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.

Learning based PTSD symptoms in persons with specific learning disabilities.

Specific learning disorders (SLD) persist into adulthood. Persons with SLD frequently experience emotional and social difficulties. Following qualitative descriptions of individuals with SLD who experienced learning, as traumatic, we hypothesized that individuals reporting SLD would report higher levels of learning-based post-traumatic-stress-disorder (PTSD) symptoms. In Study 1 (N = 216), participants responded to questionnaires concerning SLD and learning-based PTSD. A separate sample (N = 43) was queried about adjustment disorder symptoms. Study 2 (N = 176) examined if current psychological distress was predicted by levels of learning-based PTSD at each developmental stage (elementary/high-school/post-high-school) and whether SLD links to current psychological distress. Finally, we assessed if SLD-psychological distress associations are mediated by cumulative levels of learning-based PTSD across these school periods. In Study 1 individuals reporting SLD displayed higher learning-based PTSD levels than those without SLD. SLD-PTSD associations held beyond adjustment disorder symptom levels. In Study 2, SLD was linked with psychological distress, mediated by accumulated learning-based PTSD symptom levels across school periods. These results suggest that in individuals with SLD, learning experiences may be associated with learning-based PTSD symptoms. Further, persons with SLD may be scarred by their traumatic learning experiences linking with current psychological distress, a link mediated by cumulative difficulties experienced over school years.

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.

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.

Subjective Age and Late-Life Functional Status: Mediating and Moderating Effects.

OBJECTIVES: This study examined the longitudinal relationships between subjective age (SA) and future functional status in later life, via depressive symptoms. Additionally, we assessed the role of subjective nearness to death (SNtD) as a potential moderator within these pathways. METHODS: Older adults (average age 81.14 years at T1) were interviewed once a year for 3 consecutive years (N = 224 at T1, N = 178 at T2, and N = 164 at T3). Participants reported their SA, SNtD, depressive symptoms, and functional status. Additionally, grip strength was employed as an objective measure of functional status. RESULTS: Data analysis revealed distinct pathways leading from T1 SA to T3 functional status through T2 depressive symptoms. Moreover, T1 SNtD was found to significantly moderate most of these indirect pathways, so that the mediation model of T1 SA-T2 depressive symptoms-T3 functional status was mostly significant among those who felt closer to death. DISCUSSION: The findings contribute to our understanding of the underlying mechanism through which SA predicts long-term functioning sequelae by underscoring the indirect effect of depressive symptoms. They further indicate the importance of gauging the effects of SNtD on these longitudinal relationships. Present results may further contribute to establishing an integrative model for predicting long-term functional outcomes based on older adults' earlier subjective views of aging.

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.

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 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.

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.

Day-to-Day Variability in Subjective Age and Ageist Attitudes and Their Association With Depressive Symptoms.

OBJECTIVES: Evidence of daily fluctuations in subjective age and their association with older adults' well-being was recently obtained. Yet, neither the simultaneous tracking of two daily views on aging (i.e., daily subjective age and daily ageist attitudes) nor their interactive effect on mental health (i.e., depressive symptoms) has been explored. We hypothesized that (a) at days on which older adults feel older or report high ageist attitudes they would report higher depressive symptoms, (b) combined older subjective age and high ageist attitudes will be associated with the highest daily depressive symptoms. METHOD: Community-dwelling older adults (N = 134, mean age = 69.66) completed measures of subjective age, ageist attitudes, and depressive symptoms for 10 consecutive days. RESULTS: Daily older subjective age and higher ageist attitudes were related to higher depressive symptoms, but there was no combined effect of both on depressive symptoms. There was a significant three-way interaction between subjective age, ageist attitudes, and chronological age, demonstrating the interactive effect of subjective age and ageist attitudes on depressive symptoms only among the old-old respondents. Time-lagged analyses further showed that ageist attitudes during previous days predicted feeling older and more depressed on following days, but not vice versa. DISCUSSION: Results suggest that old-old individuals are more susceptible to a combination of negative views on aging on daily basis. Findings further support a daily assimilation process, whereby previous-day stereotypes are assimilated and manifested into one's identity and mental health, so that one feels older and more depressed on subsequent days.

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.

Secondary traumatic stress, vicarious posttraumatic growth and their association in emergency room physicians and nurses.

Background: Emergency room personnel are indirectly exposed to many traumas. Few studies have examined secondary traumatic stress in emergency room nurses and only a single study examined emergency room physicians. The extent of vicarious post-traumatic growth, i.e., the growth associated with such trauma, has also hitherto not been examined in emergency room personnel. Objective: Our first goal was to examine secondary traumatization in both emergency room nurses and physicians. Our second goal was to examine vicarious post-traumatic growth in emergency room personnel. Finally, we also address the association (linear and curvilinear) between secondary traumatization and vicarious traumatic growth. Methods: A questionnaire comprising demographic variables, secondary traumatic stress and vicarious post-traumatic growth was administered electronically to a sample of emergency room personnel from the Wolfson Hospital, Holon, Israel. Results: There were no differences between nurses and physicians in overall secondary trauma or vicarious post-traumatic growth levels. For physicians, there was both a linear and a curvilinear association between secondary trauma and vicarious post-traumatic growth; for nurses, there was no overall association. Further sub-group analyses revealed that emergency room nurses with low workload, in conjunction with low work experience, did show a linear association. Conclusion: Results indicate that while vicarious post-traumatic growth is linked to secondary traumatic stress for emergency room physicians, it is not so for nurses. Theoretical implications concerning the role of trauma symptoms in vicarious post-traumatic growth are discussed. Clinical implications are raised regarding the identification of excessive secondary traumatic stress levels and the need for interventions to both decrease stress levels, and to increase vicarious post-traumatic growth levels.

Antecedentes: El personal de las salas de emergencia está indirectamente expuesto a muchos traumas. Pocos estudios han examinado estrés traumático secundario en enfermeros en salas de emergencia y sólo un estudio en médicos de salas de emergencia. La envergadura del crecimiento vicario postraumático, es decir, el crecimiento asociado con tal trauma, hasta ahora tampoco ha sido estudiado en el personal de salas de emergencia.Objetivo: Nuestro principal objetivo fue examinar la traumatización secundaria tanto en médicos como enfermeros de salas de emergencia. Nuestro segundo objetivo fue estudiar el crecimiento vicario postraumático en el personal de salas de emergencia. Finalmente, abordamos también la asociación (lineal y curvilínea) entre traumatización secundaria y crecimiento vicario postraumático.Métodos: Se administró electrónicamente un cuestionario a una muestra del personal de salas de emergencia del Hospital Wolfson, Holon, Israel, abarcando variables demográficas, estrés traumático secundario y crecimiento vicario postraumático.Resultados: No hubo diferencias en general en trauma secundario o crecimiento vicario postraumático entre enfermeros y médicos. Para los médicos, hubo una asociación tanto lineal como curvilínea entre trauma secundario y crecimiento vicario postraumático; para enfermeros, no hubo asociación en general. Análisis adicionales de subgrupos revelaron que los enfermeros de salas de emergencia con baja carga laboral, en combinación con baja experiencia laboral, mostró una asociación lineal.Conclusiones: Los resultados indican que mientras el crecimiento vicario postraumático está asociado a trauma secundario en médicos de salas de emergencia, no ocurre así para el caso de los enfermeros. Se discuten implicaciones teóricas en relación al rol de los síntomas traumáticos en el crecimiento vicario postraumático. Surgen implicaciones clínicas que involucran la identificación de niveles excesivos de estrés traumático secundario y la necesidad de intervenciones para disminuir los niveles de estrés; y además, aumentar los niveles de crecimiento vicario postraumático.

Variables Connecting Parental PTSD to Offspring Successful Aging: Parent-Child Role Reversal, Secondary Traumatization, and Depressive Symptoms.

The effects of parental trauma on offspring of Holocaust survivors (OHS) are debated in the literature. Recently, scholars suggested that it may be more productive to ask when and via which mechanisms such effects are observed. Following, the current study examines if parental Holocaust-related posttraumatic stress disorder (PTSD) symptoms are linked with the aging processes of their middle-aged offspring. Beyond this association, we also suggested a putative mediation path, indicating three underlying mechanisms by which parental trauma lingers on: perceived parent-child role reversal, secondary traumatization, and depressive symptoms. Using a convenience sample of 682 community-dwelling participants, comprising 341 older adult parent-middle-aged offspring dyads (M age = 81.71 and 54.58 for parents and offspring, respectively) to address this issue. Parents reported PTSD with the valid measure of PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition. OHS reported perceived parent-child role reversal, secondary traumatization, depressive symptoms, and completed indices of successful aging. Based on parents' reports, we divided the parent-offspring dyads into three groups: OHS whose parents had probable PTSD (n dyads = 43), OHS whose parents did not have PTSD (n dyads = 161), and comparison with parents who did not undergo the Holocaust (n dyads = 137). Findings reveal that OHS with parents suffering from probable PTSD aged less successfully than comparisons. Serial mediation analyses validated the aforementioned putative pathway (perceived parent-child role reversal, secondary traumatization, and depression) linking parental PTSD with offspring successful aging. Our findings are discussed through a vignette depicting a fictional OHS character. These underlying mechanisms suggest that different types of interventions, each geared towards a specific mechanism, may mitigate the lingering effect of parental PTSD on diminished OHS successful aging.

"Spidey Can": Preliminary Evidence Showing Arachnophobia Symptom Reduction Due to Superhero Movie Exposure.

Fear of insects, mainly spiders, is considered one of the most common insect phobias. However, to date, no conducted studies have examined the effects of phobic stimulus exposure (spiders/ants) within the positive context of superhero movies, such as Spider-Man or Ant-Man. A convenience sample of 424 participants divided into four groups watched different clips. Two intervention groups (Spider-Man/Ant-Man) and two control groups (Marvel opening/natural scene) were measured twice (pre-post intervention). The measures comprised an online survey assessing socio-demographic variables, familiarity with superhero movies and comics, and phobic symptoms. Reduction in phobic symptoms was significant in the Spider-Man and Ant-Man groups in comparison to the control groups. Seven-second exposure to insect-specific stimuli within a positive context reduces the level of phobic symptoms. Incorporating exposure to short scenes from superhero movies within a therapeutic protocol for such phobias may have the potential to be robustly efficacious and enhance cooperation and motivation.

Understanding the long-term connections between posttraumatic stress, subjective age, and successful aging among midlife and older adults.

Background: The nature of the reciprocal relationships between posttraumatic stress disorder (PTSD) symptoms, proportional subjective age, and their effects on successful aging are important issues that have been so far under-studied. Clarifying the relationships between these variables has many theoretical and practical implications for the understanding of how individuals age in the shadow of traumatic exposure. Objective: The present study examined the reciprocal relationships between PTSD symptoms and proportional subjective age in a longitudinal design, and how these variables predict successful aging. Method: Using in-region random digit dialling, we collected a stratified sample of community-dwelling older adults residing in the south of Israel. Of that sample, 132 midlife and older adults (T1 age range = 50-87, mean age = 65.84, SD = 9.12) were interviewed three times across a period of two years and four months (2014-2016). Participants completed measures of PTSD symptoms and proportional subjective age in the first two interviews (T1 and T2) and successful aging indices in the third interview (T3). PTSD symptoms and proportional subjective age measured at both T1 and T2 served as predictors and outcomes in a cross-lagged model and as predictors of successful aging at T3. Results: T1 PTSD symptoms predicted an older proportional subjective age at T2, whereas the reverse relationship (i.e. T1 proportional subjective age to T2 PTSD symptoms) was non-significant. Moreover, higher PTSD symptoms and an older proportional subjective age at T2 predicted lower successful aging at T3. Conclusions: In addition to clarifying the temporal sequencing of PTSD and proportional subjective age, the study further suggests that PTSD and proportional subjective age identity could each render midlife and older adults more susceptible to less successful aging. Accordingly, we advocate to further explore the mechanisms underlining these complicated relationships.

La naturaleza de las relaciones recíprocas entre el trastorno de estrés postraumático (TEPT) y los efectos de la edad subjetiva proporcional sobre el envejecimiento exitoso son asuntos importantes que, a la fecha, han sido poco estudiados. El esclarecer las relaciones entre estas variables tiene muchas repercusiones teóricas y prácticas para la comprensión de cómo envejecen las personas bajo la sombra de la exposición traumática.Objetivo: El presente estudio evaluó las relaciones recíprocas entre los síntomas del TEPT y la edad subjetiva proporcional mediante un diseño longitudinal, además de evaluar cómo estas variables predicen el envejecimiento exitoso.Métodos: Mediante un proceso de marcación aleatoria de números telefónicos, se recolectó una muestra estratificada de adultos mayores residentes en comunidades al sur de Israel. De aquella muestra, se entrevistó a 132 adultos en la edad media y a adultos mayores (rango de edad en T1 = 50 ­ 87 años, edad promedio = 65,84 años, desviación estándar = 9,12), los cuales fueron entrevistados en tres oportunidades a lo largo de un periodo de dos años y cuatro meses (2014 ­ 2016). Los participantes completaron mediciones para síntomas de TEPT y para la edad subjetiva proporcional en las primeras dos entrevistas (T1 y T2), e índices para envejecimiento exitoso en la tercera entrevista (T3). Los síntomas del TEPT y la edad subjetiva proporcional medidas tanto en T1 como en T2 fueron usados como predictores y como resultados empleando un modelo de referencias cruzadas, y en T3 ambos fueron usados como predictores de envejecimiento exitoso.Resultados: Los síntomas de TEPT en T1 predijeron una edad subjetiva proporcional mayor en T2, mientras que la relación inversa (esto es, partir de una edad subjetiva proporcional en T1 y correlacionarlo con los síntomas del TEPT en T2) no fue significativa. Asimismo, una mayor cantidad de síntomas del TEPT y una mayor edad subjetiva proporcional en T2 predijeron un envejecimiento exitoso menor en T3.Conclusiones: Además de esclarecer la secuencia temporal del TEPT y la edad subjetiva proporcional, el estudio también sugiere que el TEPT y la edad subjetiva proporcional podrían, cada una, predisponer a adultos en la edad media y a adultos mayores a ser más susceptibles a un envejecimiento menos exitoso. Consecuentemente, abogamos por explorar con mayor profundidad los mecanismos subyacentes a estas complicadas relaciones.

Preliminary evidence linking complex-PTSD to insomnia in a sample of Yazidi genocide survivors.

Complex post-traumatic stress disorder (CPTSD) is a psychiatric diagnosis that includes three additional symptom clusters beyond those necessary for post-traumatic stress disorder (PTSD) diagnosis. CPTSD is typically associated with a prolonged trauma exposure in which a person's destiny is under the control of other people and escape is not an option. Insomnia prevalence in women suffering from CPTSD was compared to the prevalence of insomnia in those with no-PTSD and those with only PTSD. Yazidi women (N = 108, age = 24.41 ±â€¯5.71) former captives of the Islamic State terrorist group were queried about captivity variables, psychological distress, resilience, PTSD, CPTSD, and insomnia. CPTSD prevalence was high (>50%) and was highly correlated with insomnia (95% of those with CPTSD had insomnia). A dichotomous insomnia variable was regressed on age and marital-status (Step 1), captivity-duration and number of fellow captives (Step 2), resilience and psychological distress (Step 3), and group (no-PTSD/PTSD/CPTSD) (Step 4). Insomnia was 18 times more likely in the CPTSD group than in the no-PTSD group. There were no differences in insomnia prevalence between the no-PTSD and PTSD groups. Insomnia levels among Yazidi women released from captivity support an understanding of CPTSD as a separate entity than PTSD. Potential factors linking CPTSD to insomnia, beyond those associated with PTSD are discussed.