Prevalence and correlates of ICD-11 prolonged grief disorder among adults living in Ukraine during the war with Russia.

BACKGROUND: Although high rates of bereavement are evident in war-affected populations, no study has investigated the prevalence and correlates of probable ICD-11 prolonged grief disorder (PGD) under these circumstances. METHODS: Participants were 2050 adults who participated in a nationwide survey exploring the effects of the Ukraine-Russia war on the daily lives and mental health of Ukrainian people. RESULTS: Of the total sample, 87.7% (n = 1797) of people indicated a lifetime bereavement. In the full sample, 11.4% met the diagnostic requirements for probable ICD-11 PGD, and amongst those with a lifetime bereavement, the conditional rate of probable ICD-11 PGD was 13.0%. Significant risk factors of ICD-11 PGD included the recent loss of a loved one (6 months to a year ago), being most affected by a partner or spouse's death, loved one dying in the war, no recent contact with the deceased prior to their death, and meeting depression and anxiety diagnostic requirements. CONCLUSION: The study reveals that a significant percentage of Ukrainian bereaved individuals have probable ICD-11 PGD, and identifying risk factors, particularly war-related losses, will aid in the development of intervention and prevention programs for bereaved adults.

Mental health in Ukraine in 2023.

BACKGROUND: Very little is known about the mental health of the adult population of Ukraine following Russia's full-scale invasion in February 2022. In this study, we estimated the prevalence of seven mental health disorders, the proportion of adults screening positive for any disorder, and the sociodemographic factors associated with meeting requirements for each and any disorder. METHODS: A non-probability quota sample (N = 2,050) of adults living in Ukraine in September 2023 was collected online. Participants completed self-report questionnaires of the seven mental health disorders. Logistic regression was used to determine the predictors of the different disorders. RESULTS: Prevalence estimates ranged from 1.5% (cannabis use disorder) to 15.2% (generalized anxiety disorder), and 36.3% screened positive for any of the seven disorders. Females were significantly more likely than males (39.0% vs. 33.8%) to screen positive for any disorder. Disruption to life due to Russia's 2014 invasion of Ukraine, greater financial worries, and having fewer positive childhood experiences were consistent risk factors for different mental health disorders and for any or multiple disorders. CONCLUSION: Our findings show that approximately one in three adults living in Ukraine report problems consistent with meeting diagnostic requirements for a mental health disorder 18 months after Russia's full-scale invasion. Ukraine's mental healthcare system has been severely compromised by the loss of infrastructure and human capital due to the war. These findings may help to identify those most vulnerable so that limited resources can be used most effectively.

The association between dissociative symptoms and schizophrenia-related negative symptoms: A transdiagnostic approach.

Negative symptoms of schizophrenia remain clinically and theoretically understudied and represent an unmet psychiatric need. Negative symptoms are assumed to be related to other psychiatric disorders, but their association with dissociative symptoms is yet to be explored, particularly in light of depression and anxiety symptoms. We examined the five domains of negative symptoms (anhedonia, asociality, avolition, blunted affect and alogia) in an Israeli national sample of 1930 participants of whom 645 (33.4%) were with increased risk for dissociative disorder. The results show that anhedonia, blunted affect and alogia significantly associated with risk for dissociative disorder, above and beyond depression and anxiety. When assessing for negative symptoms it may be worth screening for dissociation and vice versa and thus make a more accurate clinical picture of the interplay between them.

Echoes of ancestral trauma: Russo-Ukrainian War salience and psychological distress among subsequent generations in Holocaust survivor families.

OBJECTIVE: The Russo-Ukrainian War intensified when Russian troops invaded Ukraine in February 2022. The current study examined whether children (second generation; G2) and grandchildren (third generation; G3) of Holocaust survivors are more preoccupied with the war relative to comparisons. Moreover, whether there was more exacerbation in psychological distress in Holocaust survivor families relative to comparisons since the escalation of the war. METHOD: A random sample from a web-based survey company included 1,071 Jewish Israeli adults (297 Holocaust G2, 224 comparison G2, 379 Holocaust G3, and 171 comparison G3). The average age of the participants was 62.95 ± 10.25, 61.79 ± 10.13, 34.02 ± 8.65, and 33.55 ± 8.26, respectively. Participants answered questionnaires on background characteristics, Russo-Ukrainian War exposure, Russo-Ukrainian War salience, and general psychological distress before and since the escalation of the war. RESULTS: Findings showed that Holocaust G2 and G3, relative to comparisons, reported more Russo-Ukrainian War salience. Moreover, more psychological distress symptom exacerbation was found in Holocaust survivor families relative to comparisons since the escalation of the war. Finally, Holocaust G2 and G3 with more Holocaust survivors in the family showed higher anxious preoccupation with the war and Holocaust G3 with more survivor grandparents showed more exacerbation in psychological distress. CONCLUSIONS: Findings suggest a specific vulnerability due to intergenerational transmission of trauma in Holocaust survivor families, including increased preoccupation with and perceptiveness to potential threats of human-induced trauma. Strengthening previous recommendations, mental health practitioners should focus on reducing the preoccupation with threat and the increased psychological distress of Holocaust survivor families when faced with current adversity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Interrelations of Family Relationship, Illness Cognition of Helplessness and Perceived Barriers to Medication Adherence: A Study of Adolescent and Emerging Adult Kidney Recipients and Their Parents.

Background: Medication adherence among adolescents and emerging adults following kidney transplantation was found to be lower with harmful consequences. The current study aimed to examine associations between illness cognition of helplessness, family relationships, and perceived barriers to medication adherence among post-kidney transplant adolescent and emerging adult recipients and their parents by applying a dyadic perspective. Methods: Fifty-nine dyads of adolescents and emerging adults aged 11-26 years and their parents, were recruited from a pediatric nephrology department in a medical center in Israel. Both adolescents and emerging adults and parents completed self-report questionnaires addressing illness cognition of helplessness (subscale of Illness Cognition Questionnaire), family relationships related to conflict and cohesion (Brief Family Relationship Scale), and the adolescents' perceived barriers (Adolescent Medication Barriers Scale) to taking their prescribed medications. Results: Adolescents' and emerging adults' perceptions of family conflicts moderated the link between illness cognition of helplessness among parents and barriers to medication adherence via the illness cognition of helplessness among adolescents and emerging adults. However, only the adolescents' and emerging adults' perceptions of family cohesion had a direct association with barriers to medication adherence. Parents' perceived family conflict and cohesion did not directly associate with barriers to medication adherence. Findings highlight the complex interplay between family dynamics, illness cognition, and barriers to medication adherence in adolescents and emerging adults. Conclusion: Parents', adolescents' and emerging adults' perceptions of family conflicts and cohesion, as well as their illness cognitions, can play important roles in understanding and addressing barriers to medication adherence in this population. The study reveals findings that highlight the dyadic transference process of illness cognition of helplessness among both adolescent and emerging adult kidney recipients and their parents in assessing barriers to medical treatment.

The association between daily life changes and anxiety among Ukrainians following the Russian invasion.

This study sought to explore the association between changes in daily life and war-related anxiety. In this study, we analyzed self-reported data from 2,004 Ukrainian adults, obtained through an opportunistic survey in the Ukraine. Our assessment focused on changes in everyday routines and generalized anxiety symptoms since the Russian invasion of Ukraine on the 24 February 2022. The data were collected between July-September 2022. Results show a significant dose-response connection between everyday routine changes and increased war-related anxiety. Not surprisingly, the ongoing Ukraine-Russia conflict is impacting the lives of Ukrainians. These changes are linked to heightened anxiety levels. Effective population-based crisis management should consider both war-related stressors and changes in daily life routines.

Factors associated with ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder among older adults during the COVID-19 pandemic.

ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD have been understudied in the older population. The study focused on the associations between traumatic exposure before the pandemic, COVID-19 worries, depression, and loneliness with current PTSD and CPTSD among older adults. A random sample of five hundred and twelve Israeli older adults (Mage = 72.67 ± 3.81, range 68-87) was recruited using a Web-based survey company (Ipanel, Israel). Participants completed questionnaires of demographic details, self-rated health, COVID-19 worries, trauma exposure, depressive symptoms, level of loneliness, PTSD, and CPTSD. Univariate logistic regression revealed that trauma exposure, COVID-19 worries, depression, and loneliness were associated with PTSD. Multinomial regression revealed that only trauma exposure was associated with PTSD among older adults with PTSD compared with those not reaching the PTSD cutoff level. In the comparison between older adults suffering from CPTSD with those not reaching the PTSD cutoff level, being married, higher levels of trauma exposure, COVID-19 worries, depression, and loneliness were associated with a higher risk of CPTSD. Results suggest that specific factors may be significant psychological correlates of CPTSD symptoms among older adults during the COVID-19 pandemic. Identifying these factors could assist practitioners in tailoring more effective interventions.

Let there be light: The moderating role of positive solitude in the relationship between loneliness and depressive symptoms.

Positive solitude (PS), the choice of being alone to engage in meaningful inner or physical, spiritual, mental, or cognitive activity/ experience, was recently suggested as a stand-alone phenomenon differentiated from loneliness and negative solitude. As loneliness was previously found to have adverse implications for mental health, the present study examined whether the ability to engage in PS can moderate the harmful effect of loneliness on depressive symptoms. The sample consisted of 520 community-dwelling older adults in Israel aged 68-87 (Mage = 72.66). Participants answered an online questionnaire through a survey company (Ipanel) assessing their background characteristics, depressive symptoms, loneliness, and PS. Loneliness was positively associated with depressive symptoms, whereas PS was negatively associated with depressive symptoms. Furthermore, PS moderated the relationship between loneliness and depressive symptoms, such that higher levels of PS weakened this association. The findings indicate that PS may serve as a buffering factor for mental health among older adults by augmenting coping with the adverse outcomes of loneliness. The results provide insight for tailoring future treatment interventions focusing on PS to enhance mental health among older adults.

Parent-reported posttraumatic stress reactions in children and adolescents: Findings from the mental health of parents and children in Ukraine study.

BACKGROUND: Despite the long-standing ongoing war in Ukraine, information regarding war-related negative mental health outcomes in children is limited. A nationwide sample of parents in Ukraine was surveyed to assess posttraumatic stress disorder (PTSD) symptoms in their children and to identify risk factors associated with child PTSD status. METHOD: A nationwide opportunistic sample of 1,238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected approximately 6 months after the war escalation in February 2022. The prevalence of PTSD was estimated using the parent-reported Child and Adolescent Trauma Screen (CATS). RESULTS: Based on parental reports, 17.5% of preschoolers and 12.6% of school-age children met Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for PTSD. Delay in milestone development (AOR = 2.38, 95% confidence interval [CI] [1.38-4.08]), having a parent affiliated with the emergency services or army (AOR = 2.13, [1.28-3.53]), parental PTSD/complex PTSD status (AOR = 1.88, [1.22-2.89]), and mean changes in parental anxiety (AOR = 1.98, [1.44-2.72]) were among the strongest predictors of increased risk of pediatric PTSD. CONCLUSION: Russia's war escalation in Ukraine resulted in an increased estimated prevalence of war-related PTSD in children of various ages. Urgent efforts to increase the capacity of national pediatric mental health services are critically needed to mitigate these challenges in an environment of limited financial and human resources. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trauma-related and risk factors associated with perceived exacerbation in psychological distress due to the Russo-Ukrainian war.

This study examined trauma-related and other potential risk factors associated with perceived exacerbation in psychological distress among Israelis due to the Russo-Ukrainian War. Specifically, we assessed how vulnerability factors such as previous traumatic exposure, having relatives and friends affected by the war, media exposure, having a Holocaust familial background, lower levels of resilience, and probable posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) are associated with perceived exacerbation in psychological distress. A random sample of 845 Israeli Jews aged 18-75 who reported exposure to at least one traumatic event participated in the study. Univariate logistic regression showed that Holocaust familial background, previous exposure to trauma, media exposure to the Russo-Ukrainian War, and probable diagnosis of PTSD or CPTSD are the main factors associated with perceived exacerbation in psychological distress. These results suggest that various traumatic factors associate with perceived higher psychological vulnerability to international conflicts, even when there is no direct personal threat. Practitioners should be aware of these factors among individuals exposed to trauma.

Dental anxiety and ageing anxiety: Moderated mediation roles of Oral Health-Related Quality of Life and subjective accelerated ageing.

BACKGROUND: Oral health and its relation to ageing is an important topic often neglected among geriatric populations. Proper oral rehabilitation may aid in alleviating mental health burdens in such populations. OBJECTIVES: The present study aimed to explore the association between dental anxiety and ageing anxiety, with regard to the interplay of Oral Health-Related Quality of Life (OHRQoL) as mediator and subjective accelerated ageing as a moderator. METHODS: A total of 577 participants with mean age 72.78 years (SD = 3.832, range = 68-87) were recruited via a survey company in Israel. They completed a self-report battery of questionnaires about dental anxiety, OHRQoL, subjective accelerated ageing and ageing anxiety, along with their informed consent. RESULTS: The findings revealed that dental anxiety was positively associated with ageing anxiety (direct effect), and that OHRQoL mediated the link between dental anxiety and ageing anxiety (indirect effect). Additionally, subjective accelerated ageing moderated the positive link between dental anxiety and OHRQoL, as well as the positive link between OHRQoL and ageing anxiety. CONCLUSIONS: The results provide insight for the roles of OHRQoL and subjective accelerated ageing among older adults between dental anxiety and ageing anxiety. Tailoring oral rehabilitation interventions that focus on these factors are warranted to improve older adults' dental health.

The Ukraine-Russia war: A symptoms network of complex posttraumatic stress disorder during continuous traumatic stress.

OBJECTIVE: This study is aimed to test the symptoms network of International Classification of Diseases, 11th Revision (ICD-11) complex posttraumatic stress disorder (CPTSD) symptoms, using data collected from Ukrainian civilians during the 2022 Russia-Ukraine war. Findings can inform our understanding of the stress response in individuals exposed to continuous trauma and give insight into the nature of CPTSD during the war. METHOD: A network analysis was conducted on CPTSD symptoms as assessed by the International Trauma Questionnaire using data from a nationally representative sample of 2,000 Ukrainians. RESULTS: While PTSD and disturbances in self-organization clusters did not enmesh, several communities within these clusters were merged. Results highlight that in terms of strength centrality, emotional dysregulation (emotional numbing) and a heightened sense of threat (SoT) were most prominent. CONCLUSION: The results confirm the ICD-11 structure of CPTSD but suggest that continuous traumatic stress manifests in more condensed associations between CPTSD symptoms and that emotional regulation may play a vital role in activating the CPTSD network. War-exposed populations could be provided with scalable, brief self-help materials focused on fostering emotion regulation and an SoT. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A cross-disasters comparison of psychological distress: Symptoms network analysis.

Large-scale traumatic events have the potential to trigger psychological distress, particularly among those in the affected areas. However, the manifestation of psychological distress may vary across different types of disasters. This study thus aimed to compare the symptoms network structure of psychological distress as assessed by the Kessler Psychological Distress Scale across three types of disasters: Terror (n = 5842), COVID-19 (n = 2428), and a nature-related disaster (n = 1001). Across disasters, two communities representing depression and anxiety symptoms were revealed. However, while after a nature-related disaster and the COVID-19 pandemic depression and anxiety items were interconnected via hopelessness, a terror attack resulted in more separated manifestations of anxiety and depression. Examination of symptom centrality showed that while in the Terror and the COVID-19 networks "depressed/no cheering up" was most connected to other symptoms, for the nature-related disaster network, two items were most central: "depressed/no cheering up" and "restless or fidgety". The results may point to different mechanisms of psychological distress structures after different disasters. Depending on the type of disaster, trauma-focused interventions may require targeted support and treatment.

Change in child mental health during the Ukraine war: evidence from a large sample of parents.

The ongoing war in Ukraine is expected to negatively impact the mental health of the country's population. This study aims to provide a preliminary estimate of the degree of change in the mental health problems of Ukrainian children following Russia's invasion in February 2022, and to identify the sociodemographic and war-related risk factors associated with these changes. A nationwide, opportunistic sample of 1238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected between July 15th and September 5th, 2022. Participants completed modified versions of the Pediatric Symptom Checklist (PSC-17) which was adapted to capture change in the frequency of symptoms since the beginning of the war. Parents reported increases across all 17 indicators of internalizing, externalizing, and attention problems of the PSC-17. Increased problems were most pronounced within the internalizing domain, with 35% of parents reporting that their child worried more since the beginning of the war. A number of individual, parental, and war-related factors were associated with increases across the three domains. Exposure to war trauma, pre-existing mental health problems, and child age were among the strongest predictors of change. This survey provides preliminary evidence that the Russian war on Ukraine has led to an increase in common mental health problems among children in the general population. Further research is required to determine the extent and sequela of this increase, and to develop intervention strategies for those most in need.

Development and initial validation of a short form of the Memories of Home and Family Scale.

The Memories of Home and Family Scale (MHFS; Shevlin et al., 2022) was developed as a multidimensional measure of subjective memories of experiences at home and with family during childhood. Due to the length of the scale, a short version of the MHFS (MHFS-SF) has been developed. Data were from Wave 7 of the COVID-19 Psychological Research Consortium Study (C19PRC-UK), a population based UK survey (N = 1405). Two items with the highest factor loadings from each of the six dimensions of the original MHFS were selected for inclusion. Confirmatory factor analytic (CFA) models were estimated to test the dimensionality of the scale. Convergent and discriminant validity were tested by examining associations with criterion variables. CFA results supported the multidimensionality of the scale. MHFS-SF total and sub-scale scores were negatively correlated with measures of depression, anxiety, loneliness, and paranoia, and were positively correlated with wellbeing. Regression analyses revealed that MHFS-SF total and sub-scale scores significantly predicted loneliness, paranoia, and wellbeing, even after accounting for age, gender, and current internalising symptoms. Results from this study suggest that the MHFS-SF scores retain the excellent psychometric properties of the original scale while improving efficiency. The MHFS-SF demonstrated high levels of convergent and discriminant validity with mental health and wellbeing measures. Future research should seek to validate the MHFS-SF in different populations and assess its usefulness in clinical settings. Supplementary Information: The online version contains supplementary material available at 10.1007/s42844-023-00097-x.

Self-Control and Digital Media Addiction: The Mediating Role of Media Multitasking and Time Style.

Introduction: As being an initiating actions and resisting short-term temptations, self-control is negatively related to digital media addiction. However, many studies indicate that there are variables that may mediate this relationship. The present study investigated the mediating role of media multitasking and time style in the relationship between self-control and digital media addiction. Methods: The study included N= 2193 participants with a mean age of M = 23.26 (SD = 6.98) from seven countries: Brazil, Hong Kong, Israel, Italy, Poland, Turkey, and the United States. The authors used the Brief Self-Control Scale, the Media Multitasking Scale, the Time Styles Scale, the Problematic Smartphone Use Scale, the Problematic Internet Use Scale, and the Problematic Facebook Use Scale. Results: Results revealed that self-control was negatively related to all assessed types of problematic digital media use, namely problematic Internet use, problematic smartphone use, and problematic Facebook use. Media multitasking was found to be a significant mediator of the relationship between self-control and problematic digital media use. Discussion: High self-control can be preventative against uncontrolled and automatic social media checking, whereas low self-control fosters the habit of continuously remaining current.

Investigating the latent structure of the International Trauma Questionnaire to assess ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD in an adult civilian sample during the Ukraine war.

The symptom structure of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) and the validity of the International Trauma Questionnaire (ITQ) are yet to be tested among civilians in an active war zone. The present investigation examined the factor structure of the ITQ, the internal consistency of observed scores, and their associations with demographic characteristics and war-related experiences using a nationwide sample of 2,004 adults from the general population of Ukraine approximately 6 months after the full-scale Russian invasion in 2022. Overall, rates of endorsement across all symptom clusters were high. The mean total number of war-related stressors reported was 9.07 (SD = 4.35, range: 1-26). Internal reliability was good for all six ITQ subscales, Cronbach's αs = .73-.88, and the correlated six-factor model was found to provide the best representation of the latent structure of the ITQ in the present sample based on fit indices. There was evidence of a dose-response relationship, with increasing scores on all symptom clusters associated with higher total reported war-related stressors.