Shyness and social phobia in Israeli Jewish vs Arab students.

BACKGROUND: Social anxiety disorder (SAD) has been repeatedly shown to be very prevalent in the Western society with prevalence rates of 10% or above. However, very few studies have been performed in the Middle East and in Arab countries. METHODS: A total of 300 Israeli students participated in our study and were administered the Liebowitz Social Anxiety Scale (LSAS), the Cheek and Buss Shyness Questionnaire (CBSQ), and a sociodemographic questionnaire. RESULTS: A total of 153 Jewish and 147 Arab students participated in the survey. Social anxiety disorder was found in 12.33% of the sample, according to the LSAS cutoff score of more than 60. The 2 subsamples had similar LSAS and CBSQ scores and similar SAD-positive rates (LSAS >60). Females had higher scores on the LSAS, as were those without a spouse and those who had been in psychological treatment. Based on a regression analysis, the significant predictors of the LSAS score were the CBSQ score and female sex. A very high correlation was found between the LSAS and the CBSQ scores. CONCLUSIONS: Although our sample is not representative of the whole Israeli population, we conclude that SAD and shyness were similarly prevalent in Jewish and Arab students in Israel. Social anxiety disorder scores were higher among females, those without a spouse, and those who received psychological treatment. Further studies on the clinical and cultural characteristics of SAD in Israeli subcultures would add to the growing body of knowledge on SAD in various cultures.

Exploring physician perceptions of the impact of emotions on behaviour during interactions with patients.

BACKGROUND: There is relatively little research on affective influences on physician behaviour, especially on prescribing and referrals. Affects include transitory moods and lasting emotions. OBJECTIVES: We explored physician perceptions of the impact of four mood states on perceived rates of five behaviours: talking with patients, prescribing medications and referrals for laboratory tests, diagnostic tests and specialists. We also examined whether burnout modified the impact of moods on behaviour. METHODS: A total of 188 family physicians responded anonymously to a self-reporting questionnaire that assessed the perceived rate of behaviours when in a positive, negative, tired and nervous mood and burnout level. RESULTS: Five analyses of variance with repeated measures on mood states and contrast analyses computed the effects of mood and burnout on the behaviours. The mood factor was found significant for each of the behaviours, in all P < 0.001. The respondents reported that on good mood compared with negative mood days, they talked more, prescribed less and referred less. The burnout factor was also significant: high compared with low burnout physicians had higher perceived rates of all referral behaviours. Significant mood × burnout interactions indicated that the effects of mood were stronger among high compared with low burnout physicians. CONCLUSIONS: The physicians perceived that their moods had different effects on different behaviours: the negative mood decreased talking and increased prescribing and referral behaviours and vice versa for the positive mood. Burnout intensified the effects of moods. The incremental effects of negative moods and burnout may impair quality of health care and may be costly to health services.

The relationship between type of insurance, time period and length of stay in psychiatric hospitals: the Israeli case.

BACKGROUND: According to the current standard of practice in modern medicine, medical decision-making is often forced to comply with stipulations of the insurance provider. In the field of psychiatry, there has been a trend of shortened psychiatric hospitalizations which some have suggested may be due to pressures related to insurance coverage. In Israel, soldiers have comprehensive medical coverage provided by the military, and this coverage includes full payment for psychiatric hospitalizations. In contrast, Israeli civilians are insured by the government according to a global payment system. In this study, we aimed to examine differences between these two groups in terms of length of stay (LOS) in psychiatric hospitals. METHODS: Data on psychiatric admissions of soldiers (aged 18-21) spanning the past 30 years was obtained from the military database (N=2,106). Corresponding data was collected on first psychiatric hospitalizations of a cohort of matched civilians (N=6556). The mean LOS of the two groups was compared. RESULTS: Civilians had a significantly longer LOS than soldiers. Moreover, LOS decreased between the seventies and the nineties for both groups, and the decrease was observed for all diagnoses regardless of disease severity. DISCUSSION: We conclude that in the managed care era, economic considerations may at times take precedence over psychiatric ones, irrespective of the degree of severity of illness. The parallel process is manifested in a general trend towards deinstitutionalization in the United States, Canada and Europe.

Efforts to support special-needs soldiers serving in the Israeli defense forces.

Providing treatment and support to special-needs populations can decrease psychopathology and suicide rates. Because service in the military is an important socializing force in Israeli society and most Israelis serve, the Israeli Defense Forces (IDF) makes special efforts to identify, treat, and support soldiers with emotional, behavioral, and cognitive problems. This column describes the IDF's efforts for three groups of soldiers with special needs, with a focus on those with the most severe problems who receive support throughout their service to address psychopathology and suicidality. Suicide rates for the IDF population and for the three groups are reported.

Changes in mental health policy and their influence on self-injurious behaviours in the Israeli military prison system.

OBJECTIVE: Self-injurious behaviours (SIBs) are widespread among prisoners and are sometimes classified as potentially calculated acts intended to control others. Access to a psychiatrist may be valued by imprisoned soldiers seeking immediate release from service. The main goal of the study was to assess the effects of a new mental health regulation in the Israel Defense Forces (IDF) prison system, which requires ordering an immediate interview with a psychiatrist for inmates performing SIBs. METHOD: Frequency of SIBs in 2 military prisons was examined and compared for 11 months before and 10 months after the implementation of the regulation. Severity of injuries and rates of release from service were examined for 4 months. RESULTS: The frequency of SIBs significantly increased after the implementation of the regulation in one prison, but not in the other. No effect was found for rate of release from service or for severity of injuries. CONCLUSIONS: Increased accessibility to a psychiatrist for military prisoners may have resulted in increased motivation for inmates to perform SIBs. These effects are limited to the prison that serves a higher proportion of highly stressed soldiers.