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.

Death perceptions, grief, and distress in Ultra-Orthodox Jews who witnessed the 2021 Meron disaster.

On April 29, 2021, during an Ultra-Orthodox annual communal event in Meron, a crowd rush resulted in the deaths of 45 individuals. Experiencing such events may intensify death proximity (subjective nearness to death, SNtD) and death anxiety, and increase distress. Furthermore, the experience of grief following the trauma may disrupt defense mechanisms that reduce death-related anxieties. Thus, we examined the mediating role of death anxiety on the association between SNtD and distress, and the possible moderating role of grief experiences on this model. Ultra-Orthodox Israeli Jews who experienced the Meron disaster (N = 168) responded to scales assessing demographics, SNtD, death anxiety, and psychological distress. Death anxiety mediated the SNtD-distress link and grief was a significant moderator. Specifically, for individuals low in grief, the association between high death anxiety and increased distress was nullified. Findings are discussed from the perspective of Terror Management Theory.

Reflective Functioning and Financial Exploitation Vulnerability in Older Adults: The Importance of Significant Others.

OBJECTIVES: Financial exploitation of older adults results in devastating economic, social, and psychological losses to older adults, their families, and society at large. This study examined the relationship between reflective functioning and financial exploitation vulnerability (FEV) and whether relationship status moderated the association. METHODS: A community-based sample of 156 Israeli older adults age 60 and over responded to demographic questions and questionnaires assessing reflective functioning and FEV. RESULTS: A hierarchical linear regression analysis covarying for age, sex, education, income, and sum of illnesses, revealed that higher reflective functioning was associated with lower FEV (p = .011). A main effect of relationship status was not found, but a significant interaction of reflective functioning × relationship status was discovered (p = .008), adding 4.2% to the total variance of the model. Probing the interaction revealed that the reflective functioning-FEV association was significant only for older adults not in a relationship. CONCLUSIONS: Findings suggest that low reflective functioning may be associated with increased risk of financial exploitation, specifically in certain populations of older adults. CLINICAL IMPLICATIONS: Care providers of older adults may consider assessing for, and identifying older adults with low reflective functioning, in order to prevent or intervene in the event of a potentially exploitative situation.

Subjective Age and Financial Exploitation Vulnerability: The Mediating Role of Financial Self-Efficacy.

An older subjective age, or feeling older than one's chronological age, has been associated with increased financial exploitation vulnerability (FEV) among older adults. However, the mechanisms behind this relationship have not been examined. This study examined whether financial self-efficacy mediates the relationship between subjective age and FEV. Participants were 156 Israeli older adults (M age= 66.97, SD = 6.46) who responded to questionnaires of subjective age, FEV, and financial self-efficacy. Correlations indicated that an older subjective age was associated with reduced financial self-efficacy (r= -.36, p < .001) and increased FEV (r = .51, p < .001). Testing the mediation model revealed an indirect effect of subjective age on FEV via financial self-efficacy (b = 1.57; bootstrapped 95% Cis [.80, 2.39]). Findings suggest that an older subjective age may reduce financial self-efficacy, thereby increasing FEV. Findings are discussed with regard to Stereotype Embodiment Theory and clinical implications are suggested.

Subjective Nearness-to-Death and COVID-19 Worries Among Ultra-Orthodox Jews in Israel: The Moderating Role of Israeli Identity and Sense of Community.

The Ultra-Orthodox community in Israel is characterized by close everyday contact and a strong sense of community. While the COVID-19 pandemic has resulted in global uncertainty, fear, and fatalities, this group was particularly affected by the pandemic. Accordingly, the current study examines whether subjective nearness-to-death was associated with increased COVID-19 concerns, and whether Israeli identity and sense of community moderate this association. Data were gathered from 255 Israeli Ultra-Orthodox Jews, and results yielded a significant link between subjective nearness-to-death and COVID-19 worries, moderated by both moderators. Results are discussed in line with terror management theory, and theoretical/practical implications are suggested.

The Holocaust Experience and Its Role in the Association Between Meaning in Life, Depressive Symptoms and Life Satisfaction.

Holocaust survivors often reveal long-term depressive symptoms, while demonstrating life satisfaction. The present study examined the role of meaning in life (MIL) of Holocaust survivors in this context. Survivors (n = 44) and comparisons (n = 51) provided background information and completed MIL, depressive symptoms, and life satisfaction scales. MIL was associated with lower depressive symptoms and higher life satisfaction. Moreover, the MIL-depressive symptoms/life satisfaction links were stronger among Holocaust survivors. Results provide insight for tailoring treatment interventions for older adults who have been exposed to prolonged traumatic experiences or genocide, that focus on MIL, to enhance mental health.

Parenthood during the COVID-19 pandemic: Post-traumatic growth amongst university students.

This study sought to investigate a positive dimension of coping with the COVID-19 pandemic, that of post-traumatic growth (PTG). This study investigated coping difficulties and PTG amongst parent and nonparent students in Israeli Universities. A total of 4022 parents (3648 Jews and 374 Palestinian-Arab Citizens [PACs]) and 14,651 nonparents (12,010 Jews and 2641 PACs) completed measures of coping, social support and PTG. Parents demonstrated significantly higher levels of coping and PTG. Amongst parents, fathers coped slightly better than mothers; however, while Jewish mothers demonstrated greater PTG than Jewish fathers, PAC fathers had significantly greater PTG than both PAC mothers and Jewish parents. These findings, while specific to COVID-19, indicate that PTG should be studied in greater depth in different ethnic and minority groups in order to develop enhanced understanding and facilitate promotion of post-traumatic growth, in addition to the prevention of COVID-19-related distress.

Sense of community, meaning in life, and satisfaction with life among Ultra-Orthodox Jews: A mediation model.

The Ultra-Orthodox community in Israel, characterized by close-knit ties and strong community values, has been particularly vulnerable to COVID-19, both epidemiologically and socially. Accordingly, the current study examined whether the connection between the sense of community and life satisfaction in this population is mediated by meaning in life (MIL). Three hundred and fifty-eight Ultra-Orthodox participants (age range: 30-70; M = 49.50, SD = 10.24) filled out scales assessing MIL, sense of community, and satisfaction with life (SWL), as well as sociodemographic and COVID-19-related scales. Sense of community was linked with increased MIL and life satisfaction. Moreover, the connection between sense of community and life satisfaction was mediated by MIL. This study highlights the roles of sense of community and MIL for Ultra-Orthodox individuals and emphasizes the importance of both concepts for maintaining SWL during COVID-19. Practical implications for Ultra-Orthodox communities are suggested.

Retirement anxiety and depressive symptoms among middle-aged adults: An indirect effect through death anxiety.

Basing our argument on Terror Management Theory, we posit that retirement is an age-related transition, which could result in greater death saliency and anxiety, leading to increased depressive symptoms. An indirect-effect model was tested on a convenience sample of 574 Israeli Jewish older workers (mean age = 57), finding that the link between retirement anxiety and depressive symptoms is mediated through death anxiety. Anxious anticipation of retirement could imply that the individual perceives it as an "end," resulting in greater death saliency and death anxiety, which are related to poorer mental health. Theoretical and practical implications are discussed.

The association between subjective age and financial exploitation vulnerability among older adults: The moderating role of social support.

Financial exploitation of older adults bears detrimental physical and psychological consequences. However, risk factors of financial exploitation vulnerability (FEV) remain elusive. In line with a growing awareness of the importance of subjective perceptions of the aging process for older adults' functioning and well-being, this study examined the connection between subjective age (feeling younger/older than one's chronological age) and FEV, and the moderating effect of social support on this connection. Data were collected from a convenience sample of 137 Israeli older adults (age range 60-89, M = 69.90, SD = 6.85), who completed scales of FEV, subjective age, and social support, as well as relevant socio-demographic information. Older subjective age was associated with increased FEV when social support was low, but not when social support was high. Results are discussed in line with Socio-Emotional Selectivity Theory and provide initial information pertaining to the relevance of subjective age perceptions to FEV in older adults.

Do Work-Related Factors Moderate the Association Between Subjective Nearness-to-Death and Psychological Distress?

The COVID-19 pandemic has been associated with increased existential concerns, as well as with significant changes in the work force. The current study examined the availability of meaning in work and belonging to a work group as personal resources which may mitigate psychological distress associated with feeling close to death. Data were collected from 450 working Israelis, and results indicated that the connection between feeling close to death and distress was not significant for individuals reporting high levels of belonging and meaning. Implications are discussed from the perspective of Terror Management Theory.

Activity engagement and psychological distress among Holocaust survivors during the COVID-19 pandemic.

OBJECTIVES: The COVID-19 pandemic may pose a specific threat for Holocaust survivors, as such threats may be linked with increased psychological distress. Moreover, research has demonstrated that engaging in planful problem-solving activities is associated with reduced distress. Accordingly, we aimed to examine the link between engaging in activities during COVID-19 and psychological distress among Holocaust survivors with varying levels of post-traumatic symptoms (PTS) and comparisons (not directly exposed to the Holocaust). DESIGN: A cross-sectional design composed of Holocaust survivors and a comparison group. SETTING: Participants were interviewed face-to-face, over the telephone, or filled the scales online at their leisure. PARTICIPANTS: Data were collected from 131 older Jewish Israelis (age range 76-94, M = 82.73, SD = 4.09), who were divided into three groups (comparisons; low-PTS survivors; high-PTS survivors). MEASUREMENTS: Participants completed scales assessing PTS, activity engagement, and psychological distress and provided additional sociodemographic, medical, and COVID-19-related information. RESULTS: When activity engagement was low, high-PTS survivors reported extremely high levels of psychological distress relative to low-PTS survivors and comparisons. However, when activity engagement was high, these group differences were considerably reduced, as the psychological distress of high-PTS survivors was significantly lower. CONCLUSIONS: The study highlights the importance of daily planning and activity engagement for Holocaust survivors with high PTS levels in reducing psychological distress. Clinicians are urged to take this factor into account when dealing with the psychological effects of COVID-19 on survivors and on traumatized older adults in general.

COVID-19 health worries and anxiety symptoms among older adults: the moderating role of ageism.

A prominent feature of anxiety in late life is concerns regarding physical health. Anxiety symptoms among older adults have been connected with various psychological outcomes, including social isolation and loneliness. During the coronavirus disease 2019 (COVID-19) pandemic, many societies have demonstrated increased ageist attitudes, encouraging older adults to distance themselves from society. Accordingly, the current study examined the moderating role of COVID-19-related ageism in the connection between COVID-19 health worries and anxiety symptoms among older adults. Data were collected from 243 older adults (age range 60-92; M = 69.75, SD = 6.69), who completed scales assessing COVID-19-related health worries and ageism, as well as anxiety symptoms. The results demonstrated that both health worries and ageism were positively associated with anxiety symptoms. Moreover, the connection between health worries and anxiety symptoms was more pronounced among older adults with high ageism levels. The study highlights the vulnerability of older adults in general, and ageist older adults in particular, to the negative consequences of COVID-19-related health worries, and emphasizes the role of the increased ageist stance of society during the pandemic in this regard.

Age is not just a number: age awareness, subjective nearness-to-death, self-esteem, and depressive symptoms among older adults.

Objectives: Humans often hold structured generalizations about themselves, which include attributes of qualities or characteristics they consider as important to their personal self-definitions. In this regard, holding one's age as an important defining personal category (high age awareness) was demonstrated to be connected with increased distress in older adults. However, little is known about the manner by which this connection is affected by individuals' perceptions regarding how close they are to their death on the one hand, and their personal resources on the other hand. Accordingly, the current research examined whether the connection between age awareness and depressive symptoms is mediated by subjective nearness-to-death, and whether this mediation is moderated by self-esteem.Method: A convenience sample of 386 older adults was collected using an online panel survey (age range 60-97, M = 71.62, SD = 6.88). Participants were requested to fill out scales assessing age awareness, subjective nearness-to-death, self-esteem, and depressive symptoms, as well as various sociodemographic scales.Results: Age awareness was associated with increased subjective nearness-to-death and depressive symptoms. In line with the hypotheses, subjective nearness-to-death mediated the age awareness-depressive symptoms connection, and this mediation was moderated by self-esteem.Conclusion: Age awareness is an important concept in old age, and is connected with increased depressive symptoms. We discuss this issue in line with Terror Management Theory, and emphasize the relevance of personal resources, such as feeling far from death and holding a positive view of oneself, in this regard.

Subjective nearness-to-Death, filial obligations, and depressive symptoms: the case of Jews and Arabs in Israel.

Objectives: Research has examined the link between subjective perceptions of life and death and psychological well-being. However, while cultural values were shown to provide a defense against death-related thoughts, little is known about specific cultural expectations with regard to this issue. Accordingly, the current study focused on two sub-cultures within the Israeli society, and examined whether filial obligations moderate the connection between subjective nearness-to-death and depressive symptoms. Moreover, the study also examined whether this moderating effect is culture-dependent, by examining differences between Jewish and Arab citizens of Israel.Method: Data were collected from 337 participants, two-thirds of which were Jewish. Age ranged from 45 to 65 (M = 52.32, SD =4.49). All participants filled out scales examining subjective nearness-to-death, filial piety, and depressive symptoms.Results: Filial piety did not moderate the connection between subjective nearness-to-death and depressive symptoms for the entire cohort. However, a significant three-way interaction of cultural group × filial piety × subjective nearness-to-death was found, and further analyses demonstrated that filial piety served as a significant moderator among Jews, but not among Arabs.Conclusions: This study highlights the importance of examining subjective perceptions of mortality in a cultural context, as culture was shown to affect how such perceptions are connected with depressive symptoms. These effects are discussed from the framework of terror management theory within the context of the Israeli society, and future directions are suggested.

Subjective nearness-to-death and negative attitudes toward persons with disability: Attachment patterns moderate.

We examined whether subjective nearness-to-death is associated with negative attitudes toward people with disabilities, and whether attachment patterns moderate this connection. A total of 462 Israeli adults, average age 57 years, completed scales measuring subjective nearness-to-death, negative attitudes toward people with disability, and attachment patterns. High levels of subjective nearness-to-death were associated with negative attitudes toward people with disability, and attachment patterns were significant moderators. Findings point to the theoretical importance of both perceptions of death and personal resources for coping with subjective nearness-to-death in relation to attitudes toward individuals with disabilities.

Subjective nearness to death and end-of-life anxieties: the moderating role of ageism.

OBJECTIVES: Subjective nearness to death (SNtD), or individuals' subjective evaluation of how close they are to death, has been demonstrated to be an important predictor for different aspects of the individual's aging process across the life cycle. However, the relationship between SNtD and anxieties linked with the aging process has not been examined among individuals who may be in the initial stages of experiencing the first physical and cognitive signs of aging. Thus, this study examined the association between SNtD and aging, dying, and death anxieties. Moreover, the role of ageism, or negative attitudes toward older adults, as a moderator for these perceptions regarding the end of life has not been addressed. Moreover, we examined whether ageism serves as a moderator for the aforementioned association. METHOD: A convenience sample of 1146 Israeli participants, ranging in age from 45 to 65, filled out scales assessing SNtD, aging anxiety, dying anxiety, death anxiety, and ageism. RESULTS: High levels of SNtD were positively associated with aging, dying, and death anxieties. Moreover, there was a positive association between ageism and the three end-of-life anxieties. Significant interactions demonstrated the moderating effect of ageism for the relationship between SNtD and both aging and dying anxieties, but not for death anxiety. CONCLUSION: SNtD is an important construct, which is connected to various perceptions and anxieties concerning the aging and dying processes. Moreover, while high ageism mitigates the positive association between SNtD and certain anxieties, the role of ageism is more complicated, and its negative aspects are discussed.

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.

Ageist attitudes block young adults' ability for compassion toward incapacitated older adults.

BACKGROUND: Upon encountering older adults, individuals display varying degrees of prosocial attitudes and behaviors. While some display compassion and empathy, others draw away and wish to maintain their distance from them. The current study examined if and how ageist attitudes influence the association between the sight of physical incapacity in older age and compassionate reactions toward them. We predicted that ageist attitudes would interfere with the ability to respond to them with compassion. METHODS: Young adults (N = 149, ages 19-29) were randomly distributed into two experimental conditions, each viewing a short video portraying different aspects of older adult physicality; one group viewed older adults displaying incapacitated behavior, and the other viewed fit behavior. Participants subsequently filled out scales assessing aging anxieties, and ageist and compassionate attitudes. RESULTS: Ageism was associated with reduced compassion toward the figures. Moreover, viewing incapacitated older adults led to increased concern toward them and perceived efficacy in helping them. However, significant interactions proved that higher scores of ageism in response to the videos led to increased need for distance and reduced efficacy toward incapacitated adults, an effect not observed among subjects with lower ageism scores. CONCLUSIONS: Ageism seems to be a factor which disengages individuals from older adults displaying fragility, leading them to disregard social norms which dictate compassion. The results are discussed from the framework of terror management theory, as increased mortality salience and death-related thoughts could have led to the activation of negative attitudes which, in turn, reduce compassion.

Online activity and participation in treatment affects the perceived efficacy of social health networks among patients with chronic illness.

BACKGROUND: The use of online health-related social networks for support, peer-to-peer connections, and obtaining health information has increased dramatically. Participation in an online health-related social network can enhance patients' self-efficacy and empowerment, as they are given knowledge and tools to manage their chronic health condition more effectively. Thus, we can deduce that patient activation, the extent to which individuals are able to manage their own health care, also increases. However, little is known about the effects of participation in online health-related social networks and patient activation on the perceived usefulness of a website across disease groups. OBJECTIVE: The intent of the study was to evaluate the effects and benefits of participation in an online health-related social network and to determine which variables predict perceived site usefulness, while examining patient activation. METHODS: Data were collected from "Camoni", the first health-related social network in the Hebrew language. It offers medical advice, including blogs, forums, support groups, internal mail, chats, and an opportunity to consult with experts. This study focused on the site's five largest and most active communities: diabetes, heart disease, kidney disease, spinal injury, and depression/anxiety. Recruitment was conducted during a three-month period in which a link to the study questionnaire was displayed on the Camoni home page. Three questionnaires were used: a 13-item measure of perceived usefulness (Cronbach alpha=.93) to estimate the extent to which an individual found the website helpful and informative, a 9-item measure of active involvement in the website (Cronbach alpha=.84), and The Patient Activation Measure (PAM-13, Cronbach alpha=.86), which assesses a patient's level of active participation in his or her health care. RESULTS: There were 296 participants. Men 30-39 years of age scored higher in active involvement than those 40-49 years (P=.03), 50-64 years (P=.004), or 65+ years (P=.01). Respondents 20-29 years of age scored higher in perceived usefulness than those 50-64 years (P=.04) and those 65+ years (P=.049). Those aged 20-29 years scored significantly lower on the PAM-13 scale than those aged 30-39 years (P=.01) and 50-64 years (P=.049). Men and women had similar PAM-13 scores (F9,283=0.17, P=.76). Several variables were significant predictors of perceived usefulness. Age was a negative predictor; younger age was indicative of higher perceived usefulness. Active involvement was a positive predictor. There was a negative relationship found between PAM-13 scores and perceived usefulness, as taking a less active role in one's own medical care predicted higher perceived website usefulness. A trend toward higher frequency of website activity was associated with increased perception of usefulness. CONCLUSIONS: Online health-related social networks can be particularly helpful to individuals with lower patient activation. Our findings add information regarding the social and medical importance of such websites, which are gradually becoming an inseparable part of day-to-day chronic disease management in the community.