Stanford University, Psychiatry and Behavioral Sciences
Postdoctoral research fellow
Main Specialties: Psychiatry
10PubMed Central Citations
Psychiatry Res 2018 03 5;261:281-289. Epub 2018 Jan 5.
I-Core Research Center for Mass Trauma, Tel-Aviv University, Israel; Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
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J Psychosom Res 2016 10 20;89:61-8. Epub 2016 Aug 20.
I-Core Research Center for Mass Trauma, Tel-Aviv University, Israel; Bob Shapell School of Social Work, Tel-Aviv University, Israel.
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J Psychosom Res 2015 Dec 28;79(6):471-6. Epub 2015 Oct 28.
Bob Shapell School of Social Work, Tel Aviv University, Israel, Postdoc, University of Southern Denmark, Denmark.
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Journal of Psychosomatic Research
The present study assesses the possible disruption effect of posttraumatic stress symptoms (PTSS) with regard to the protective role of attachment on pain, among ex-POWs.While secure attachment seems to serve as a buffer, decreasing the perception of pain, this function may be disrupted by PTSS. The study sample included 104 subjects who were combat veterans of the 1973 Yom Kippur War comprising of 60 male ex-prisoners of war (ex- POWs) and 44 comparable male combat veterans. Both attachment and pain were investigated experimentally in the laboratory and via questionnaires. We found that ex-POWs showed higher levels of clinical pain and attachment insecurities compared to controls.Moreover, attachment avoidance and soothing effect of attachment (SEA) were both associated with lower levels of clinical pain. Most importantly, PTSS moderated the associations between attachment and pain, as well as the mediation role of attachment between captivity and pain. The results imply that although attachment can be an important resource for coping with pain, it can be severely disrupted by PTSS among trauma survivors.
Journal of Gerontology: Psychological Sciences
Objectives: Exposure to captivity increases the risk for multiple disturbances that may intensify during old age. In later phases of life, former-prisoners-of-war (ex-POWs) may suffer from depression as well as from accelerated aging, manifested in older subjective age and leukocyte telomere shortening. The current study assesses the link between these varied facets of increased vulnerability during old age and explores (a) the associations between subjective age and telomere length; (b) the mediating role of changes in subjective age over time within the associations between depression and telomere length. Methods: Eighty-eight ex-POWs were assessed prospectively 30 (T1), 35 (T2), and 45 (T3) years after the 1973 Israeli Yom-Kippur War. Depression was assessed at T1; subjective age was assessed at T2 and T3; and telomere length and control variables were assessed at T3. Results: Older subjective age at T3 was associated with concurrent shorter telomeres, beyond the effect of chronological age. Change in subjective age between T2 and T3 mediated the relations between depression at T1 and shorter telomeres at T3 beyond the effects of control variables. Discussion: Findings suggest that the detrimental ramifications of accelerated subjective age involve premature cellular senesces, and may explain the relation between depression and accelerated aging processes among trauma victims. Hence, clinical interventions may seek to address accelerated subjective age among trauma survivors who suffer from depression.
Journal of Psychiatry: Open Access
Introduction: Attachment orientations are associated with the severity of posttraumatic stress disorder (PTSD). However, the mediator role of trauma type in the association between attachment orientation and PTSD remains unknown. Method: The relationship between trauma type, attachment, and PTSD was investigated in a large multiple trauma sample (n=3735). All participants were assessed for PTSD using the Harvard Trauma Questionnaire (HTQ) and for attachment orientations utilizing the Revised Adult Attachment Scale (RAAS). Results: Overall, a secure attachment style was related to lower PTSD severity, while insecure attachment styles were related to higher PTSD severity. Although both attachment dimensions were related to PTSD severity, attachment anxiety had greater contribution in predicting PTSD. PTSD symptom clusters were not found to depend on attachment dimensions. Finally, type of traumatic event moderated the association between attachment dimensions and PTSD severity. While among trauma survivors of family illness, the securely attached group showed the lowest PTSD severity, among trauma survivors of disease and physical health, the dismissively attached individuals showed the lowest level of PTSD severity, compared to other attachment groups. Conclusion: The results underscore the importance of taking into account the nature of the traumatic event while assessing the effects of attachment in posttraumatic reactions. Moreover, dismissing attachment style might be adaptive when facing the trauma of disease.
Journal of Family Issues
This study examines (a) secondary trauma by evaluating World Assumptions (World Assumptions Scale scores) among spouses of Israeli ex-prisoners of war (ex-POWs) and (b) the relationship between the husbands’ current posttraumatic stress disorder (PTSD) symptoms and PTSD trajectory and the wives’ world assumptions. Data were prospectively collected thrice for ex-POWs and comparable veterans, and twice for their spouses. This study extends current research as it links trauma, beyond PTSD symptoms, to more negative world assumptions among spouses of traumatized ex-POWs. Spouses of ex-POWs with PTSD symptoms reported lower benevolence of the people and self-worth and higher randomness compared with spouses of ex-POWs without PTSD symptoms. Spouses of ex-POWs who endorsed chronic PTSD symptoms also reported greater levels of selfcontrol compared with the delayed PTSD symptoms group. Results suggest that the relationship between husbands’ PTSD symptoms and wives’ world assumptions may be mediated by wives’ PTSD symptoms. The implications of the findings are discussed.