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Going through it together: Dyadic associations between parents' birth experience, relationship satisfaction, and mental health

Seefeld, Lara; Handelzalts, Jonathan E; Horesh, Danny; Horsch, Antje; Ayers, Susan; Dikmen-Yildiz, Pelin; Akik, Burcu Kömürcü; Garthus-Niegel, Susan
BACKGROUND:Previous research suggests that a negative birth experience is associated with symptoms of postpartum depression and anxiety in mothers and partners. However, this has mostly been investigated within the first year postpartum and research on the long-term effects is lacking. Additionally, the role of relationship satisfaction and the interdependence between parents have not been considered so far. METHODS:Couples (N = 1992) completed questionnaires on their birth experience, relationship satisfaction, and symptoms of depression and anxiety at two months, 14 months, and two years after birth, respectively. RESULTS:Actor-Partner Interdependence Mediation Models indicated no partner effects, but several significant actor and indirect effects. A more positive birth experience was associated with higher relationship satisfaction and less depression and anxiety symptoms for both parents. Higher relationship satisfaction was in turn associated with less depression (mothers and partners) and anxiety symptoms (mothers). The association between birth experience and depression symptoms was partially mediated by relationship satisfaction for mothers and partners, while the association between birth experience and anxiety symptoms was partially mediated by relationship satisfaction only for mothers. LIMITATIONS/CONCLUSIONS:Due to the highly educated, very healthy sample with low levels of depression and anxiety as well as high relationship satisfaction, results cannot be generalized to less privileged parents. Moreover, all effects were very small. CONCLUSIONS:Results highlight the importance of a positive birth experience for parents' relationship satisfaction and mental health. Negative birth experiences need to be avoided to prevent a negative impact on the whole family.
PMID: 38154585
ISSN: 1573-2517
CID: 5623352

Study protocol: A multimethod psychophysiological randomized controlled trial of a couple therapy for post-traumatic stress disorder

Zaks, Ilil; Dekel, Rachel; Zuckerman, Yael Shoval; Horesh, Danny
Posttraumatic stress disorder (PTSD) sequelae often have ripple effects on victims' families and spouses. Yet there has been a lag in the development and study of couple therapy for PTSD. To fill this gap, we present here a protocol for a study examining the efficacy of Cognitive Behavioral Conjoint Therapy (CBCT), a 15- session couple therapy protocol meant to alleviate PTSD and improve relationship satisfaction, in the Israeli context. The study will be a randomized controlled trial examining outcomes and processes of change via self-report questionnaires, qualitative interviews, and physiological measures (e.g., both partners' heart rate variability and electrodermal activity). We will employ a modified remote treatment protocol via video conferencing. The study will examine whether there is a reduction in couples' levels of symptomatic, emotional, and behavioral difficulties following CBCT and whether relationship satisfaction and couples' physiological synchrony increases. The study will also examine physiological and psychological change mechanisms in CBCT. Sixty Israeli couples (n = 120) will be randomly assigned to either a CBCT group or a wait-list control group. Outcomes will be assessed at four timepoints: before treatment, during treatment, post-treatment, and four months after treatment. The proposed study has the potential to shed light on the unique psychological and physiological mechanisms underlying CBCT and will be the first RCT study to employ this unique methodology in CBCT research, particularly in a video conferencing setting. This study may increase our ability to offer effective, cost-efficient, and attainable treatments for patients with PTSD and their spouses.
PMID: 37419309
ISSN: 1559-2030
CID: 5539492

Moderating Role of Depression on the Association of Tic Severity With Functional Impairment in Children

Sadeh, Dana Feldman; Frenk, Mira Levis; Simha, Tomer; Horesh, Danny; Steinberg, Tamar; Geva, Nofar; Nahon, Matan; Dietrich, Andrea; Hoekstra, Pieter J; Ruhrman, Daphna; Apter, Alan; Fennig, Silvana; Benaroya-Milshtein, Noa
BACKGROUND:Chronic tic disorders (CTDs) commonly co-occur with other psychiatric disorders. CTDs have been linked to functional impairment and reduction in quality of life. Insufficient research is available on depressive symptoms in patients with CTD, especially children and adolescents, yielding conflicting findings. To investigate the presence of depressive symptoms in a cohort of children and young adolescents with CTD and to test whether they moderate the link between tic severity and functional impairment. METHODS:The sample consisted of 85 children and adolescents (six to 18 years) with a CTD who were treated in a large referral center. Participants were evaluated using gold-standard self- and clinician-reporting instruments to measure tic symptom severity and tic-related functional impairment (Yale Global Tic Severity Scale), depression (Child Depression Inventory), and obsessive-compulsive symptoms (Children Yale Brown Obsessive Compulsive Scale). RESULTS:Depressive symptoms (mild to severe) were exhibited by 21% of our sample. Study participants with CTD and comorbid obsessive-compulsive disorder (OCD) and/or attention-deficit/hyperactivity disorder had higher rates of depressive symptoms compared with those without comorbidities. Significant correlations were found within and among all tic-related and OCD-related measures, yet depressive symptoms only correlated to tic-related functional impairment. Depression significantly and positively moderated the correlation between tic severity and tic-related functional impairment. CONCLUSIONS:Findings suggest that depression plays an important part as a moderator in the link between tic severity and functional impairment in children and adolescents. Our study highlights the importance of screening for and treating depression in patients with CTD.
PMID: 37196601
ISSN: 1873-5150
CID: 5508022

Why Does It Hurt So Much? Emotion Regulation Mediates the Association between Fibromyalgia Symptoms and Psychological Distress

Frumer, Lee; Marom Harel, Hadar; Horesh, Danny
While it is known that fibromyalgia patients often suffer from depression and stress symptoms, there is inconclusive evidence as to why these symptoms occur. The aim of this study is to examine the role of emotion regulation in mental health symptoms among treatment-seeking individuals with fibromyalgia. Ninety-three (93) participants (mean age = 47.25, SD = 12.4) were recruited from one of Israel's largest community healthcare providers. They were administered self-report questionnaires assessing fibromyalgia (FIQR), perceived stress (PSS), major depression (PHQ-9), and difficulties in emotion regulation (DERS). Associations were found between measures of fibromyalgia symptoms, psychological distress, and emotion regulation. Several sub-indices of emotion regulation showed significant correlations with psychological distress, with non-acceptance of emotional responses showing the strongest associations. Moreover, non-acceptance of emotion responses mediated the association between fibromyalgia symptoms and psychological distress. Our findings show that the connection between fibromyalgia symptoms and psychological distress is partially explained by difficulties in emotion regulation. Moreover, we show that specific emotion regulation strategies play a differential role in fibromyalgia patients' distress, thereby highlighting the importance of identifying unique psychotherapeutic targets. Specifically, regulating emotions through acceptance of emotional responses seems to be particularly important for fibromyalgia patients, as they cope with stigma and a lack of validation.
PMCID:10218633
PMID: 37239659
ISSN: 2227-9032
CID: 5543992

Perineal tear and childbirth-related posttraumatic stress: A prospective cohort study

Baumann, Sophie; Staudt, Andreas; Horesh, Danny; Eberhard-Gran, Malin; Garthus-Niegel, Susan; Horsch, Antje
Objective: Quantitative studies examining the occurrence of childbirth-related posttraumatic stress disorder (CB-PTSD) following severe perineal rupture are lacking. The objective of this population-based study was to investigate the prospective associations between the degree of perineal tear during childbirth and CB-PTSD symptoms, when adjusting for known covariates (maternal age, years of school education, premature birth, and parity). We hypothesized that women with different degrees of perineal tear will differ regarding (1) the level of CB-PTSD symptoms at 8 weeks and 2 years postpartum and (2) the rate of change in CB-PTSD symptoms from 8 weeks to 2 years postpartum. Method: Secondary data analysis from the Akershus Birth Cohort, a large population-based prospective cohort study using self-report questionnaires and hospital record data. Results: The degree of perineal tear was significantly associated with CB-PTSD symptoms at 8 weeks and 2 years postpartum. However, the degree of perineal tear was not significantly associated with the change in CB-PTSD symptoms over time. Similar patterns were found for both total CB-PTSD symptoms as well as for avoidance and intrusion symptoms only. Conclusion: Results seem to support a dose"“response model, suggesting that the higher the severity of the perineal tear, the higher the posttraumatic morbidity.
SCOPUS:85167353373
ISSN: 0001-690x
CID: 5619582

Predictors and comorbidity patterns of maternal birth-related posttraumatic stress symptoms: A Latent Class Analysis

Staudt, Andreas; Baumann, Sophie; Horesh, Danny; Eberhard-Gran, Malin; Horsch, Antje; Garthus-Niegel, Susan
Birth-related posttraumatic stress symptoms (PTSS) place a significant burden on mothers and their families. The aim was to (1) identify differential profiles of maternal birth-related PTSS; (2) determine the predictive value of established risk factors; (3) examine comorbidity patterns related to depression and anxiety symptoms. As part of the Norwegian Ahus Birth Cohort, 2,088 (expectant) mothers completed self-report questionnaires from 17 weeks of gestation to 2 years postpartum. The Impact of Event Scale was used to assess PTSS 8 weeks after birth. Latent class analysis revealed four latent classes: a High birth-related PTSS class (4%), a Moderate birth-related PTSS class (16%) particularly characterized by endorsement of intrusion symptoms, a Mild birth-related PTSS class (47%), as well as a No birth-related PTSS class (33%). We found similar (younger age, worse subjective birth experience, higher fear of childbirth) and differential predictors (prior posttraumatic stress disorder, lower education, birth complications). Women classified with High, Moderate, or Mild birth-related PTSS showed higher depression and anxiety symptoms compared to women with No birth-related PTSS. A considerable number of mothers experienced birth-related PTSS, most on a subclinical level, but these women still showed signs of mental distress 2 years postpartum, calling for more universal prevention approaches.
PMID: 36603381
ISSN: 1872-7123
CID: 5410062

Virtual Reality Combined with Artificial Intelligence (VR-AI) Reduces Hot Flashes and Improves Psychological Well-Being in Women with Breast and Ovarian Cancer: A Pilot Study

Horesh, Danny; Kohavi, Shaked; Shilony-Nalaboff, Limor; Rudich, Naomi; Greenman, Danielle; Feuerstein, Joseph S; Abbasi, Muhammad Rashid
BACKGROUND AND AIMS/OBJECTIVE:Breast and ovarian cancers affect the lives of many women worldwide. Female cancer survivors often experience hot flashes, a subjective sensation of heat associated with objective signs of cutaneous vasodilatation and a subsequent drop in core temperature. Breast and Ovarian cancer patients also suffer from sleep difficulties and mental health issues. The present study aimed to assess the effectiveness of Bubble, a novel artificial intelligence-virtual reality (AI-VR) intervention for the treatment of hot flashes in female breast or ovarian cancer patients. METHODS:Forty-two women with breast and/or ovarian cancer participated in the study. The mean age was 47 years (range: 25-60 years). Patients suffered from hot flashes at different frequencies. They used Bubble, a virtual reality (VR) mobile psychological intervention based on elements from both cognitive behavioral therapy and mindfulness-based stress reduction. The intervention took place in a VR environment, in a winter wonderland setting called Frosty. Patients were instructed to use Bubble at home twice a day (morning and evening) and when experiencing a hot flash. Participants were asked to use the application for 24 consecutive days. Before and after this 24-day period, patients completed self-report questionnaires assessing hot flashes, general psychiatric distress, perceived stress, illness perception, sleep quality, and quality of life. RESULTS:Between pre- and post-intervention, participants reported a significant reduction in the daily frequency of hot flashes, stress, general psychiatric distress, several domains of QOL, and sleep difficulties, as well as an improvement in illness perception. In addition, they reported very high satisfaction with Bubble. Importantly, both age and baseline levels of psychopathology moderated the effect of Bubble on sleep difficulties. DISCUSSION/CONCLUSIONS:This study showed preliminary evidence for the potential of VR interventions in alleviating hot flashes and accompanying mental distress among those coping with breast and ovarian cancer. VR is a powerful therapeutic tool, able to address mind-body aspects in a direct, vivid way. More studies are needed in order to fully understand the potential of this unique intervention.
PMCID:9690775
PMID: 36421585
ISSN: 2227-9032
CID: 5384342

Searching for Certainty During a Pandemic: A Longitudinal Investigation of the Moderating Role of Media Consumption on the Development of Posttraumatic Stress Symptoms During COVID-19

Negri, Ofir; Horesh, Danny; Gordon, Ilanit; Hasson-Ohayon, Ilanit
The current study longitudinally examined the moderating effects of consuming different types of media ( i.e. , formal [news] and informal [social media, WhatsApp]) in the association among COVID-19-related worries, intolerance of uncertainty (IU), and posttraumatic stress symptoms (PTSSs). Data were collected at two time points during July and September 2020, with approximately 60 days between measurements. Results showed that both COVID-19-related worries and IU were found to be positively associated with PTSSs. An interaction with formal media consumption was found, so that when one's formal media consumption was high, he or she were most vulnerable to the aforementioned effects on the development of PTSSs. Our findings point to the interactive effects of both COVID-19 worries and IU with media consumption on the development of PTSSs. Although media consumption might provide information during uncertainty, it may also intensify PTSSs during times of crisis. Implications and limitations are discussed.
PMCID:9426309
PMID: 35394974
ISSN: 1539-736x
CID: 5364992

Prevalence and risk factors of birth-related posttraumatic stress among parents: A comparative systematic review and meta-analysis

Heyne, Clara-Sophie; Kazmierczak, Maria; Souday, Ronnie; Horesh, Danny; Lambregtse-van den Berg, Mijke; Weigl, Tobias; Horsch, Antje; Oosterman, Mirjam; Dikmen-Yildiz, Pelin; Garthus-Niegel, Susan
This systematic review and meta-analysis aimed to determine mean estimates of prevalence rates for fulfilling all diagnostic criteria of posttraumatic stress disorder (PTSD) or at least showing significant levels of posttraumatic stress (PTSS) in relation to the traumatic event of childbirth. For the first time, both mothers and fathers were included in the synthesis. Studies were identified through systematic database search and manual searches, irrespective of language. Meta-analyses of 154 studies (N = 54,711) applied a random-effects model to four data sets, resulting in pooled prevalence rates of 4.7% for PTSD and 12.3% for PTSS in mothers. Lower rates of 1.2% for PTSD and 1.3% for PTSS were found among fathers. Subgroup analyses showed elevated rates in targeted samples (those with a potential risk status) most distinctly for maternal PTSS. The significant amount of heterogeneity between studies could not be explained to a satisfactory degree through meta-regression. Given the substantial percentage of affected parents, the adoption of adequate prevention and intervention strategies is needed. As this field of research is evolving, attention should be broadened to the whole family system, which may directly and indirectly be affected by birth-related PTSD. Further studies on paternal PTSD/PTSS are particularly warranted.
PMID: 35584590
ISSN: 1873-7811
CID: 5283672

Trust in Political Leadership During COVID-19 Pandemic: A Positive Trend Between Trust in Government Decisions and COVID-19-Related Worries

Negri, Ofir; Horesh, Danny; Gordon, Ilanit; Hasson-Ohayon, Ilanit
Although there is much evidence that trust in different types of authority figures has positive implications for individuals, this topic has rarely been addressed in the context of the COVID-19 pandemic. In this brief communication, we present trends that might challenge widely held assumptions regarding the benefits of trust in leadership. Namely, in our exploratory study, which took place in September 2020 upon the announcement of the second lockdown in Israel, we found that trust in the political leadership contributed positively to the prediction of COVID-19-related worries. As it is an exploratory study which includes only a small convenience sample, we suggest directions that might be interesting to examine further.
SCOPUS:85165580926
ISSN: 2617-2402
CID: 5550532