Activity engagement and psychological distress among Holocaust survivors during the COVID-19 pandemic

Abstract

Objectives: The COVID-19 pandemic may pose a specific threat for Holocaust survivors, as such threats may be linked with increased psychological distress. Moreover, research has demonstrated that engaging in planful problem-solving activities is associated with reduced distress. Accordingly, we aimed to examine the link between engaging in activities during COVID-19 and psychological distress among Holocaust survivors with varying levels of post-traumatic symptoms (PTS) and comparisons (not directly exposed to the Holocaust). Design: A cross-sectional design composed of Holocaust survivors and a comparison group. Setting: Participants were interviewed face-to-face, over the telephone, or filled the scales online at their leisure. Participants: Data were collected from 131 older Jewish Israelis (age range 76–94, M = 82.73, SD = 4.09), who were divided into three groups (comparisons; low-PTS survivors; high-PTS survivors). Measurements: Participants completed scales assessing PTS, activity engagement, and psychological distress and provided additional sociodemographic, medical, and COVID-19-related information. Results: When activity engagement was low, high-PTS survivors reported extremely high levels of psychological distress relative to low-PTS survivors and comparisons. However, when activity engagement was high, these group differences were considerably reduced, as the psychological distress of high-PTS survivors was significantly lower. Conclusions: The study highlights the importance of daily planning and activity engagement for Holocaust survivors with high PTS levels in reducing psychological distress. Clinicians are urged to take this factor into account when dealing with the psychological effects of COVID-19 on survivors and on traumatized older adults in general.

Psychological reactions to the coronavirus pandemic: a comparative study of Holocaust survivors and other older adults in Israel

“…In other words, despite their relative vulnerability due to past trauma, a lower level of education and self-perceived health, the HS in our study demonstrated similar resilience to that of other older adults while coping with the unexpected threatening and long-lasting event of the COVID-19 pandemic. Although assessed differently, the coexistence of both vulnerability and resilience has been reported in previous studies conducted in Israel (e.g., [18,27]), probably because the HS that are still alive have developed specific psycho-behavioral coping patterns such as daily planning and activity engagement which was reported to reduce psychological distress during the Coronavirus pandemic even among HS with high PTSD levels [37], and may explain to some degree the ability of HS to reach old age in spite of their traumatic pasts.…”

“…This may require developing additional professional practices and outreaching interventions directed to appropriately locating and addressing mental, physical and social needs. For instance, interventions to strengthen daily planning and activity engagement have been reported to reduce psychological distress during the Corona pandemic even among HS with high PTSD levels [37]. Additionally, intervention programs should include practices for maintaining and strengthening existing psychosocial protective resources such as the will to live.…”