Holocaust centrality, anxiety, and other risk factors associated with terror threat salience among descendants of Holocaust survivors.

The study examined risk factors for sensitivity to terror threats among descendants of Holocaust survivors (Holocaust G1) during a significant rise in terrorist attacks in Israel. We examined the association of the number of familial Holocaust G1, trauma exposure, probable posttraumatic stress disorder (PTSD), anxiety symptoms, and Holocaust centrality with terror threat salience (TTS) in children and grandchildren of Holocaust G1 (Holocaust G2; G3). A web-based national sample included 297 Holocaust G2 (Mage=62.95, SD=10.25), 224 comparison G2 (Mage=61.79, SD=10.13), 379 Holocaust G3 (Mage=34.02, SD=8.65) and 171 comparison G3 (Mage=33.55, SD=8.26). Participants completed questionnaires on background characteristics, Holocaust background, trauma exposure, probable PTSD, anxiety symptoms, Holocaust centrality, and TTS. Findings showed that Holocaust G2 and G3 reported higher Holocaust centrality and TTS relative to comparisons, and Holocaust G3 reported higher levels of anxiety than comparison G3. The number of Holocaust G1, background characteristics, Holocaust centrality, and anxiety symptoms were associated with TTS in G2 and G3. Probable PTSD and trauma exposure were also associated with TTS in G2 and G3, respectively. Results highlight Holocaust centrality and anxiety among the factors associated with an increased preoccupation with terror threats in Holocaust descendants. Practitioners should implement interventions focusing on these factors, particularly at times of increased terrorism.

Cultural Differences in Daily Coupling of Subjective Views of Aging and Negative Affect.

OBJECTIVES: The established link between subjective views of aging (VoA) and well-being shows variations across different cultures. Although VoA show daily fluctuations, little is known about cultural differences in such fluctuations and the daily coupling of VoA and well-being. We compared Israeli Arabs to Israeli Jews in the daily coupling of VoA and negative affect (NA). METHODS: Community-dwelling older adults (N=76, Mage=66.71) completed measures of subjective age, subjective accelerated aging, ageist attitudes, and NA over 14 consecutive days. RESULTS: Respondents reported higher daily NA when they felt older, reported to be aging faster, or had more ageist attitudes. The daily coupling between subjective age/subjective accelerated aging and NA was stronger among Israeli Arabs compared to Israeli Jews. There was no such interaction with ageist attitudes. DISCUSSION: It is important to adopt a cultural perspective when investigating daily fluctuations in VoA and their correlates. In applied contexts, this might help to identify cultural groups that are particularly sensitive to the effects of VoA.

PTSD symptoms and subjective traumatic outlook in the Israel-Hamas war: Capturing a broader picture of posttraumatic reactions.

This study examined the unique associations of both probable posttraumatic stress disorder (PTSD) and subjective traumatic outlook (STO) with psychiatric and psychological concomitants among Israelis during the Israel-Hamas War. While PTSD reflects phenomenological psychiatric reactions to traumatic events, STO reflects subjective evaluations that one is traumatized. A convenience sample of 375 Israelis aged 20-87 from around Israel completed an online survey in the first two months of the war. A series of univariate logistic and linear regressions showed that while both probable PTSD and STO were associated with significant depression and anxiety symptoms, STO showed unique associations with hope and revenge, psychological variables that may be more sensitive following exposure to human-made and war trauma. Theoretical and practical considerations regarding these results suggest that a broader picture of post-trauma reactions can be captured by accounting for both the observed symptoms (PTSD) and one's introspective perception of being traumatized (STO).

Older adults' subjective aging perceptions, mentalization, and social relationships: a micro-longitudinal study.

OBJECTIVES: Social relationships are associated with various positive physical, psychological, and emotional outcomes in older adults. In line with the growing understanding of the role of subjective views of aging (VoA) for older adults' quality of life, the current work examines how daily fluctuations in VoA affect social relationships. Moreover, as the ability to mentalize others' states of mind (i.e. Theory of Mind) considerably enhances such relationships, this study assesses whether mentalization abilities mediate the VoA-social relationships link. METHOD: Eighty-two Israeli older adults (mean age = 73.44, SD = 8.64, range = 60-95) completed a baseline online questionnaire containing background information, and subsequently filled out daily online questionnaires assessing ageist attitudes, subjective age, mentalization abilities, and positive social relationships for 14 consecutive days. RESULTS: Positive VoA (reduced ageist attitudes and/or a young subjective age) were associated with enhanced mentalization and positive relationships on a given day and in time-lagged analyses. Moreover, mentalization mediated the effect of previous-day VoA on next-day positive social relationships. VoA also mediated the effect of previous-day mentalization on next-day positive social relationships. CONCLUSION: The study highlights the importance of mentalization capabilities for maintaining positive VoA/social relationships and expands the understanding of underlying factors associated with meaningful and close relationships in older adults.

Amplified psychological reaction to civil unrest among Holocaust survivor descendants.

The evidence regarding the intergenerational effects of the Holocaust points to a heightened sensitivity to traumatic and stressful events, as well as to threats. These effects were found across at least three generations: the survivors themselves, their children, and their grandchildren. More specifically, this sensitivity is manifested in increased psychological reactions to adverse circumstances, especially when such situations trigger associations with the Holocaust. During 2023 Israel has experienced unprecedented civil unrest and protests following the government's plan to promote a judicial overhaul. Many expressed fears for Israeli democracy and the integrity of the social fabric in Israel. The current study examined how Holocaust descendants (i.e., children and grandchildren of Holocaust survivors) experienced this prolonged social unrest. A web-based random sample of 706 Israeli Jews born after World War II completed questionnaires several months before the unrest began (Wave 1, 2022) and seven months into the unrest (Wave 2, 2023). Supporting most of our hypotheses, Holocaust descendants reported higher civil unrest salience (i.e., more preoccupation with the political and social upheaval) relative to comparison descendants (i.e., children and grandchildren of those not directly exposed to the Holocaust). Relative to comparison descendants, Holocaust descendants were also at a greater risk of reporting exacerbation in anxiety since the judicial overhaul was introduced, but not in depression or somatisation symptoms. Results remained significant after controlling Wave 1 distress level, background characteristics, level of engagement in civil unrest, and participants' viewpoint on the judicial overhaul. The findings further corroborate unique reactions to stress among Holocaust descendants, this time by highlighting increased preoccupation and increased exacerbation in anxiety during a period of prolonged political and social turmoil.

Age differences in acute stress and PTSD symptoms during the 2023 Israel-Hamas war: Preliminary findings.

Traumatic exposure can result in acute stress symptoms in the immediate aftermath and post-traumatic stress disorder (PTSD) symptoms that persist beyond the initial weeks. Both short-term and long-term reactions require research and clinical attention. There is considerable evidence for age differences in PTSD, and older adults frequently present lower rates of PTSD compared to young adults. Much less is known concerning age differences in acute reaction or the extent to which age differences in PTSD are affected by age differences in acute stress. The current study examined acute stress and PTSD symptoms among young and older adult Israelis during the 2023 Israel-Hamas war. A web-based sample of 428 participants (mean age = 48.36 ± 16.29) completed retrospective accounts of pre-war psychological distress and acute stress in the first week of the war and further reported current PTSD symptoms. Rates of elevated levels of acute stress symptoms and probable PTSD were significantly higher among young adults (24.8% and 42.8%, respectively) compared to their older counterparts (3.7% and 13.7%, respectively). Age differences in probable PTSD remained significant even after controlling for other demographics, traumatic exposure, pre-war psychological distress, and acute stress symptoms. These preliminary findings further attest to the impressive resilience manifested by older adults during wartime. Moreover, as age differences in probable PTSD were not fully explained by acute reactions, unique mechanisms may be mobilized by older adults to cope with warfare trauma in the short- and long term.

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).

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.

Financial exploitation and mental health among Holocaust survivors: the moderating role of posttraumatic symptoms.

OBJECTIVES: We examined whether anxiety and depressive symptoms associated with self-reported history of financial exploitation (FE) are more pronounced among Holocaust survivors (HS), especially those with high-level posttraumatic stress disorder (PTSD) symptoms. DESIGN: Self-report questionnaires completed online via Qualtrics. SETTING: An online-based survey conducted in Israel. PARTICIPANTS: A community-based cohort of 137 Israeli older adults born prior to 1945 were included in the study sample. HS (n = 61) were participants who reported living in a European country occupied or dominated by Nazi or pro-Nazi regimes between 1939 and 1945. Groups were further subdivided into survivors with low or high levels of PTSD symptoms (≥31 on the PTSD Checklist; PCL-5). MEASUREMENTS: Questionnaires assessed FE history, posttraumatic symptoms (PCL-5), depressive symptoms (PHQ-9), and anxiety (GAD-7). Age, education, self-rated health, and non-Holocaust lifetime adversity were also measured and included as covariates. RESULTS: Hierarchical linear regression models revealed that relationships between FE and depressive and anxiety symptoms were significant only among survivors (p = 0.005 and p = 0.008, respectively). The interaction between PTSD symptom level group and FE was also significant for both depressive (p = 0.007) and anxiety (p = 0.012) symptoms, such that survivors with PTSD who reported FE had significantly greater symptoms of depression and anxiety compared to all other groups. CONCLUSIONS: Findings suggest that the experience of FE may be particularly impactful among survivors who continue to struggle with posttraumatic symptoms related to the Holocaust. Future studies may consider examining whether findings are relevant to other groups with PTSD.

Feeling Younger, Rehabilitating Better: Reciprocal and Mediating Effects between Subjective Age and Functional Independence in Osteoporotic Fracture and Stroke Patients.

INTRODUCTION: The current study aimed to find reciprocal effects between subjective age and functional independence during rehabilitation from osteoporotic fractures and stroke and whether these effects can be mediated by indicators of well-being. METHODS: Participants were 194 older adults (mean age = 78.32 years, SD = 7.37; 64.8% women) who were hospitalized following an osteoporotic fracture or stroke. Participants completed measures of subjective age and well-being (i.e., optimism, self-esteem, and life satisfaction) several times during rehabilitation. Functional Independence Measure (FIM) was completed by nursing personnel at admission and at discharge. RESULTS: Younger subjective age at admission predicted higher FIM scores at discharge. The reverse effect, that is, of FIM scores at admission on subjective age at discharge, was nonsignificant. Optimism during hospitalization mediated the effect of subjective age on subsequent FIM scores while self-esteem and life satisfaction did not. Sensitivity analyses further showed that the effect of subjective age on FIM was significant for both fracture and stroke patients. DISCUSSION: The findings highlight the effect of subjective age on rehabilitation outcomes among osteoporotic fractures and stroke patients and suggest several potential mechanisms behind this effect. Rehabilitation outcomes following osteoporotic fractures or strokes could improve if subjective age and an optimistic outlook are taken into consideration.

The Association between Ageist Attitudes, Subjective Age, and Financial Exploitation Vulnerability Among Older Adults.

Ageism, or age-based negative stereotypes, prejudice, and/or discriminatory behaviors toward older adults, has been linked with various detrimental physical and psychological consequences. The current study examined the relevance of ageist attitudes to financial exploitation vulnerability (FEV) among older adults and investigated whether feeling older than one's chronological age (i.e., older subjective age) moderated the ageist attitudes-FEV association. 230 participants (M age = 72.08, SD = 5.74) filled out scales assessing ageist attitudes, subjective age, and provided relevant sociodemographic information. High levels of ageist attitudes and an older subjective age were associated with increased FEV. Moreover, the ageist attitudes-FEV association was significantly stronger among participants reporting an older subjective age. The results highlight the importance of taking into account ageism and subjective age in order to gain a deeper understanding of the underlying mechanisms which render older adults vulnerable to financial exploitation. Practical and empirical implications are discussed.

Attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning.

OBJECTIVE: To understand if attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning among older adults with medical conditions. We examined: (1) if these effects are reciprocal; (2) if attitudes to aging (psychological loss, psychological growth, physical change) play a mediating role in these effects. DESIGN: A sample of 226 community-dwelling older adults (T1 age range = 65-94, mean age = 73.59, SD = 6.29) reporting at least one chronic medical condition completed two phone interviews across six months. MAIN OUTCOME MEASURES: Background measures, health anxiety, physical functioning, and attitudes to aging at T1 and T2. RESULTS: T2 attitudes to aging served as a mediator controlling for T1 attitudes. There was a direct effect of worse physical functioning at T1 on increased health anxieties at T2. Negative (but not positive) attitudes to aging mediated that effect. The reversed temporal sequencing (T1 health anxiety leading to T2 physical functioning) was significant only when mediated by negative attitudes to aging. CONCLUSIONS: Findings suggest that viewing aging as mostly a time of losses (but not as a time of gains) serves as an important mechanism through which health anxieties and physical functioning affect each other among older adults having chronic medical conditions.

Daily fluctuations in subjective age and depressive symptoms: the roles of attitudes to ageing and chronological age.

Studies indicate that both subjective age-individuals' perception of their own age as older or younger than their chronological age, and attitudes to ageing are related to physical and mental health. Less is known about the possible dual effect of these two constructs of subjective views of ageing. In the current study, 334 participants (aged 30-90, M = 58.15) reported their daily subjective age and mental health along 14 consecutive days. Attitudes to ageing were measured at baseline. Results indicated that daily variation in subjective age was related to daily variation in depressive symptoms, such that people experienced more depressive symptoms at days they felt older. Furthermore, we found that attitudes to ageing (perceptions of losses, physical change, and psychological growth) moderated this relationship. The covariation between daily subjective age and daily depressive symptoms was stronger when attitudes to ageing were less favorable (e.g., high perceptions of losses and low psychological growth). The moderating effect of losses was especially prominent among older participants. This indicates that attitudes to ageing moderate the toll that feeling old takes on mental health, especially in older age. The results also emphasize the need to understand how different subjective views on ageing, measured in different time frames, operate interactively to shape individual's daily experiences.

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.

Family involvement and secondary traumatization in Holocaust survivor families: An actor-partner interdependence model.

OBJECTIVE: The study aimed to examine the interpersonal relationships between family involvement (i.e., emotional and behavioral strategies that underscore family members' well-being and familial legacy) and secondary traumatization (i.e., symptoms of distress resulting from close contact with a traumatized individual) in Holocaust survivors and comparison families. We assessed levels of family involvement and secondary traumatization in children and grandchildren of survivors (Holocaust G2 and G3) and comparisons. Next, we examined whether there are within and between generation relationships between family involvement and secondary traumatization (i.e., G2's family involvement affects G3's secondary traumatization and vice versa). METHOD: The sample included 92 Holocaust G2-G3 dyads and 67 equivalent comparison dyads (comparison G2 and G3 of European origin, whose parents or grandparents were not in Nazi/pro-Nazi dominated countries). Participants answered questionaries on background characteristics, family involvement, and secondary traumatization. RESULTS: Secondary traumatization was significantly higher among Holocaust G2 and G3 than comparison G2 and G3, respectively. Family involvement was significantly higher among Holocaust G2 than comparison G2. An Actor-Partner Interdependence model showed that participants who reported greater family involvement reported higher secondary traumatization in all families (i.e., an actor effect). A significant partner effect was found only in Holocaust families. In these families, greater family involvement in one generation was related to higher secondary traumatization in the other generation. CONCLUSIONS: The findings suggest a unique interpersonal mechanism of intergenerational transmission of trauma in Holocaust families that appears to affect both generations, which may help design multigenerational interventions with survivor families, focusing on family involvement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Association Between Views of Aging and Subjective Cognitive Complaints in Older Adults: Findings From Two Samples.

This cross-sectional study examined whether views of aging (VoA) relate to subjective cognitive complaints in two separate cohorts of older adults. Ageist attitudes, attitudes to aging (psychological loss, physical change, and psychological growth), subjective age, and subjective successful aging were examined. A moderating effect of chronological age was also examined. Samples included 572 adults aged 50 or older (Sample 1; mean age = 67.63, SD = 11.39, 49.4% female) and 224 adults aged 65 or older (Sample 2; mean age = 81.50, SD = 6.61, 75.3% female). More negative VoA (higher ageist attitudes, lower psychological growth, lower physical change, older subjective age, and less successful aging) were associated with more subjective cognitive complaints after controlling for covariates. An increase in chronological age strengthened some of these associations. Findings suggest that improving dimensions of VoA may have a complementary positive effect on subjective cognitive complaints in older adults.

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.

Caregiver burden among adults caring for their Holocaust-survivor parents during the COVID-19 pandemic.

This study aimed to examine the caregiver burden among offspring of Holocaust survivors (OHS) caring for their parents during the COVID-19 pandemic, hypothesizing that caregivers whose parents suffer from posttraumatic stress disorder (PTSD) would report an increased burden. The sample consisted of 109 caregivers with older adult care recipient parents (average caregivers' age = 57.67, SD = 8.49). Caregivers were divided into three groups: 20 OHS who reported that at least one care recipient had PTSD, 60 OHS who reported that their care recipients did not have PTSD, and 29 comparison caregivers (whose care recipients did not undergo the Holocaust). Caregivers completed questionnaires about SARS-CoV-2 exposure, COVID-19 concerns, helping their care recipients, their experiences of caregiver burden, and perceived changes to their caregiver burden during the pandemic. The caregivers also reported PTSD symptoms-in themselves as well as in their care recipients. Relative to comparisons, OHS with parental PTSD reported higher caregiver burden in four aspects: time-dependent burden, developmental burden, physical burden, and social burden. Furthermore, OHS reported a greater perceived increase in caregiver burden during the pandemic than the comparisons. The study findings illuminate the difficulties OHS caregivers, especially those whose care recipients have PTSD, face during the COVID-19 pandemic. This group of caregivers is at risk of experiencing more distress and may need help and support. Further research is needed to determine whether people taking care of their posttraumatic parents following other massive traumatic events also feel a heavier caregiver burden-both in general and specifically during the current pandemic.