Intolerance to uncertainty and self-efficacy as mediators between personality traits and adjustment disorder in the face of the COVID-19 pandemic.

In April 2020, early in the COVID-19 outbreak, governments restricted public gatherings and ordered social distancing. These demands led to challenging adaptations, which in some cases resulted in mental health issues, including adjustment disorder. Guided by the transactional stress model, the current study aimed to examine the relations between personality traits and adjustment disorder in crisis situations and vagueness and the role of intolerance to uncertainty and self-efficacy in these relations. During Israel's first lockdown, 673 Israeli adults completed self-reported e-version questionnaires regarding Big Five personality traits, adjustment disorder, intolerance to uncertainty, self-efficacy, and background variables. The study was designed to examine the association between personality traits and adjustment disorder and the potential mediation of intolerance to uncertainty and self-efficacy in associations. The findings revealed that intolerance to uncertainty and self-efficacy mediated the association between personality traits and adjustment disorder. The results are consistent with the transactional stress model. They shed light on the role of intolerance to uncertainty and self-efficacy as cognitive mechanisms that promote the development of adjustment disorder. Recommendations for future studies and practice are discussed.

Adjustment Disorder in the Face of COVID-19 Outbreak: The Impact of Death Anxiety, Media Exposure, Fear of Contagion and Hypochondriasis Symptoms.

Based on the theoretical view of Terror Management Theory, the current research examines whether higher levels of death anxiety symptoms, in the face of the COVID-19 outbreak, increase the extent to which participants are exposed to information regarding the spread of the pandemic, as well as the fear of contagion and symptoms of hypochondriasis, which all in turn increase symptoms of adjustment disorder. A total number of 302 participants filled out self-report questionnaires regarding death anxiety, adjustment disorder, the extent of exposure to information regarding COVID-19, fear of contagion, hypochondriasis, and demographic information. Structural Equation Modeling analysis indicated a very good fit of the theoretical model with the data, confirming the mediation effect of exposure to information, fear of contagion, and symptoms of hypochondriasis on the association between death anxiety and adjustment disorder symptoms. Implications for practice are discussed.

Mitigating Loss and Trauma: The Continuing Bonds Experience of Daughters Bereaved to Intimate Partner Femicide.

The current study sheds light on the continuing bonds experience of adult Israeli daughters whose mothers were murdered by their fathers. Through 11 semi structured interviews, common externalized and internalized continuing bonds with the deceased mothers were closely examined. The interpreted results supported the existence of bonds, yet revealed a unique manifestation; the bonds were purposefully and defensively restricted, which seemed to be an adjustive compromise in light of the strong traumatic component of the loss. Our results contribute to the theoretical and clinical understanding of the restrictive effect that trauma components have on loss components in cases of traumatic bereavement.

A Trisonance: Identities of Women Whose Mothers Were Murdered by Their Fathers.

The current qualitative study aimed to examine the narrative identities of women bereaved to intimate partner femicide. Eleven adult Israeli female offspring whose biological mothers were murdered by their biological fathers were interviewed for the purpose of this study. Due to the uniqueness of their loss experience and circumstances, participants' identity is narrated as a "trisonance": They are not like their fathers, their mothers, nor as society perceives them. This very particular route for identity reconstruction as a means of psychological survival is discussed in light of the literature on identity construction and bereavement and derives recommendations for practice.

Congenital loss: Loss of an immediate family member prior to or during one's birth.

The loss of a family member is often conceptualized as a disruption in one's life story. However, when a loss occurs prior to, or during, one's birth, the bereaved life stories are not interrupted by the loss, but rather begin with loss. The paper offers a new conceptualization of these losses as "congenital losses" and captures the core aspects of this phenomenon. A qualitative phenomenological analysis of 34 in-depth semi-structured interviews with offspring and siblings whose family members died before/during their birth revealed four main challenges presented by congenital loss: incoherency and fragmentation; story-ownership; bond-establishment, and; identity challenges.

Being a parent, emotional stability, and adjustment disorder symptoms in the face of COVID-19.

Objective: The current study examines the correlation between emotional stability and symptoms related to adjustment to the stresses related to the pandemic for parents and nonparents at the initial stage of the COVID-19 outbreak in Israel. Background: At the early stage of the COVID-19 outbreak, governments prohibited public gatherings and demanded social distancing. These challenges may be especially difficult for individuals with low levels of emotional stability as adaptation difficulties may lead to stress-related outcomes, such as adjustment disorder symptoms. Additionally, in the face of a significant external threat and the demand for intensive joint familial time at home, the parental role becomes especially salient. Methods: Two hundred forty-four Israeli adults filled in self-reported e-version questionnaires regarding emotional stability, adjustment disorder symptoms, and background variables. A cross-sectional design was used to examine the association between emotional stability and adjustment disorder symptoms, as well as the potential moderation by parenting status. Results: The findings revealed that the levels of emotional stability were negatively correlated with adjustment disorder symptoms, while being a parent mitigated this correlation. This correlation was nonsignificant among parents. Conclusion and Implications: It appears that the identity salience of parental role in the current stressful situation and its associated strain may have overcome the advantage of emotional stability. The identity of being a parent has the potential to dismiss it. Here, the social role emerges as more forcible than the personality trait. Recommendations for practice are discussed.

"Empty Chairs at Empty Tables": Disenfranchisement by Association.

The rise in research publications over the last few decades about disenfranchised grief has deepened our understanding of this field. Importantly, it raises awareness and validates human experiences of bereavement, which are often socially ignored, muted, and stigmatized. However, while researchers in the field actively engage in the task of "enfranchisement," as they present their work at scientific conferences, they might experience what we term disenfranchisement by association in the academic sphere. Based on our own experience, this article will demonstrate the parallel pathways between disenfranchisement of bereaved individuals and disenfranchisement of disenfranchised grief researchers, as it emerges in three main expressions of disenfranchisement: reluctance to listen, shame and guilt inflicting, and demand for euphemism. A conclusive note on how to address this kind of disenfranchisement is suggested.

Shattered Voices: Daughters' Meaning Reconstruction in Loss of a Mother to Intimate Partner Homicide.

Intimate partner homicide is a major public health concern around the world and the most lethal outcome of domestic violence. Its impact on the surviving bereaved offspring is immense, yet there is a significant gap in the literature regarding the long-term effects of this type of loss. The current qualitative study is aimed at filling this gap. The study used the constructivist paradigm of bereavement as a theoretical background to reveal the meanings constructed by bereaved Israeli daughters whose biological mothers were killed in acts of intimate partner homicide by their biological fathers. Three main themes of meaning emerged from 12 in-depth semi-structured interviews: "destruction of one's home"; "blast injury"; and "in doubt". An examination of the three themes in the current study reveals a deep shatter in participants' world of meaning to its very basic foundations. In light of intense psychological and social forces, the participants constructed and reconstructed such narratives of meaning in a continuous process of meaning making throughout their lives, years, and decades post loss. Derived from the findings are implications for practice. Mental healthcare professionals must attend to this basic shatter with an extreme level of caution, as they help homicide survivors reconstruct a world of meaning shattered by loss. Moreover, the long-lasting effects emphasize an appropriate legal and political involvement; specifically, policy regulations and rights should provide psychosocial care programs that are suited to the needs of offspring co-victims of intimate partner homicide in particular. In light of the strong social influence on participants' loss experience, further efforts are required to raise social awareness about this burning social concern and to fight the stigmatization of co-victims of homicide in general and co-victims of intimate partner homicide in particular.

"If only ": Counterfactual thinking in bereavement.

When grief over the death of a loved one becomes complicated, protracted and circular, ruminative counterfactual thinking in which the bereaved relentlessly but vainly seeks to somehow reverse the tragedy of the loss often plays a contributory role in sustaining the person's suffering. In this article we summarize the growing evidence implicating this cognitive process in interfering with meaning reconstruction following loss, and identify four foci for counterfactual, "if only" cognition, directed at the self, the deceased, relevant others, or the circumstances of the death itself. We then illustrate each with an actual case vignette, along with approaches to resolving, dissolving, mitigating, or redirecting such rumination, and conclude with a general principle of practice for other therapists whose clients struggle with similarly anguished and entrenched counterfactual preoccupations.

Designing in-depth semi-structured interviews for revealing meaning reconstruction after loss.

The recent upsurge in the use of qualitative empirical studies, aiming to provide a deeper understanding of human reactions to loss, requires a methodological account of how to conduct better qualitative research with regard to data collection. This paper offers six general interview guidelines aimed at assisting researchers to achieve quality interviews in qualitative bereavement studies, based on the theoretical framework of meaning (re)construction in loss.

"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.

Revalidation of Adjustment Disorder-New Module-4 screening of adjustment disorder in a non-clinical sample: Psychometric reevaluation and correlates with other ICD-11 mental disorders.

In line with the new conceptualization of adjustment disorder (AjD) in the 11th revision of the International Classification of Diseases (ICD-11), a new 20-item self-report questionnaire was developed and validated - the Adjustment Disorder-New Module (ADNM). However, such a long research tool has the potential to become problematic for use in epidemiological and clinical settings. Therefore, an ultra-brief measure for AjD (ADNM-4) was established and validated in a recent study conducted with a representative national sample. The aim of the present study was to revalidate the ultra-brief ADNM-4 Scale, as well as to reestablish cutoff scores for clinical use. An online survey was conducted with a convenience sample of 484 Israelis aged 18-65 years, who were recruited via social media. Participants filled out self-report questionnaires dealing with diagnostic criteria of stress-related disorders, that is, AjD (the original and ultra-brief modules), prolonged grief disorder, depression, anxiety, and hypochondriasis. Construct, discriminant, and convergent validity were assessed via confirmatory factor analysis and correlation coefficients, while cutoff scores were established through receiver-operating characteristic analysis. The findings confirmed the ultra-brief module's validity. The high fit indices indicated construct validity, and the correlations with the various stress-related disorders indicated good convergent and discriminant validity. Cutoff scores resembled earlier cutoff scores calculated with a representative national sample, indicating a consistent and accurate diagnostic ability. These findings provide additional evidence for the psychometric characteristics of the ADNM-4, which seems to be a suitable brief screening tool for assessing AjD symptoms according to the ICD-11 definition. Therefore, the ADNM-4 is recommended in cases where prompt screening is required, as well as for research purposes.

Subjective traumatic outlook as a screening tool for psychological trauma: Cut-off values and diagnostic criteria.

The Subjective Traumatic Outlook (STO) deals with changes in individuals' perception, following a traumatic event and the difficulties of integrating pre-trauma past memories, inner traumatic memories, and current daily life. Although this short scale has excellent psychometric properties its cut-off scores for potential clinical use have yet to be established. In addition, due to the discrepancy between the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) in the meaurement of post-traumatic stress disorder (PTSD), the present study aimed at revalidating the STO and establishing cut-off scores for potential clinical use, based on both approaches to measure PTSD and complex post-traumatic stress disorder (CPTSD). Three hundred forty-three adults who were recruited through social media apps filled in self-report online questionnaires dealing with subjective perception of psychological trauma, PTSD and CPTSD. Results revalidate the STO as a screening tool for PTSD and CPTSD. We recommend a STO cut-off score of 13 and above when using the ICD-11 PTSD proposed algorithm along the PCL-5 cutoff score and a STO cut-off score of 15 when using the ICD-11 CPTSD proposed algorithm. In light of the present findings, the integration of DSM and ICD approaches is discussed.

The spark that might have ignited the fire: The association of cognitive and psychological factors with state anxiety in light of the Syrian-Israeli incident.

The current study aimed to explore Israelis' state anxiety due to a Syrian-Israeli incident that occurred on February 10, 2018, when an Israeli F-16 fighter jet was shot down by Syrian air defense forces. In line with the "looming vulnerability" model which emphasizes the importance of the dynamic nature of psychologically threatening situations, the following psychological factors were suggested: associative memory of prior events, worries of future war, sense of safety, and death anxiety. We employed two cross-sectional points of time in our assessment: 36 hours and three months after the incident. Using an online survey, 162 adult participants were recruited in Study 1 and 172 in Study 2. The participants completed set of questionnaires measuring state anxiety along with other psychological measures. The results of the two studies suggested that higher levels of worry of future war and lower levels of sense of safety associated with higher state anxiety. The looming vulnerability model and variables associated with state anxiety were found to have a salient role in explaining state anxiety as a response to a negative unexpected event.

Truck attack: Fear of ISIS and reminder of truck attacks in Europe as associated with psychological distress and PTSD symptoms.

Following an ISIS attack, the present study examined the association between psychological distress and severe stress symptoms with vulnerability variables: i.e. Physical proximity to the site of the terror attack, Associative memory of prior events, Danger perception and ISIS anxiety. Using an online survey, 397 adult participants were recruited, Seventy-two hours after an ISIS terror attack, and filled out Psychological distress Patient Health Questionnaire 4 and severe stress symptoms questionnaire as well as physical proximity to the site of the terror attack, associative memory of prior events, danger perception and ISIS anxiety scales. Physical proximity to the site of the terror attack and ISIS anxiety were found to be significantly associated of both psychological distress and severe stress symptoms. Regarding danger perception, only danger perception of terror attacks was associated with both psychological distress and with severe stress symptoms. Lastly, whereas being reminded of the 2014 Jerusalem tractor attack (tapping to association via location) was neither associated with psychological distress nor with severe stress symptom, the reminder of the truck attack in Berlin (tapping into association by recency and similarity) was associated with psychological distress but not with severe stress symptoms. The importance of the findings is discussed.

Factors associated with post-election psychological distress: The case of the 2016 U.S. presidential election.

This study, through the lens of Social Cognitive Theory, examined potential risk factors that may intensify election-related psychological distress. Six weeks after the 2016 U.S. election, 772 U.S. adult citizens filled out an online survey that assessed psychological distress along with sociodemographic characteristics, and a set of variables tapping various dimensions of political self-efficacy (i.e., importance of politics in one's life, preferences for different media outlets, political directness, and voting choices). The findings showed that election-related psychological distress was positively associated with young age, greater reliance on new media, greater importance of politics in one's life, higher political directness, and voting for the candidate who did not win the election. Findings should be valuable for health-care providers informing them about potential risk factors intensifying psychological distress in the context of significant political events.

Evoked Death-Related Thoughts in the Aftermath of Terror Attack: The Associations Between Mortality Salience Effect and Adjustment Disorder.

ICD-11 has provided a revised definition for adjustment disorder (AjD). The current study examined whether mortality salience effect, a possible consequence of a terror attack, may serve as a significant predictor associated with each of the AjD subscales. Using an online survey, 379 adult participants were recruited and filled out self-reported questionnaires dealing with adjustment disorder symptoms as well as mortality salience effect. Findings revealed that mortality salience effect was a significant predictor of all AjD subscales. The importance of mortality salience effect for AjD is discussed in light of terror management theory.

Concern and death anxiety during an ongoing terror wave: The moderating role of direct vs. indirect exposure.

The current study examined whether emotional concern over one's security situation is connected with death anxiety during an ongoing terror wave, and whether type of exposure (media exposure vs. contact with witnesses) moderates this connection. A total of 345 individuals, aged 18-70, were sampled during an ongoing wave of terror in Israel and filled out scales measuring death anxiety, concern over security situation, and type of exposure. Results indicated that increased concern was connected with enhanced death anxiety. Moreover, this connection was more pronounced among individuals exposed to the events through the media, in comparison with individuals who had first-hand contact with witnesses.

Do previous experience and geographic proximity matter? Possible predictors for diagnosing Adjustment disorder vs. PTSD.

The minority of people who have experienced a traumatic event and were diagnosed as either suffering from PTSD or from Adjustment disorder, may suggest that victims of a traumatic event vary in risk factors for the disorders. The current research aimed at examining the association between reports of Adjustment disorder and PTSD symptoms (In accordance with the proposed revisions of the ICD-11) and several vulnerability variables: previous traumatic event, previous stressful event and physical proximity to the terror attack. Using an online survey, 379 adult participants were recruited, and filled out Adjustment disorder, PTSD symptomatology scales, as well as a previous exposure, magnitude of exposure and death anxiety scales. Findings revealed that previous experience of traumatic events was a significant predictor associated with both PTSD and Adjustment disorder symptoms. Previous experience of stressful events was a significant predictor associated with Adjustment disorder alone. Physical proximity to the site of the attack was a significant predictor associated with PTSD symptoms but not Adjustment disorder symptoms. The importance of previous traumatic events, previous stressful events and physical proximity to the terror attack as factors which are associated with Adjustment disorder and PTSD symptomatology is discussed.

When the human spirit helps? The moderating role of somatization on the association between Olympic game viewing and the will-to-live.

This study examined whether participants with low somatization (no bodily manifestations of anxiety) who are assumed to identify with- and be inspired- by the Olympic-Games-spirit will present a stronger association between their Olympic-game viewing hours and their will-to-live, than persons with high somatization. One hundred and thirty seven participants reported their daily Olympic-game viewing hours, somatization and will-to-live levels. Results show that while among those with low somatization symptoms level, the relationships between Olympic game viewing hours and will-to-live was positive, the opposite was found among those with high somatization symptoms level. Viewing the Olympic Games may be beneficial for individuals with low somatization level but less so to individuals with higher somatization.