The mental health impact of terrorism in Israel: a repeat cross-sectional study of Arabs and Jews

Objective: Since September 2000 Israeli society has been subjected to numerous deadly terror attacks. Few studies have studied the comparative mental health vulnerability of minorities and majorities to continuous terror attacks. Method: Two telephone surveys (N = 512 and 501) on two distinct representative samples of the Israeli population after 19 months and after 44 months of terror. The Arab minority and Jewish majority were compared on measures of exposure to terrorism, posttraumatic stress symptomatology, feeling depressed, coping, sense of safety, future orientation, and previous traumatic experiences. Results: After 19 months of terrorist attacks Arab Israelis and Jewish Israelis reacted roughly similarly to the situation, however after 44 months of terror, posttraumatic symptom disorder in the Arab population increased three‐fold, posttraumatic symptomatology doubled and resiliency almost disappeared. Conclusion: We suggest that certain conditions inherent to political conflict situations may potentially put minorities at risk and may only be observable as terrorism‐related stressors become chronic.     

Daily stresses and uplifts during times of political tension: Jews and Arabs in Israel

This study examined similarities and differences between Jews and Arabs in Israel in terms of their daily stressful and uplifting experiences and assessed the relation between these experiences and family and life satisfaction. Data were collected from representative samples of 697 Jews and 303 Arabs by using a computerized-assisted telephone interviewing system. Contrary to expectation, Jews reported more sources of hassles than did Arabs, whereas Arabs reported more uplifts. A structural equation modeling multigroup analysis indicated a similar factor suucture for hassles and uplifts in both groups. Family satisfaction was positively related to uplifts but not to hassles. For Arabs, uplifts had a positive effect only on family satisfaction, whereas for Jews they had a positive effect on both family and general life satisfaction.     

Suicidal behavior among Muslim Arabs in Israel

Purpose  

Countries with Muslim populations report relatively lower rates of suicide. However, authors have noted methodological flaws in the data. This study examined reliable rates of completed suicide, suicide ideation, planning and attempts among Muslims as compared to Jews in Israel.     

A Glanzmann's thrombasthenia cluster among Iraqi Jews in Israel

A country-wide survey of Glanzmann's thrombasthenia in Israel identified 44 patients. The patients belong to 23 unrelated families, 17 of whom are of Iraqi Jewish origin. The frequency of thrombasthenia among Iraqi Jews in Israel (total population 270,000) is 1:7714 and thus the calculated frequency of the carrier state is 2.3%.     

Depression and anxiety disorders among Jews from the former Soviet Union five years after their immigration to Israel

BACKGROUND: Epidemiological studies have shown that the prevalence rates of major depression and anxiety are lower in the elderly than in younger adults. In a recent survey, we found, among immigrants, that the association of age with psychological distress was the reverse. OBJECTIVE: The objective of the present study was to examine, among immigrants, whether the relationship of age with clinically diagnosed depression and anxiety disorders is also reversed. This was done by assessing the age-specific incidence and prevalence of depression and anxiety among immigrants from the former Soviet Union to Israel five years after their immigration. METHODS: A stratified subsample was chosen from a larger random sample of immigrants from the Former Soviet Union who arrived in Israel in 1990. We selected the subsample to include an over-representation of those with a high level of distress in order to increase the probability of finding people suffering from psychopathology. The subjects were interviewed with a diagnostic instrument, the CIDI-S, an abbreviated version of the CIDI. Prevalence and incidence rates of depression and anxiety were calculated separately for two age groups (those below age 65 and those aged 65 and above). RESULTS: Before immigration, incidence rates were lower among the elderly than among younger adults, a finding consistent with the literature. However, after immigration, the reverse was found, with higher prevalence and incidence rates among elderly immigrants. CONCLUSION: The data suggest that immigration contributes to an increase of psychopathology which is particularly pronounced among the elderly.     

In search of the saddiq: visitational dreams among Moroccan Jews in Israel

Folk veneration of saints (hagiolatry) plays a major role in the lives of many Moroccan Jews living in Israel and constitutes a basic ingredient of their distinctive ethnic identity. In this context, pilgrimages to the saint's tomb and visitational dreams, in which he appears in person or in some symbolic guise, are related phenomena through which the linkage to the saint is maintained and his blessing is granted to his adherents. This paper is concerned with visitational dreams collected among Moroccan Jews in a major pilgrimage center in northern Israel. An attempt is made to show how personal concerns of the dreamers are mediated through the culturally shared idiom of the saint. We discuss the basic structure of visitational dreams, the major life problems conveyed by them (drawing on illustrations from the dream collection), their therapeutic qualities and their significance in the framework of the pilgrimage to the saint's sanctuary.     

Head injuries and cognitive decline among older adults: a population-based study

OBJECTIVE: To examine the relationship between minor and major head injuries caused by fall accidents and cognitive decline among a cohort of adults age 70 years or older (n = 588). BACKGROUND: Even a mild brain injury may affect cognitive functions. Among older adults, results from case-control studies suggest that the occurrence of head injury is positively associated with the onset of AD. METHODS: The shortened version of the Mini-Mental State Examination (sMMSE) was performed and a set of demographic and clinical variables were collected at the beginning of the study. All falls were recorded during a period of 2.5 years, after which the sMMSE tests were repeated. The risk of falls causing head injury in terms of a defined cognitive decline was examined during another follow-up period of approximately 2.5 years. RESULTS: There was no association between the occurrence of minor head injuries and decline in sMMSE scores. A positive relationship existed between the occurrence of major head injuries and a decline in sMMSE scores. The risk of cognitive decline increased linearly as higher cut-off points were used to define the decline in sMMSE scores-with relative risks (95% CI) of 0.94 (0.47 to 1.90), 1.35 (0.64 to 2.85), 1.75 (0.78 to 3.91), 2.38 (1.02 to 5.52), and 3.72 (1.64 to 8.44)-for a decline of > or =1, > or =2, > or =3, > or =4, and > or =5 points in the sMMSE score. The high risk remained unchanged after adjustment for other potential factors contributing to cognitive decline or dementia. The risk factors associated with falls causing major head injury during the second follow-up period were high age, OR (95% CI) 3.58 (1.87 to 6.85); use of psychotropic medication, 2.04 (1.09 to 3.83); diagnosis of hypertension, 1.80 (0.96 to 3.37); and decline in sMMSE score of >5 points, 2.41 (0.86 to 6.76). CONCLUSIONS: Our results suggest that the occurrence of major head injury increases the risk of cognitive decline. The cause of cognitive decline may be dementia, but this assumption remains to be elucidated in future studies.     

Cross-national study of attitudes towards seeking professional help: Jordan, United Arab Emirates (UAE) and Arabs in Israel

BACKGROUND: Help-seeking processes provide critical links between the onset of mental health problems and the provision of professional care. But little is known about these processes in the Arab world, and still less in transnational, comparative terms. This is the first study to compare help-seeking processes among Muslim Arab female students in Jordan, the United Arab Emirates and Israel. AIMS: The present study compares the attitudes of Arab Muslim female students from Israel, Jordan and the United Arab Emirates (UAE) towards mental health treatment. METHOD: A convenience sample of 262 female Muslim-Arab undergraduate university students from Jordan, United Arab Emirates (UAE) and Arab students in Israel completed a modified Orientation for Seeking Professional Help (OSPH) Questionnaire. RESULTS: Data revealed that nationality was not statistically significant as a variable in a positive attitude towards seeking professional help; year of study, marital status and age were found to be significant predictors of a positive attitude towards seeking help. High proportions of respondents among the nationalities referred to God through prayer during times of psychological distress. CONCLUSIONS: The discussion considers implications for professional service delivery and programme development. Future research could extrapolate findings to other Arab countries and to Arab peoples living in the non-Arab world.     

Alternative Modalities of Help Within Socio-Political and Ethnic Minorities: Self-Help Among Arabs Living in Israel

The present paper deals with alternative modalities of help within socio-political and ethnic minorities. It explores the phenomenon of self-help as one modality of help within the Arab population living in Israel. The analysis is based on four research studies, which incorporate the perspectives of lay people, professionals, self-help group members, and students in the helping professions, regarding definitional issues associated with the concept of self-help and attitudes toward such a modality of help. Findings obtained from the four studies reported here suggest that a natural fit exists between the Arab culture and such a helping modality as self-help organizations. Based on the findings, practical recommendations are outlined for use in the area of social work with socio-political and ethnic minorities.     

Cancer incidence among persons with fragile X syndrome in Finland: a population-based study

Background   Fragile X syndrome is a common inheritable cause of intellectual disability (ID) and is characterised by a large number of CGG repeats at the gene FMR1 located on the X-chromosome. It has been reported that this genetic mechanism may protect against malignant transformations.
Methods   We extracted from the Finnish registry on persons with ID a cohort of 302 persons with a fragile X diagnosis during 1982–1986. Follow-up for cancer incidence was performed in the Finnish Cancer Registry until the end of the year 2005.
Results   There were 11 reported cancers during the mean follow-up of 21.4 years per person. The expected number of cancers based on the average Finnish population was 13.8 and no statistically significant protective effect was detected [standardised incidence ratios (SIR) 0.80, confidence interval (CI) 95% 0.40–1.4]. An increased risk for lip cancer was found (SIR 23, CI 95% 2.8–85).
Conclusions   Confirmation of hypotheses about the mechanisms linking FXS and cancer needs further research.     

Birth order and narcolepsy risk among genetically susceptible individuals: a population-based case-control study

BackgroundBirth order may play a role in autoimmune diseases and early childhood infections, both factors implicated in the etiology of narcolepsy. We investigated the association between birth order and narcolepsy risk in a population-based case–control study in which all study subjects were HLA-DQB1*0602 positive.MethodsSubjects were 18–50 years old, residents of King County, Washington, and positive for HLA-DQB1*0602. Birth order was obtained from administered interviews. We used logistic regression to generate odds ratios adjusted for income and African American race.ResultsAnalyses included 67 cases (mean age 34.3 [SD = 9.1], 70.2% female) and 95 controls (mean age 35.1 [SD = 8.8], 58.1% female). Associations for birth order were as follows: first born (cases 38.8% vs. controls 50.2%, OR = 1.0; reference), second born (cases 29.9% vs. controls 32.9%, OR = 1.6; 95% CI 0.7, 3.7), and third born or higher (cases 31.3% vs. controls 16.8%, OR = 2.5; 95% CI 1.0, 6.0). A linear trend was significant (p < 0.05). Sibling number, sibling gender, having children, and number of children did not differ significantly between narcolepsy cases and controls.ConclusionsNarcolepsy risk was significantly associated with higher birth order in this population-based study of genetically susceptible individuals. This finding supports an environmental influence on narcolepsy risk through an autoimmune mechanism, early childhood infections, or both.     

Incidence rates of first-ever ischemic stroke subtypes among blacks: a population-based study

BACKGROUND AND PURPOSE: The aim of this study was to determine the incidence rates of ischemic stroke subtypes among blacks. METHODS: Hospitalized and autopsied cases of stroke and transient ischemic attack among the 187 000 blacks in the 5-county region of greater Cincinnati/northern Kentucky From January 1, 1993, through June 30, 1993, were identified. Incidence rates were age- and sex-adjusted to the 1990 US population. Subtype classification was performed after extensive review of all available imaging, laboratory data, clinical information, and past medical history. Case-control comparisons of risk factors were made with age-, race-, and sex-matched control subjects. RESULTS: Annual incidence rates per 100 000 for first-ever ischemic stroke subtypes among blacks were as follows: uncertain cause, 103 (95% confidence interval [CI], 80 to 126); cardioembolic, 56 (95% CI, 40 to 73); small-vessel infarct, 52 (95% CI, 36 to 68); large vessel, 17 (95% CI, 8 to 26); and other causes, 17 (95% CI, 9 to 26). Of the patients diagnosed with an infarct of uncertain cause, 31% underwent echocardiography, 45% underwent carotid ultrasound, and 48% had neither. Compared with age-, race-, and sex- (proportionally) matched control subjects from the greater Cincinnati/northern Kentucky region, the attributable risk of hypertension for all causes of first-ever ischemic stroke is 27% (95% CI, 7 to 43); for diabetes, 21% (95% CI, 11 to 29); and for coronary artery disease, 9% (95% CI, 2 to 16). For small-vessel ischemic stroke, the attributable risk of hypertension is 68% (95% CI, 31 to 85; odds ratio [OR], 5.0), and the attributable risk of diabetes is 30% (95% CI, 10 to 45; OR, 4.4). For cardioembolic stroke, the attributable risk of diabetes is 25% (95% CI, 4 to 41; OR, 3.1). CONCLUSIONS: Stroke of uncertain cause is the most common subtype of ischemic stroke among blacks. Cardioembolic stroke and small-vessel stroke are the most important, identifiable causes of first-ever ischemic stroke among blacks. The incidence rates of cardioembolic and large-vessel stroke are likely underestimated because noninvasive testing of the carotid arteries and echocardiography were not consistently obtained in stroke patients at the 18 regional hospitals. Most small-vessel strokes in blacks can be attributed to hypertension and diabetes.     

Depression among family caregivers of community-dwelling older people who used services under the Long Term Care Insurance program: a large-scale population-based study in Japan

Objective: To identify predictors for depression among family caregivers of community-dwelling older people under the Long Term Care Insurance (LTCI) program in Japan through a large-scale population-based survey.

Method: All 5938 older people with disabilities, using domiciliary services under the LTCI in the city of Toyama, and their family caregivers participated in this study. Caregiver depression was defined as scores of ≥16 on the Center for Epidemiological Studies Depression Scale (CES-D). Other caregiver measures included age, sex, hours spent caregiving, relationship to the care recipient, income adequacy, living arrangement, self-rated health, and work status. Care recipient measures included age, sex, level of functional disability, and severity of dementia. The data from 4128 pairs of the care recipients and their family caregivers were eligible for further analyses. A multiple logistic regression analysis was used to examine the predictors associated with being at risk of clinical depression (CES-D of ≥16).

Results: Overall, 34.2% of caregivers scored ≥16 on the CES-D. The independent predictors for depression by logistic regression analysis were six caregiver characteristics (female, income inadequacy, longer hours spent caregiving, worse subjective health, and co-residence with the care recipient) and one care-recipient characteristic (moderate dementia).

Conclusion: This is one of the first population-based examinations of caregivers of older people who are enrolled in a national service system that provides affordable access to services. The results highlighted the importance of monitoring caregivers who manifest the identified predictors to attenuate caregiver depression at the population level under the LTCI.     

Activity limitations among young adults with developmental disabilities: a population-based follow-up study

Developmental disabilities are a heterogeneous group of chronic conditions that may result in substantial activity limitations. The type and number of limitations may vary by impairment characteristics. Economic and social constraints may impact activity limitations beyond those attributable to their impairment. Using the International Classification of Functioning (ICF), Disability, and Health conceptual framework, this study tests the hypothesis that activity limitations in young adulthood are not inevitable consequences of childhood impairment. The Metropolitan Atlanta Developmental Disabilities Follow-up Study of Young Adults, a cohort of young adults ages 21-25, is used to examine the relationship between childhood impairment and activity limitations in young adulthood. For young adults with isolated impairment, activity limitations are not probable outcomes. This situation is not the case for those with severe intellectual disability and/or multiple impairments. The type and extent of activity limitations vary by impairment characteristics. With the goal of improving and preventing activity limitations in young adults with various types and severities of childhood impairment, additional research is needed to further identify areas for secondary and tertiary prevention of the consequences of childhood impairment. The conceptual framework of the ICF provides a useful tool for testing hypotheses to pinpoint areas of intervention.