מחקרים בשיתוף סטודנטים

Aisenberg, D., & Harmatz, M. (2023). Improving depressive symptoms and maintaining cognitive abilities of seniors within the nursing homes: A pilot study of Brief Mindfulness-Based Interventions for Seniors in a Semi-randomized trial. Frontiers in Psychology, 7554

Introduction

Seniors in nursing homes are at higher risk for depression and emotional distress. The COVID-19 crisis and isolation have even increased the risk for cognitive decline and suicidality. Since social media is often unfamiliar to older adults, their treatment options were diminished during quarantine. Recently, studies showed the potential for Mindfulness-Based Intervention in improving cognitive functioning and psychological well-being among healthy older adults. Standardized courses such as MBSR and MBCT are not suited to the majority of seniors for several reasons. First, the interventions are too long and demanding, physically and cognitively. Second, they require an instructed counselor for delivery, which makes it almost impossible in times of quarantine, and third, very expensive. Hence, the purpose of this study was to examine whether similar improvements in emotional distress and cognitive functioning can be achieved through a brief intervention, that can be delivered by workers in nursing homes.

Methods

A course of 8 half-hour sessions each (MBIS: Mindfulness-Based Intervention for Seniors) was employed in two versions: (1) An 8-week course with weekly meetings (2) A 4-week course with 2 sessions per week and compared to a control care-as-usual group. Depression and mood were measured, as well as cognitive abilities in the Simon task. In addition, the level of Mindfulness skills was measured before and after the interventions.

Results

We showed that brief interventions succeeded in improving mindfulness Non-reactivity and produced changes in the facets Acting with awareness and Non-judging. More importantly, the brief intervention, in both frequency versions, improved the level of depression and mood (BDI and PHQ-9). At the cognitive level, an adaptive sequential effect appeared after the intervention only in the 8-week MBIS group.

Discussion

These findings indicate the effectiveness of this pilot of a short, simple, mindfulness-based intervention, in improving depression and psychological distress, as well as improving cognitive control over time. This may enhance significant developments in the field of treatment solutions for seniors, with a ready-to-use protocol to administer in nursing homes.

סטודנטית: מרגלית חרמץ
מנחה: ד"ר דניאלה איזנברג-שפרן

Aharon, O. N., Aisenberg-Shafran, D., & Levi-Belz, Y. (2023). The effect of suicide severity and patient’s age on mental health professionals’ willingness to treat: The moderating effect of ageism. Death Studies, 1-11.‏ 

Understanding mental health professionals’ (MHPs) willingness to treat suicidal older adults is critical in preventative psychotherapy. We examined the effect of a hypothetical patient’s age and suicide severity on MHPs’ willingness to treat or refer them to another therapist. Vignettes of hypothetical patients were presented to 368 MHPs aged 24-72 years. The vignettes had two age conditions (young/old) and three suicidality severity conditions. MHPs completed measures of their levels of willingness to treat/likeliness to refer and their levels of ageism. As suicide severity intensified, MHPs were less willing to treat and more likely to refer. Willingness to treat was the lowest for the old/suicide attempt condition. Ageism moderated the relationships between patient age and willingness to treat: MHPs with higher ageism were less willing to treat older than younger patients, regardless of suicidality severity. Findings indicate that MHPs with higher ageism levels are more reluctant to treat older suicidal patients and highlight the need for training MHPs to reduce ageism and enhance competence in suicide interventions.

סטודנט: אופיר אהרון
מנחים: ד"ר דניאלה איזנברג-שפרן ופרופ' יוסי לוי-בלז

Rabinowitz, Y., Ravona-Springer, R., Heymann, A., Moshier, E., Berman, Y., Schwartz, J., Sano, M., Aisenberg, D. & Schnaider-Beeri, M. (2023). Physical activity is associated with slower cognitive decline in older adults with type 2 diabetes. The Journal of Prevention of Alzheimer's Disease. 1-6. 

Background

Physical activity is associated with slower cognitive decline in old age. Type 2 diabetes (T2d) is a risk factor for dementia and cognitive decline. Physical activity protects against several T2d complications. Yet, little is known about the contribution of physical activity to cognitive health among the elderly with T2d.

Objectives

To examine the association between physical activity and cognitive decline in older adults with T2d. DESIGN: This is a prospective longitudinal study using data from the Israel Diabetes and Cognitive Decline (IDCD) study. Setting: ICDC study (N=1,213), is a population-based cohort of adults over the age of 65, diagnosed with type 2 diabetes, who were cognitively normal at baseline and followed up every 18 months.

Participants

Participants with at least one follow-up assessment who were in the same physical activity group consistently and had complete demographic data.

Measurements

Physical activity was measured using Minnesota Leisure Time Activity Questionnaire, cognitive functioning was measured using a broad neuropsychological assessment measuring Executive Functioning, Attention/ Working Memory, Semantic Categorization and Episodic Memory.

Results

Participants were classified into physical activity groups based on self-reported physical activity at baseline and all follow ups: “active” - participation in recreational physical activity (n=286); “non-active” - the only physical activity was walking from place to place (n=93) and “sedentary” (n=19). Linear mixed effects models were applied to adjust for key demographic and cardiovascular risk factors. Participants were 72.4 (SD 4.6) years old, had 13.3 (SD 3.6) years of education, and 163 (41%) were female. In the fully adjusted model, compared to the non-active group the active group had significantly slower rate of decline in Global Cognition (p=0.005), Executive Functioning (p=.014), and Attention/Working Memory (p=.01). There were no significant group differences for Semantic Categorization (p=.17) and Episodic Memory (p=.88).

Conclusions

Among initially cognitively normal and independent older adults with T2d, a physically active lifestyle was associated with a slower rate of cognitive decline. Future research should examine whether promoting physical activity may prevent or delay onset of dementia in this high-risk population.

סטודנט: יעקב רבינוביץ
מנחים: ד"ר דניאלה איזנברג-שפרן, ד"ר רמית רבונה ופרופ' מיכל בארי

Aisenberg-Shafran, D., & Shturm, L. (2022). The effects of mindfulness meditation versus CBT for anxiety on emotional distress and attitudes toward seeking mental health treatment: a semi-randomized trial. Scientific Reports, 12(1), 1-11.

Older adults often avoid seeking psychological treatment, thus challenging their ability to cope effectively with anxiety, stress, and depression. The current study aimed to compare the effects of a mindfulness intervention with cognitive behavioral therapy (CBT) on measures of emotional distress and attitudes toward seeking mental health treatment among older adults. Twenty-four seniors were assigned to three groups: (1) Mindfulness-based intervention for seniors (MBIS), (2) CBT for anxiety, or (3) a care-as-usual control group. Participants in the two intervention groups of eight weekly sessions were randomly assigned. Results showed that attitudes toward seeking psychological treatment and depression, anxiety, and worry levels were evaluated before and after the interventions. Following both interventions, participants considered the prospect of utilizing psychological treatment more positively, whereas no changes were observed in the control group. Interestingly, worry levels were eased only in the MBIS group, and anxiety levels were eased only in the CBT group. Our findings support the understanding that cognitive group interventions can effectively achieve their intended aim (decreasing worry or anxiety) and positively impact attitudes toward psychological treatment.

סטודנטית: ליאב שטורם
מנחה: ד"ר דניאלה איזנברג-שפרן

Ulus, G. & Aisenberg-Shafran, D. (2022). Interoception In Old Age. Brain sciences. 12(10), 1398. 

Emotion regulation in old age was found to be more efficient; seniors seem to focus less on the negative aspects of experiences. Here, we ask, do older individuals regulate their emotions more efficiently or are they numb to the physiological changes that modulate these emotions? Interoception, the perception of physical feelings, influences a person’s mood, emotions, and sense of well-being, and was hardly tested among older adults. We examined the awareness of physiological changes (physiological arousal—blood pressure and heart rate) of 47 older adults, compared to 18 young adults, and their subjective reports of emotional experiences while viewing emotional stimuli. Interoception was decreased in old age. Blood pressure medications had a partial role in this reduction. Moreover, interoception mediated emotional experience, such that low interoception led to lower experiences of changes in physiological arousal. These findings may account for the emotional changes in old age, suggesting a decline in sensitivity with age, which leads to a positive interpretation of information.

סטודנטית: גילי אולוס

מנחה: ד"ר דניאלה איזנברג-שפרן

Fonia, D. & Aisenberg-Shafran, D. (2022). The Effects of Mindfulness Interventions on Fibromyalgia in Adults aged 65 and Older: A Window to Effective Therapy. Journal of Clinical Psychology in Medical Settings, 1-18. DOI: https://doi.org/10.1007/s10880-022-09911-7. 

Pain usually receives insufficient attention by individuals due to the misconception that pain is a natural consequence of aging. For persons aged 65 and older, a disease requiring further research is fibromyalgia, characterized by chronic pain without clear pathology. Mind–body therapies like mindfulness are beneficial for this population as they affect psychological and biological aspects of pain. These therapies emphasize a nonjudgmental acceptance of thoughts and attention to the experience without attempting to resist or change them. Despite the potential benefits of mindfulness interventions for persons with fibromyalgia aged 65 and older, only few studies have examined the effects of these therapies, yielding conflicting findings. Importantly, no study has yet to be conducted exclusively on this population. This comprehensive review examined existing literature focusing on the effects of mindfulness-based interventions on the physical and mental well-being of persons with fibromyalgia aged 65 and older. It highlights the need for further research on the relationship between mindfulness, fibromyalgia, and gerontology, calling for a standard protocol of intervention.

סטודנט: דביר פוניה
מנחה: ד"ר דניאלה איזנברג-שפרן

Gigi, O., Levi-Belz, Y., & Aisenberg, D. (2021). Death anxiety and intrusive thinking during the COVID-19 pandemic. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 34(4), 201–212. https://doi.org/10.1024/1662-9647/a000268.

COVID-19 has expanded into a life-threatening global pandemic. We examined COVID-19 effects on trauma measures, loneliness, and death anxiety in senior Israelis. Young and old adults (N = 277) were recruited through social media. They completed online questionnaires assessing mental status during the crisis. The findings yielded correlations between trauma reactions, death anxiety, and loneliness, age-related change in rates of death anxiety and traumatic symptoms, but not in perceived loneliness. Trauma-related intrusive thinking was predicted by age, loneliness, death anxiety, and being in isolation. Traumatic reactions, as indicated by DSM-V, were observed for young adults, while grandchildren were found to be protective for older adults. Conclusions point to a high risk of postcrisis symptoms in older adults. The article recommends methods for maintaining mental health, highlighting the role of social interaction.

סטודנטית: אור גיגי
מנחה: ד"ר דניאלה איזנברג-שפרן

Sidi, R., & Aisenberg-Shafran, D. (2020). Effects of Kibbutz communal upbringing in adulthood: trait emotional intelligence and attachment patterns. Heliyon, 6(12), e05775.‏  

Past research regarding the emotional characteristics of kibbutz children raised with communal sleeping arrangements (CSA) showed inconsistent findings for emotional difficulties, such as insecure attachment and lowered ability for intimacy. Only little research has examined these children's emotional characteristics in their adulthood. Trait emotional intelligence (trait EI) is a new concept measuring a constellation of correlated emotional traits that capture a person's typical way of processing emotional information and reacting to it.

The present study examined if difficulties in intimacy and trait EI characterize adults who had been raised in CSA kibbutzim (Hebrew plural of kibbutz). Participants comprised 1185 adults, aged 30–79, of whom 735 were raised in CSA kibbutzim, and the rest did not grow up in a Kibbutz at all. The participants completed three self-report questionnaires: Schutte's Self-Report Emotional Intelligence Test (SSEIT) to measure trait EI; the Revised Adult Attachment Scale to measure adult attachment; and the Rosenberg Self-Esteem Questionnaire to measure self-esteem.

Results showed that most of the kibbutz CSA participants revealed levels of intimacy and trait EI comparable to the non-kibbutz group. However, a significant difference was found among adults with low self-esteem and poor attachment quality: For these participants, trait EI and intimacy were significantly lower for the CSA kibbutz group than for the non-kibbutz group. Furthermore, the CSA kibbutz group reported poorer non-verbal communication skills than the non-kibbutz group.

We suggest that a minority of the CSA kibbutz children were less resilient to the kibbutz ecology. These children might have been more vulnerable to the effects of limited social options, decreased parental support, and the kibbutz education's ideological demands. For these children, the effects of communal upbringing on intimacy and attachment appear to be long-lasting, extending throughout their adulthood.

סטודנט: רונן סידי
מנחה: ד"ר דניאלה איזנברג-שפרן

Kinory, D., Aisenberg, D. & Levi-Belz, Y. (2020). The cost of being apart: The contribution of perceived burdensomeness and thwarted belongingness to suicide ideation among Israeli older adults. Journal of Nervous and Mental Disease. Accepted for publication. 

Older adults have the highest suicide rates of all age groups in most industrialized countries. However, research concerning psychological risk factors for suicide among older adults is sparse. Thus, our study aimed to examine the contribution of perceived burdensomeness (PB) and thwarted belongingness (TB) to suicide ideation (SI) among older adults. Participants included 160 Israeli older adults (aged 65–91 years), who completed measures of suicide risk, PB, and TB as well as hopelessness and depression. Using hierarchical regression, we found that PB and TB accounted for 9.8% of the variance in SI and that the interaction of PB and TB had a significant unique contribution to SI among the participants, beyond the effect of hopelessness and depression. The study's findings highlight the contribution of interpersonal variables to SI among older adults and suggest that mental health professionals should be aware of PB and TB levels when assessing suicide risk among older adults.

סטודנטית: דנה כינורי
מנחים: ד"ר דניאלה איזנברג-שפרן ופרופ' יוסי לוי-בלז

Lev-Ari, L., Kreiner, H., & Avni, O. (2021). Food Attention Bias: Appetite comes with eating. Journal of Eating Disorders, 9(1), 1-10.

Objective

Cognitive interventions may be effective in weight loss. The purpose of this study was to assess if cognitive reappraisal (CR; reframing the meaning of a stimulus in order to change the resulting emotional response), can reduce food attentional bias (FAB) using the Visual Dot Probe (VDP) paradigm.

Method

126 participants (age 27 ± 5.8) were randomly assigned either to a CR or to a control (CN) group. After assessing baseline VDP levels for FAB, participants either wrote sentences that discourage eating fattening food or neutral sentences. Next, all participants performed the VDP post intervention. Participants also self-reported on disordered eating behaviors and their height and weight were charted. We hypothesized that CR would reduce FAB and that disordered eating would moderate the association between group and FAB.

Results

FAB decreased post intervention, specifically in the CR group. The bulimia sub-scale showed an interaction between bulimic eating, time and group. Among those who were high on the bulimia scale, the CR group showed lower FAB post-intervention compared to the CN group.

Discussion

This study suggests that CR may decrease the attentional bias toward high-calorie food compared to other strategies in the general population and among people with high bulimia measures, in particular.

סטודנט: עומר אבני
מנחים: ד"ר לילך לב-ארי ופרופ' חמוטל קריינר

Ifrah, K., & Tsipper, I. (in press). Does interpersonal vulnerability mediate the association between parental bereavement and mental health? OMEGA-Journal of Death and Dying. https://doi.org/10.1177/00302228221080021

Abstract
Objective: Cognitive interventions may be efective in weight loss. The purpose of this study was to assess if cognitive reappraisal (CR; reframing the meaning of a stimulus in order to change the resulting emotional response), can reduce food attentional bias (FAB) using the Visual Dot Probe (VDP) paradigm.

Method: 126 participants (age 27± 5.8) were randomly assigned either to a CR or to a control (CN) group. After assessing baseline VDP levels for FAB, participants either wrote sentences that discourage eating fattening food or neutral sentences. Next, all participants performed the VDP post intervention. Participants also self‑reported on disordered eating behaviors and their height and weight were charted. We hypothesized that CR would reduce FAB and

that disordered eating would moderate the association between group and FAB.

Results: FAB decreased post intervention, specifcally in the CR group. The bulimia sub‑scale showed an interaction between bulimic eating, time and group. Among those who were high on the bulimia scale, the CR group showed lower FAB post‑intervention compared to the CN group.

Discussion: This study suggests that CR may decrease the attentional bias toward high‑calorie food compared to other strategies in the general population and among people with high bulimia measures, in particular

סטודנט: איתי ציפר
מנחה: ד"ר כפיר יפרח

Levi-Belz, Y., & Ben-Yaish, T. (2022). Prolonged grief symptoms among suicide-loss survivors: The contribution of intrapersonal and interpersonal characteristics. International journal of environmental research and public health, 19(17), 10545.‏

Abstract

Background: Suicide-loss survivors (SLSs) are a population with unique characteristics that place them at increased risk for developing grief complications and painful feelings of guilt that may impact their supportive social environment. However, no studies to date have examined the role of intrapersonal and interpersonal variables that may contribute to prolonged grief symptoms (PGS) as outlined by the new DSM-5 criteria. The present study aimed to extend knowledge regarding the role of interpersonal variables, such as perceived burdensomeness, thwarted belongingness, and self-disclosure, in determining the impact of guilt on the development of PGS among SLSs. Method: This study is part of a longitudinal study, though, in this study, we used a cross-sectional examination of the recently completed fourth measurement. Study participants included 152 SLSs aged 22 to 76 who completed questionnaires measuring guilt, depression, perceived burdensomeness, thwarted belongingness, self-disclosure, and PGS using the Prolonged Grief–Revised Inventory. Participants’ demographics and loss-related characteristics, such as time since suicide and participant’s age at the time of suicide, were examined. Results: Confirming the hypotheses, intrapersonal variables (i.e., guilt and depression), as well as interpersonal variables (i.e., perceived burdensomeness, thwarted belongingness, and self-disclosure), contributed significantly to PGS beyond sociodemographic and loss-related factors. Perceived burdensomeness significantly moderated the contribution of guilt to PGS: for participants with high burdensomeness levels, guilt contributed to PGS more strongly than for participants with low burdensomeness. Conclusion: Guilt is an important contributor to PGS among SLSs, and perceived burdensomeness plays a critical role in moderating this contribution. In light of these findings, it can be suggested that SLSs with high levels of guilt should receive special attention and may benefit from therapeutic interventions focusing on reducing maladaptive cognitions that elicit intense guilt or perceived burden.

סטודנט: תמיר בן יעיש
מנחה: פרופ' יוסי לוי-בלז

תקציר

מטרת המחקר: אֵבֶל של מטפל עשוי להיות עמוק בעקבות מוות של מטופל שאיתו התקיים קשר משמעותי. עם זאת, הקשר הטיפולי הוא מקצועי ופרטי, וכאשר מטופל נפטר, פעמים רבות המטפל נותר לבדו מבלי יכולת להתאבל באופן גלוי. מטרת מחקר זה היא לחקור את התמודדותם של פסיכותרפיסטים עם מוות של מטופלים זקנים.

שיטה: המחקר נערך בגישה איכותנית בשיטת תיאוריה מעוגנת בשדה. הנתונים במחקר נאספו באמצעות ראיונות עומק חצי מובנים עם 40 פסיכותרפיסטים מהכשרות שונות (פסיכולוגים קליניים, פסיכולוגים שיקומיים, פסיכולוגים רפואיים ועובדים סוציאליים) אשר חוו במהלך עבודתם פטירה של לפחות מטופל אחד בן 65 ומעלה.

תוצאות: נמצאו חמש תמות עיקריות – 1. תגובות מטפלים לפטירת מטופליהם; 2. דרכי התמודדות של מטפלים; 3. גורמים המשפיעים על אבל של המטפלים; 4. השלכות האבל על המטפלים; 5. בדידותו של המטפל האבל.

סיכום ומסקנות: חוויית האבל של מטפלים היא אישית ומשתנה בהתאם למספר גורמים, כולל טיב הקשר עם המטופל, נסיבות מותו, וניסיונו המקצועי והאישי של המטפל. נמצא כי אבל שלא מקבל הכרה מקשה מאוד על תחושותיהם של המטפלים האבלים. המטפלים דיווחו על העדר הכרה בזכותם להתאבל בהיבטים חברתיים, מקצועיים ואישיים, וכי קיים מעגל של שתיקה בנושא של מוות בטיפול. אמצעים שנמצאו מועילים להתמודדות עם האבל כוללים שיתוף עמיתים, השתתפות בטקסים ופעולות של דאגה עצמית. כמו כן, נמצאו מאפיינים מיוחדים להתמודדות של מטפלים עם מוות של מטופלים זקנים. מוות של מטופלים זקנים נתפס כנורמלי וטבעי. עוד נמצא כי תחושות של הלם ועצב, בעקבות פטירת המטופל הזקן, התחלפו בהמשך בתחושות של השלמה עם המוות ותחושה של סיפוק מכך שהמטרות הטיפוליות הושלמו. המטפלים דיווחו כי הטיפול במטופלים זקנים שיפר את יכולותיהם המקצועיות, סייע לתחושת תיקון אישית והגביר את המודעות לזמן החיים הקצוב. לדיון נוספו גם המלצות להתמודדות עם מותם של מטופלים.

סטודנטית: גלית ברין
מנחה: ד"ר ליאורה בר-טור