, the therapist asks the patient about associations between the traumatic event and other memories and life events. In the present study, 30 participants with PTSD were randomly assigned to an immediate (n = 17) or delayed (n = 13) 15-session narrative reconstruction intervention. Participants in the immediate narrative reconstruction group were evaluated using self-report measures and structured interviews at baseline, posttreatment, and 15-week follow-up. Participants in the delayed narrative reconstruction group were evaluated at baseline, postwaitlist/pretreatment, and posttreatment assessments. Data from the pretreatment evaluation showed no significant differences between groups. Mixed linear models showed significant intervention effects for posttraumatic symptom severity, d = 1.17, from pre- to posttreatment. Although preliminary, these promising findings suggest that narrative reconstruction may be an effective standalone therapy or an add-on to current effective treatment strategies.

Patient-therapist congruent exchanges engaged with the potential-to-experience is associated with better outcome of psychotherapy.

BACKGROUND: The concept of potential-to-experience is a major component in psychodynamic theory and assumed to be an important component of psychotherapeutic technique. However, as this assumption has never been empirically tested, the relationship between such interventions and treatment outcome is unclear. The aim of this pilot study is to explore the relationship between patient-therapist congruence of potential-to-experience engaged statements and the outcome of psychodynamic treatments. METHODS: Transcripts of 90 sessions from good- and poor-outcome treatments (N = 18) were encoded using the MATRIX - a novel content analysis tool of psychodynamic psychotherapy. Based on fixed algorithms, this observer-coding system is designed to identify different types of clinical interventions, including those which focus on the potential-to-experience. Total number of MATRIX codes analysed was 11,125. We compared the total congruence/incongruence ratio of such statements in good and poor treatments. The importance of the congruence/incongruence ratio of the potential-to-experience statements was measured by applying general linear models to classify treatment outcome. RESULTS: The congruence/incongruence ratio of the potential-to-experience engaged statements was significantly higher in good treatments. In the best model for classifying treatment outcome based on the congruence/incongruence ratios of several parameters, the congruence/incongruence ratio of the potential-to-experience engaged statements was the single most important predictor. DISCUSSION: Maintaining the congruence of potential-to-experience engaged statements within the therapeutic session is associated with better clinical outcome. This provides an initial empirical indication to the importance of the potential-to-experience discourse in psychotherapy praxis. PRACTITIONER POINTS: The concept of potential-to-experience is a major component in psychodynamic theory and assumed to be an important component of psychotherapeutic technique. The current results suggest that the ability of both patient and therapist to maintain the congruence of potential-to-experience statements within the session may improve clinical outcomes. These findings suggest a practical approach for a better management of the therapeutic process. Mainly, it recommends therapists to implement a very careful, active listening to potential-to-experience-related content throughout the session, while highlighting the patient's associations for their potential to become new modus operandi. Moreover, the current study presents an integrative, micro-level tool that enables the translation of complex theoretical concepts in psychotherapy into measurable constructs, aiming at the creation of a bridge between clinical theory and evidence-based practice.

Using computerized text analysis to examine associations between linguistic features and clients' distress during psychotherapy.

Raw linguistic data within psychotherapy sessions may provide important information about clients' progress and well-being. In the current study, computerized text analytic techniques were applied to examine whether linguistic features were associated with clients' experiences of distress within and between clients and whether changes in linguistic features were associated with changes in treatment outcome. Transcripts of 729 psychotherapy sessions from 58 clients treated by 52 therapists were analyzed. Prior to each session, clients reported their distress level. Linguistic features were extracted automatically by using natural language parser for first-person singular identification and using positive and negative emotion words lexicon. The association between linguistic features and levels of distress was examined using multilevel models. At the within-client level, fewer first-person singular words, fewer negative emotional words and more positive emotional words were associated with lower distress in the same session; and fewer negative emotion words were associated with lower next session distress (rather small f2 effect sizes = 0.011 < f2 < 0.022). At the between-client level, only first session use of positive emotion words was associated with first session distress (ηp2 effect size = 0.08). A drop in the use of first-person singular words was associated with improved outcome from pre- to posttreatment (small ηp2 effect size = 0.05). The findings provide preliminary support for the association between clients' linguistic features and their fluctuating experience of distress. They point to the potential value of computerized linguistic measures to track therapeutic outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Connecting Veterans and Their Community Through Narrative: Pilot Data on a Community Strengthening Intervention.

Military personnel transitioning to civilian life commonly report difficulty with establishing friendships, reconnecting with family, and a greater sense that they do not "fit in." Personal narrative interventions have the potential to increase the community's interest and understanding of Veterans' experience. This study examines the impact of a narrative intervention in which Veterans used film or verbal storytelling to describe their experience of being a Veteran to civilian audiences. A total 12 Veterans participated in at least one performance, and 88 community audience members attended one of six performances of the Veterans' narratives. Survey data indicate increase in positive attitudes towards Veterans, as well as a shift in the Veterans' perspective of civilians as receptive and supportive. These preliminary findings suggest that narrative interventions appear to have a positive impact on civilians' interest in Veterans and therefore, may be a valuable community reintegration intervention.

Ability to move between self-states and emotional experiencing and processing as predictors of symptomatic change.

OBJECTIVES: Contemporary relational theories consider clients' ability to move between multiple self-states and clients' ability to experience and process emotions to be two therapeutic processes inherently connected and fundamental to growth and change in psychotherapy. The current research aimed to empirically explore these theoretical assumptions by (1) examining the between- and within-client temporal association between clients' levels of ability to move between multiple self-states and clients' emotional experiencing and processing over the course of therapy, and by (2) testing whether this association would be more prominent for clients presenting good treatment outcomes. METHOD: Based on treatment outcome measures, two contrasting groups were selected, nine successful and nine unsuccessful. Ninety session transcripts (five per client) were analysed using the Two-Person APES (TPA), an extension of the Assimilation of Problematic Experiences Scale (APES), for the measurement of the ability to move between self-states. Sessions were also analysed using the Experiencing Scale (EXP), for the measurement of emotional experiencing. For all predictors, we disaggregated within- and between-client effects. RESULTS: No association was found between EXP and TPA levels. However, at the between-client level, an interaction effect was found indicating a positive correlation between TPA and EXP only for the good-outcome cases, whereas a negative correlation between these variables was found for the poor-outcome cases. CONCLUSIONS: The ability to move between multiple self-states and accessibility to emotional experiencing may be seen as complementary processes enhancing the effectiveness of therapy. However, a high level of one process combined with a low level of the other may be a sign of poor therapeutic outcome. PRACTITIONER POINTS: Clients' capacity to negotiate between conflicted self-states and their ability to experience and process emotions are two determinants working in a synergistic way to predict improvement in clients' symptoms. The presence of only one of these psychological processes without the other might be an indication of poor therapeutic outcome. Therapists should aim to increase their clients' progress in both the movement between self-states and emotional experiencing.

Attachment to God as a mediator of the relationship between religious affiliation and adjustment to child loss.

OBJECTIVES: The loss of a child is a traumatic life event. While bereavement research has examined the roles of both interpersonal attachment and religiosity in coping with loss, only a handful of studies have addressed the concept of attachment to God (ATG). The current study examined ATG's role as a mediator in the relationship between religious affiliation (RA) and adjustment to child loss. METHOD: Seventy-seven bereaved parents (68% women; average age, 55 years) were administrated questionnaires referring to RA, ATG, and adjustment to loss (Two-Track Bereavement Questionnaire-TTBQ_70). RESULTS: The hypothesized mediation model was confirmed. CONCLUSIONS: The findings highlight the need to examine internal religion-related variables, such as ATG, while addressing religion and loss. From a clinical perspective, the findings may help therapists implement culturally sensitive practice as a part of spiritually informed psychotherapy. Enhancing therapists' familiarity with the client's internal constructs will enable a better evaluation and accommodation of therapy when working with bereaved parents. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Patterns of Romantic Pathways among 23 Year Olds and their Adolescent Antecedents.

Observation of the romantic lives of the majority of young people shows that they might move between transitory and inconsistent states, being in and out of a relationship. The present study aims to better understand the meaning of these fluctuations. For this purpose, and employing a multi-method design, 144 Israeli adolescents (59.7% females) were followed from age 16 to 23. At age 23 in-depth interviews were conducted with the participants, focusing on their romantic histories. Analyses of interviews at age 23 yielded four distinctive romantic pathways differing in stability and the ability to progress toward intimacy: Sporadic and Casual Encounters, Sporadic Encounters in Response to a Stressful Romantic Experience, Steady Non-Intimate Involvements, and Progression toward Steady Intimate Involvements. The findings showed that more than half of participants belonged to the Progression toward Steady Intimate Involvements pathway, suggesting that romantic fluctuations served as means to progress toward intimate involvements. Progression toward steady intimate involvement was explained by greater secure attachment, greater capacity to face tension and to express one's views, and greater parental support measured seven years earlier. In contrast, lower earlier intra- and interpersonal assets during adolescence were more likely to associate with a variety of romantic experiences during emerging adulthood that are characterized by romantic instabilities and difficulty to progress toward intimacy. The findings are discussed within the framework of the Developmental Systems Theory.

Multiplicity and mutuality in the transition of patient and therapist's self-states: Comparison of good vs. poor outcome groups.

Objective: According to the Assimilation Model, the self is consisted of multiple internal voices which are sometimes conflicted, or even dissociated, from one another. Thus, a key therapeutic goal is to create awareness and dialogue between a patient's various internal voices, in order to facilitate positive change. A recent development of this theoretical line suggests that clinically addressing both the patients' and therapists' internal voices, and their mutual influences, contributes significantly to the treatment outcome. Current study aims to examine: (a) Patients' progression throughout treatment in their quality of movement of self-states, from lower levels of dissociation to higher ones of dialectics, and whether this pattern is associated with positive outcomes; (b) temporal congruence in patient-therapist quality of movement of self-states and its association with session outcome. Method: Nine good and nine poor-outcome cases of psychodynamic treatment were analyzed (N = 18) for both the patient and the therapist using the TPA, an expansion of the assimilation of problematic experiences scale (APES). Patients completed the Outcome Rating Scale (i.e., ORS), a session-by-session measure that assesses overall functioning, and symptomatic pre-and-post treatment measures (BDI). Results: A quadratic pattern of change was observed on the TPA of patients from the good-outcome cases: Patients showed more conflict in the beginning, avoidance between self-states in the middle phase, and dialectics towards the end. Additionally, the patient-therapist TPA temporal congruence was significantly related to session outcome of the good-outcome group. Conclusion: These findings emphasize the importance of combining an intra-psychic and inter-psychic set of lenses when inquiring therapeutic processes.

"When You Make a Movie, and You See Your Story There, You Can Hold It": Qualitative Exploration of Collaborative Filmmaking as a Therapeutic Tool for Veterans.

Despite the availability of effective treatments for coping with traumatic experiences, a large percentage of military veterans in need do not seek help. The "I Was There" model is a new filmmaking program which is a creative-expressive tool, developed to enable veterans to reflect on their experiences and jointly create short artistic films. These artistic films articulate, often metaphorically, aspects of the veterans' service experiences, traumatic events, and reintegration challenges. The current study employed a qualitative methodology to explore participants' subjective experience of the program. We interviewed 50 participants following the intervention, focusing specifically on their perceptions of the filmmaking process, the aspects they viewed as meaningful, and whether and how the process affected them. Most participants reported their experience as positive and empowering. Three overarching themes emerged as significant in describing the benefits of participation: Gaining a new sense of agency, regaining a sense of affiliation, and processing the trauma. The findings are illustrated and discussed within the context of narrative therapy, as is the potential of video-based therapy, especially regarding non-articulated, sensory traumatic memories, and for the process of (re)construction of the trauma narrative.

Correction: Shared trauma reality in war: Mental health therapists' experience.

[This corrects the article DOI: 10.1371/journal.pone.0191949.].

Shared trauma reality in war: Mental health therapists' experience.

INTRODUCTION: Shared traumatic reality occurs when therapists are doubly exposed to a traumatic event, both through their clients' experience, along with their own direct exposure. Studies have shown that a shared traumatic reality can lead to both positive and negative outcomes for therapists. Most studies have examined these reactions sometime after the end of the traumatic event, and less is known about reactions that occur during a traumatic event. In addition, most studies have assumed, rather than examined, indirect exposure. In this study, we extend this literature by examining direct and indirect exposure of therapists during a war situation, and their psychological reactions. METHOD: Over a period of two months in 2014, 70% of the Israeli population was exposed to rocket fire. Geographical areas differed in terms of amount of exposure, and its potential danger. 151 therapists living throughout Israel were assessed via an Internet based survey in the middle of the war, and were assessed for the effects on their professional and personal lives, degree of burnout, ways of coping and symptoms levels of PTSD and psychological distress. RESULTS: These indicate that significant differences in direct exposure occurred depending on place of residence. PTSD levels were related to higher direct exposure, as well as prior trauma exposure, but not to indirect exposure. Indirect exposure, as measured by increased workload, was related to increased distress and emotional exhaustion. DISCUSSION: These data shed light on the effects of direct and indirect exposure to a shared traumatic experience of war amongst therapists. The data support previous studies showing a greater effect of direct exposure on PTSD. Since indirect exposure appears to negatively impact burnout and psychological distress, rather than PTSD, this study shows that symptoms other than PTSD should be the result of in a shared traumatic reality.

Distress Levels among Parents of Active Duty Soldiers during Wartime.

Objective: Military service is a highly stressful period both for the soldiers serving and for their parents. Surprisingly, parents' experience has been mostly ignored in the research. This study's goal is to shed light on the experience and distress levels of parents of active duty combat soldiers during Operation Protective Edge, a military operation carried out by the Israel Defense Forces during July and August of 2014. Methods: During the advanced stages of the operation, 69 parents of Israeli male combat soldiers (55 mothers and 14 fathers) completed an online survey measuring symptoms of Posttraumatic Stress Disorder (PTSD-Checklist-5) and distress (Brief Symptom Inventory-18). Participants were recruited using a convenience sample, by posting ads on the public Facebook pages of the researchers and of the groups dedicated to parents of Israeli soldiers. Results: Parents' depression and anxiety symptom levels were higher than depression and anxiety symptom levels of the adult community norms in Israel. General distress rates of parents were similar to those presented by adults in southern Israel who were exposed for 7 years to the ongoing threat of daily rocket fire from Gaza, and higher than rates of a non-threatened Israeli population. Finally, 20.2% of the parents presented PTSD-like symptoms, a higher percentage than the probable PTSD diagnosis rates that were found in the general population in Israel during previous terror waves. Conclusion: This study provides preliminary evidence of soldiers' parents' distress and indicates the need for a better understanding of the impact of military service on soldiers' parents.