Prof Ehud Bodner
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.
Bodner, E.., Shrira, A., Hoffman, Y., & Bergman, Y. (2021). Day-to-day variability in subjective age and ageism and their association with depressive symptoms. The Journals of Gerontology: Series B. The Journals of Gerontology: Series B, 76(5), 836-844.
Objectives: Evidence of daily fluctuations in subjective age and their association with older adults’ well-being was recently obtained. Yet, neither the simultaneous tracking of two daily views on aging (i.e., daily subjective age and daily ageist attitudes) nor their interactive effect on mental health (i.e., depressive symptoms) has been explored. We hypothesized that (a) at days on which older adults feel older or report high ageist attitudes they would report higher depressive symptoms, (b) combined older subjective age and high ageist attitudes will be associated with the highest daily depressive symptoms.
Method: Community-dwelling older adults (N = 134, mean age = 69.66) completed measures of subjective age, ageist attitudes, and depressive symptoms for 10 consecutive days.
Results: Daily older subjective age and higher ageist attitudes were related to higher depressive symptoms, but there was no combined effect of both on depressive symptoms. There was a significant three-way interaction between subjective age, ageist attitudes, and chronological age, demonstrating the interactive effect of subjective age and ageist attitudes on depressive symptoms only among the old-old respondents. Time-lagged analyses further showed that ageist attitudes during previous days predicted feeling older and more depressed on following days, but not vice versa.
Discussion: Results suggest that old-old individuals are more susceptible to a combination of negative views on aging on daily basis. Findings further support a daily assimilation process, whereby previous-day stereotypes are assimilated and manifested into one’s identity and mental health, so that one feels older and more depressed on subsequent days.
Bodner, E.., Bergman, Y. S., Shiloh-Levin, S., & Hoffman, Y. S. G. (2021). The interactive effect of aging anxiety and age awareness on meaning in life and psychological distress: A moderated mediation model. Current Psychology: A Journal for Diverse Perspectives on Diverse Psychological Issues. Advance online publication.
Aging anxiety has been linked with negative psychological and physical consequences. However, little is known about the association between aging anxiety, meaning in life, and psychological distress among middle-aged adults. Accordingly, the current study examines the links between these constructs among this age-group. Moreover, in light of the importance of age as a cognitive category for one’s self-perception, we examined the moderating role of age awareness for the aforementioned links. A convenience sample of 309 adults (age range 40–65, M = 53.92, SD = 7.38) filled out scales assessing aging anxiety, meaning in life, psychological distress, and age awareness, together with various sociodemographic scales. Results demonstrated that aging anxiety was associated with reduced meaning in life and increased psychological distress. Moreover, meaning in life mediated the aging anxiety-psychological distress link, and this mediation was moderated by age awareness. The results are discussed from the perspective of Terror Management Theory, and clinical implications are suggested.
Yaakubov, L., Hoffman, Y., & Rosenbloom, T. (2020). Secondary traumatic stress, vicarious posttraumatic growth and their association in emergency room physicians and nurses. European Journal of Psychotraumatology, 11(1), 1830462.
Background: Emergency room personnel are indirectly exposed to many traumas. Few studies have examined secondary traumatic stress in emergency room nurses and only a single study examined emergency room physicians. The extent of vicarious post-traumatic growth, i.e., the growth associated with such trauma, has also hitherto not been examined in emergency room personnel.
Objective: Our first goal was to examine secondary traumatization in both emergency room nurses and physicians. Our second goal was to examine vicarious post-traumatic growth in emergency room personnel. Finally, we also address the association (linear and curvilinear) between secondary traumatization and vicarious traumatic growth.
Methods: A questionnaire comprising demographic variables, secondary traumatic stress and vicarious post-traumatic growth was administered electronically to a sample of emergency room personnel from the Wolfson Hospital, Holon, Israel.
Results: There were no differences between nurses and physicians in overall secondary trauma or vicarious post-traumatic growth levels. For physicians, there was both a linear and a curvilinear association between secondary trauma and vicarious post-traumatic growth; for nurses, there was no overall association. Further sub-group analyses revealed that emergency room nurses with low workload, in conjunction with low work experience, did show a linear association.
Conclusion: Results indicate that while vicarious post-traumatic growth is linked to secondary traumatic stress for emergency room physicians, it is not so for nurses. Theoretical implications concerning the role of trauma symptoms in vicarious post-traumatic growth are discussed. Clinical implications are raised regarding the identification of excessive secondary traumatic stress levels and the need for interventions to both decrease stress levels, and to increase vicarious post-traumatic growth levels.
Hoffman, Y. S., Hamama-Raz, Y., Ben-Ezra, M., & Lavenda, O. (2021). A Dissociation Between Two Cognitive Biases in Acute Stress Disorder: Preliminary Evidence for the Reverse Gambling Fallacy. Cognitive Therapy and Research, 45(4), 783-794.
Background: Rationality biases, such as the gambling fallacy (e.g., predicting future coin-tosses based on previous tosses) and the famous “Linda” conjunction fallacy (estimating the conjunction that “Linda” is both teller and feminist based on her description) have not been examined in people suffering from acute stress disorder (ASD). We analyze potential outcomes and align them with different theories.
Methods: To discern the precise pattern of rationality biases in persons with ASD, we examined performance on these 2 tasks within a month of the Hayian Super-Typhoon (August 27th, 2013). Out of a sample of 1001 persons, 82 had clinical ASD and their performance was compared to the remaining 919 participants.
Results: A specific link between ASD and rationality biases revealed that although conjunction task performance was not associated with ASD diagnosis, coin-task performance was. Namely, responding “Heads” to a 6th coin-toss after 5 successive “Heads” (reverse gambling fallacy) was robustly linked with ASD diagnosis.
Conclusion: The results align with the bridging of trauma theories claiming that trauma symptoms are generated by disequilibrium following trauma exposure, with prospect theory’s notion of chance, which is conceived as belief in equilibrium restoration. Such disequilibrium following trauma exposure is thus linked with the belief underlying reverse gambling fallacy biases, namely “what-was-will-be”. Implications regarding themes important to address in therapy are mentioned.
Cohn-Schwartz, E., Hoffman, Y., & Shrira, A. (2022). Reciprocal associations of posttraumatic stress symptoms and cognitive decline in community-dwelling older adults: The mediating role of depression. International Psychogeriatrics, 1-11.
Background: People with posttraumatic stress disorder (PTSD) may have cognitive decline, a risk which can be particularly threatening at old age. However, it is yet unclear whether initial cognitive decline renders one more susceptible to subsequent PTSD following exposure to traumatic events, whether initial PTSD precedes cognitive decline or whether the effects are reciprocal.
Objective: This study examined the bidirectional longitudinal associations between cognitive function and PTSD symptoms and whether this association is mediated by depressive symptoms.
Method: The study used data from two waves of the Israeli component of the Survey of Health, Ageing, and Retirement in Europe (SHARE), collected in 2013 and 2015. This study focused on adults aged 50 years and above (N = 567, mean age = 65.9 years). Each wave used three measures of cognition (recall, fluency, and numeracy) and PTSD symptoms following exposure to war-related events. Data were analyzed using mediation analysis with path analysis.
Results: Initial PTSD symptoms predicted cognitive decline in recall and fluency two years later, while baseline cognitive function did not impact subsequent PTSD symptoms. Partial mediation showed that older adults with more PTSD symptoms had higher depressive symptoms, which in turn were linked to subsequent cognitive decline across all three measures.
Conclusions: This study reveals that PTSD symptoms are linked with subsequent cognitive decline, supporting approaches addressing this direction. It further indicates that part of this effect can be explained by increased depressive symptoms. Thus, treatment for depressive symptoms may help reduce cognitive decline due to PTSD.
Prof. Amit Shrira
Kalir, D., Shrira, A., Palgi, Y., Batz, C., Ben-Eliezer, A., Heyman, N., Liberman, D., Selznev, I., Shugaev, I., Zaslavsky, O., Zikrin, E., & Bodner, E. (in press). Feeling young, functioning better: Reciprocal and mediating effects between subjective age and functional independence in rehabilitation. Gerontology.
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.
Greenblatt-Kimron, L., Shrira, A., Rubinstein, T., & Palgi, Y. (2021). Event centrality and secondary traumatization among Holocaust survivors' offspring and grandchildren: A three-generation study. Journal of Anxiety Disorders, 81, 102401.
The present study examined the intergenerational transmission of the Holocaust trauma in relation to levels of secondary traumatization and event centrality across three generations in a cross-sectional survey. Participants included 92 Holocaust survivor-offspring-grandchild triads (Holocaust G1-G2-G3) and 67 comparison triads (Comparison G1-G2-G3). Holocaust G1 reported higher levels of post-traumatic stress disorder (PTSD) symptoms relative to Comparison G1. Holocaust G2 and G3 reported significantly higher secondary traumatization relative to Comparison G2 and G3, respectively. Holocaust G3 also reported significantly higher scores in event centrality relative to Comparison G3. In survivor families, the indirect effect of PTSD symptoms in Holocaust G1 predicted Holocaust G2's secondary traumatization, which subsequently predicted Holocaust G3's secondary traumatization. Moreover, PTSD symptoms in Holocaust G1 predicted Holocaust G3's event centrality through secondary traumatization in both Holocaust G2 and G3 and event centrality in Holocaust G2. In the comparison groups, trauma transmission was not observed in three generations. Findings elucidate unique intergenerational transmission of the Holocaust trauma in survivor families, which comprise both personal and societal constituents. Moreover, the findings show that event centrality is a distinctive mechanism in intergenerational transmission in survivor families.
Palgi, Y., Shrira, A., & Neupert, S. (2021). Views on aging and health: A multidimensional and multitemporal perspective. The Journals of Gerontology: Series B. The Journals of Gerontology: Series B, 76(5), 821-824.
As we get older, we repeatedly construct the way we refer to our age and our aging. This process seems to occur mainly on two levels, the social and cultural levels, where the way our society refers to older adults affects the inner dialogue with ourselves regarding our identity as an aging individual in society. The second process occurs at the inner psychological level, where small biological and physical changes increase our awareness of the aging process and force us to confront these changes and the fact that we are mortal and getting older. These social and psychological processes interact with each other, construct our view toward our aging, and serve as the basis for vast theoretical and practical research. In recent decades there has been a dramatic increase in interest in views on aging (VoA), as evidence accumulated to show they serve as potent predictors of health and longevity (see Diehl & Wahl, 2015; Wurm et al., 2017, for a review). However, most work has typically used a unidimensional perspective focusing on one VoA construct within a specific time frame. As research on VoA is taking its place at the forefront of the study of aging, this special issue aimed to push beyond what has been done before. Thus, using data collected across several countries and across several timescales, the body of works assembled here delves deeper into the VoA–health nexus, presenting novel insights about the importance of multidimensionality of VoA and health assessed across different time frames.
Orly Turgeman Goldschmidt
This study’s aim was to explore how stroke survivors cope with their stroke and its consequences. While the concept of chronic illness dominates the stroke -recovery literature, for some, their stroke is part of an ongoing life story. Bury conceptualized chronic illness as a major disruptive experience, specifically for rheumatoid arthritis patients. The interviews in this article focused on how individuals reconstructed their lives post-injury/stroke. This article seeks to investigate whether stroke survivors also construct their stroke as a biographic disruption. Open-ended interviews were conducted with 33 stroke survivors. It was found that stroke survivors choose hope more than they do grief, often contrary to their physician’s evaluation. Moreover, while the story of the onset was always sad, they chose to turn their backs on the victim role and being sick, and found ways to live with it. For them, it appears that the stroke is part of an ongoing life story more than it is a “biographical disruption.” Most of them were narratives of redemption, rather than contamination. My conclusion is that stroke survivors can choose how to construct a stroke’s onset as well as its consequences.
*Martinez, A.E ., *Weissberger, G. H., *Kuklenyik, Z., He, X., Meurut, C., Parekh, T., Rees, J. C., Parks, B. A., Gardner, M., King, S. M., Collier, T.S., Harrington, M. G., Sweeney, M. D., Wang, X., Zlokovic, B., Joe, E., Nation, D. A., Schneider, L. S., Chui ,H. C., Barr, J. R.,…& Yassine, H. N. (2022). The small HDL particle hypothesis of Alzheimer’s disease. Alzheimer’s and Dementia. Advanced Online Publication.
We propose the hypothesis that small high-density lipoprotein (HDL) particles reduce the risk of Alzheimer's disease (AD) by virtue of their capacity to exchange lipids, affecting neuronal membrane composition and vascular and synaptic functions. Concentrations of small HDLs in cerebrospinal fluid (CSF) and plasma were measured in 180 individuals ≥60 years of age using ion mobility methodology. Small HDL concentrations in CSF were positively associated with performance in three domains of cognitive function independent of apolipoprotein E (APOE) ε4 status, age, sex, and years of education. Moreover, there was a significant correlation between levels of small HDLs in CSF and plasma. Further studies will be aimed at determining whether specific components of small HDL exchange across the blood, brain, and CSF barriers, and developing approaches to exploit small HDLs for therapeutic purposes.
Weissberger, G. H., Mosqueda, L., Nguyen, A. L., Axelrod, J., Nguyen, C. P., Boyle, P. A., Spreng, N., Han, S. D. (2020). Functional connectivity correlates of perceived financial exploitation in older adults. Frontiers in Aging Neuroscience, 12, 583433.
Financial exploitation (FE) in old age is devastating and common; however, the neural correlates of FE are poorly understood. Previous studies of FE in older adults have implicated declines in decision making and social cognition as two risk factors for FE in later life. Here we examined whether functional connectivity among brain regions implicated in decision making and social cognition differed for those with an experience of FE vs. those without. Participants included 16 older adults without cognitive impairment who reported FE (Mean age = 70.5, 62.5% female, Mean education = 16.0 years) and 16 demographically and cognitively matched adults who denied a history of FE (Mean age = 65.1, 37.5% female, Mean education = 15.1 years). Measures of whole-brain resting-state functional connectivity in the hippocampus, insula, and medial frontal cortex were derived for each group. Compared to the non-FE group, FE was associated with greater functional connectivity between the right hippocampus and bilateral temporal regions, and less functional connectivity between the right hippocampus and the right cerebellum and bilateral lingual gyri. The FE group showed less connectivity between the right and left insula and cingulate cortex, and between the right insula and regions of the left lateral temporal gyrus and dorsolateral prefrontal cortex. Finally, the FE group showed greater functional connectivity between the medial frontal cortex and the right lateral temporal gyrus and orbitofrontal cortex, and less functional connectivity with the right pre- and postcentral gyri. Results suggest that perceived FE in old age is associated with whole-brain functional connectivity differences involving the hippocampus, insula, and medial frontal cortex, consistent with models implicating age-associated changes in decision making and social cognition in FE.
Weissberger, G. H., Goodman, M. C., Mosqueda, L., Schoen, J., Nguyen, A. L., Wilber, K., Gassoumis, Z. D., Nguyen, C. P., & Han, S. D. (2019). Elder abuse characteristics based on calls to the National Center on Elder Abuse (NCEA) Helpline. Journal of Applied Gerontology, 39, 1078-1087.
Characterizing the types of elder abuse and identifying the characteristics of perpetrators are critically important. This study examined the types of elder abuse reported to the National Center on Elder Abuse (NCEA) resource line. Calls were coded with regard to whether abuse was reported, types of abuse alleged, whether multiple abuse subtypes occurred, and who perpetrated the alleged abuse. Of the 1,939 calls, 818 (42.2%) alleged abuse, with financial abuse being the most commonly reported (449 calls, 54.9%). A subset of calls identified multiple abuse types (188, 23.0%) and multiple abusers (149, 18.2%). Physical abuse was most likely to co-occur with another abuse type (61/93 calls, 65.6%). Family members were the most commonly identified perpetrators (309 calls, 46.8%). This study reports the characteristics of elder abuse from a unique source of frontline data, the NCEA resource line. Findings point to the importance of supportive resources for elder abuse victims and loved ones.