Yael Benyamini
Tel Aviv University, Bob Shapell School of Social Work, Faculty Member
- I study how people think about their health and illness: My research is in Health Psychology with a main focus on sub... moreI study how people think about their health and illness: My research is in Health Psychology with a main focus on subjective perceptions of health and illness and their effects on coping with health threats and ultimately on the psychological and physical outcomes. Particular interests include women's health issues - particularly women's reproductive health (infertility, pregnancy and childbirth). I attained my master's degree in social psychology at the Hebrew University of Jerusalem and my PhD in health and social psychology at Rutgers University in New Jersey. I am currently a Professor at the Bob Shapell School of Social Work. I am a Fellow of the European Health Psychology Society.edit
OBJECTIVES Despite the well-documented negative effects of posttraumatic stress symptoms following childbirth (PTSS-FC), research on protective factors for PTSS-FC is still missing. Aiming to fill this gap, we proposed and examined a... more
OBJECTIVES Despite the well-documented negative effects of posttraumatic stress symptoms following childbirth (PTSS-FC), research on protective factors for PTSS-FC is still missing. Aiming to fill this gap, we proposed and examined a process model through which maternal-infant skin-to-skin contact after birth reduces PTSS-FC by decreasing negative emotions, especially for women who had operative births. METHOD In this longitudinal study, pregnant women (N = 1833) were recruited at community and hospital medical centres in the center of Israel and through internet forums. At Time 1, during pregnancy, they rated their prenatal depressive symptoms which served as an indicator for prenatal vulnerabilities. At Time 2, two-months postpartum (N = 1371, 75% of the sample), they reported their mode of birth, whether they had skin-to-skin contact with their newborn after birth, their emotions during birth, and rated their current PTSS-FC. A moderated mediation analysis was used to examine the proposed model. RESULTS Guilt and fear during birth mediated the association between mode of birth (instrumental or cesarean versus vaginal) and PTSS-FC. Skin-to-skin contact was related to reduced feelings of guilt and fear during birth, especially for women who had a cesarean section. CONCLUSIONS Our results recognize the specific emotions that contribute to the development of PTSS-FC following operative births and show how skin-to-skin contact can possibly reduce them. As such they emphasize the importance of the implementation of skin-to-skin contact following childbirth, and especially following a cesarean section as recommended by the Baby Friendly Health Initiative (World Health Organization & UNICEF, 2009).
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Abstract We present the concept of aintegration (not integrated, maintaining incongruence), defined as the human ability to bear cognitive/emotional complexity, manifested in the capability to maintain incongruence and live with... more
Abstract We present the concept of aintegration (not integrated, maintaining incongruence), defined as the human ability to bear cognitive/emotional complexity, manifested in the capability to maintain incongruence and live with inconsistencies, discontinuities, contradictions and paradox, and yet not experience strain or discomfort. After defining aintegration, we present aintegrative-related issues in major psychological areas such as personality, adult development and aging, social and clinical psychology, cognitive processes, and coping with trauma, emphasizing the necessity of aintegration conceptualizations in these theories. We also relate to relevant cognitive, philosophical, and cultural systems of thought. We then present the operationalization of aintegration using a script-type questionnaire [the Aintegration Questionnaire (AIQ)] and three studies that tested its reliability and validity in different contexts: Study 1 revealed that aintegration is higher with age, education, and among divorced/separated people and the non-religious. Study 2 showed that individuals high in aintegration are more likely to report positive life events and to view negative events as not solely negative. Study 3 showed that among adults in middle and old age, aintegration is related to fewer post-traumatic symptoms, even after controlling for the number of traumas. The AIQ showed high internal reliability and divergent validity from need for structure. The findings support the concept of aintegration and its theoretical contribution to adult development and the psychological sciences. Aintegration can serve as an umbrella construct to areas typically investigated separately. Our epilogue emphasizes possible future theoretical evolutions of our concept and further research. The validity of the AIQ measurement supports the importance of the ability to live with incongruence, contradictions and complexity and the potential for this concept to inform research on modern life.
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Background: In the modern world women’s perceptions of birth are shaped by culture, myths and abundant information. Although birth has been medicalized, women can take part in the decision-making process regarding how and where to birth.... more
Background: In the modern world women’s perceptions of birth are shaped by culture, myths and abundant information. Although birth has been medicalized, women can take part in the decision-making process regarding how and where to birth. The current study investigates how perceptions of birth relate to birth choices and mode of delivery. Method: 850 Israeli parturients were asked to fill in questionnaires measuring beliefs about birth as a medical or natural process, fear of birth (FoB) and planned birth choices. 6 weeks postpartum actual mode of delivery and birth satisfaction were assessed. Findings: Stronger beliefs about birth as a natural process were related to less FoB and more natural birth choices, such as homebirth and analgesia-free birth. Stronger beliefs about birth as a medical process were related to more FoB, more medical birth choices, such as use of epidural and more unplanned modes of delivery such as assisted vaginal delivery and emergency cesarean section. Discussion: Perceptions of birth are the basic building blocks that shape women’s birth choices. Understanding them could improve psychological and medical interventions and outcomes.
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BackgroundThe effectiveness and long‐term outcomes of spinal cord stimulation (SCS) are not fully established, especially considering that data from patients who withdrew from the trial are rarely analysed, which may lead to... more
BackgroundThe effectiveness and long‐term outcomes of spinal cord stimulation (SCS) are not fully established, especially considering that data from patients who withdrew from the trial are rarely analysed, which may lead to overestimation of SCS efficacy. We evaluated short‐ and long‐term effects of SCS on chronic pain and perceived health, beyond natural variability in these outcomes.MethodsIn a prospective design, 176 chronic pain patients referred to SCS were evaluated five times (baseline; retest ~6 weeks later; post‐SCS trial; 8 and 28 weeks post‐permanent implantation). Patients whose SCS trial failed (Temp group) were followed up and compared to those who underwent permanent SCS (Perm group).ResultsAnalyses revealed a non‐linear (U‐shaped) trend significantly different between the two groups. In the Perm group, a significant improvement occurred post‐SCS implantation in pain severity, pain interference, health‐related quality of life and self‐rated health, which was followed by gradual worsening and return to baseline values at end of follow‐up. In the Temp group, only minor changes occurred in these outcomes over time. On average, baseline and end of follow‐up values in the Perm and Temp groups were similar: ~40% in each group exhibited an increase in pain severity over time and 38% and 33%, respectively, exhibited reductions in pain severity over time.ConclusionsSince the greatest improvement in the outcome measures occurred from baseline to post‐SCS trial (T1–T3) followed by a gradual decline in the effect, it appears that SCS may not be effective for the majority of chronic pain patients.SignificanceThis longitudinal study evaluated short and long term effects of spinal cord stimulation (SCS) on chronic pain outcome measures, beyond their natural variation in time. Despite significant short term improvements, by the end of the seven months' follow‐up, the outcomes in the treatment group (people who received the permanent implantation) were similar to those of the control group (people whose SCS trial failed and did not continue to permanent implantation) suggesting SCS may not be cost‐effective for chronic pain patients.
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Background: To assess changes in pain levels, self-rated health (SRH) and identity of a pain patient in adults with chronic pain from referral to implantation of a spinal cord stimulation (SCS) device to ~6 weeks following implantation.... more
Background: To assess changes in pain levels, self-rated health (SRH) and identity of a pain patient in adults with chronic pain from referral to implantation of a spinal cord stimulation (SCS) device to ~6 weeks following implantation. Methods: Patients with chronic pain (N=148) filled in questionnaires at referral to SCS (T1) and ~8 months later (T2; n=119), including ratings of pain and general health (SRH), acceptance of pain (indicating identification with being a pain patient), and the IPQ-R. Findings: 20% did not undergo SCS (no SCS=nSCS), 29% underwent only temporary implantation of a SCS device and discontinued ("disappointed"=dSCS), and 51% continued to permanent SCS (pSCS). Repeated measures ANOVA showed that pain levels significantly decreased in the dSCS and much more so in the pSCS but remained the same in the nSCS. SRH and pain perceptions improved only for the pSCS whereas stronger pain identity was reported only by the dSCS. Discussion: Continuous use of SCS relieves pain and leads to improved SRH yet pain still dominates these patients' lives and thoughts. Failing treatment leads to even stronger pain identity and intrusion, despite some improvement in pain level.
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The present study examined the relationship between risk experience and risk perceptions in relation to the target (risk to the self vs. others) and for two different types of risk: acute risks (i.e., terrorist attacks) and cumulative... more
The present study examined the relationship between risk experience and risk perceptions in relation to the target (risk to the self vs. others) and for two different types of risk: acute risks (i.e., terrorist attacks) and cumulative health risks (i.e., alcohol consumption, tobacco consumption, and unhealthy eating) in two countries (Israel and Germany). An online survey (N = 571) was conducted to assess participants’ previous personal experience with acute and cumulative risks and their personal and general risk perceptions. The results showed that personal experience with terrorism was related to increased personal and general risk perceptions, while personal experience with cumulative health risks was related to increased personal but not general risk perceptions. It is argued that an increase in risk perception with more risk experience can be explained by the amount of available information about people's personal as well as other people's risk status. The findings emphasize that the experience–risk perception relationship depends on the target of the risk and the type of risk experience.
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Background: A single self-rated health (SRH) assessment is associated with clinical outcome and mortality, but the biological process linking SRH with immune status remains incompletely understood. Objectives: To examine the association... more
Background: A single self-rated health (SRH) assessment is associated with clinical outcome and mortality, but the biological process linking SRH with immune status remains incompletely understood. Objectives: To examine the association between SRH and inflammation in apparently healthy individuals. Methods: Our analysis included 13,773 apparently healthy individuals attending the Tel Aviv Sourasky Medical Center for periodic health examinations. Estimated marginal means of the inflammation-sensitive biomarkers [i.e., highly sensitive C-reactive protein (hs-CRP) and fibrinogen] for the different SRH groups were calculated and adjusted for multiple potential confounders including risk factors, health behavior, socioeconomic status, and coexistent depression. Results: The group with the lowest SRH had a significantly higher atherothrombotic profile and significantly higher conentrations of all inflammation-sensitive biomarkers in both genders. Hs-CRP was found to differ significantly between SRH groups in both genders even after gradual adjustments for all potential confounders. Fibrinogen differs significantly according to SRH in males only, with low absolute value differences. Conclusions: A valid association exists for apparently healthy individuals of both genders between inflammation-sensitive biomarker levels and SRH categories, especially when comparing levels of hs-CRP. Our findings underscore the importance of assessing SRH and treating it like other markers of poor health.
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Aims: This symposium set out to a) investigate the development of physical activity and well-being after transition into retirement and b) to reveal age-related factors associated with decreases or increases in activity and well-being. It... more
Aims: This symposium set out to a) investigate the development of physical activity and well-being after transition into retirement and b) to reveal age-related factors associated with decreases or increases in activity and well-being. It further aims to c) investigate active ageing from different perspectives (older adults, exercise programme providers), with different methodologies (quantitative, qualitative, meta-synthetic) and new concepts (effect of vacation) and d) to suggest innovative approaches for health promotion programmes. Rationale: The potential for promoting active ageing and maintained well-being in older adults is often underestimated. The specific needs of this population differ from younger adults, but are not yet well understood. In line with this year’s conference topic "Behaviour change: Making an impact on health and health services" this symposium extracts risk factors and resources for active and successful ageing. All five presentations contribute innovative and age-specific factors associated with active ageing and provide suggestions for activities and services tailored to the specific needs of adults aged 65+. Summary: Lisa Warner investigates trajectories of physical activity after transitions to retirement and possible influencing factors. Angela Devereux-Fitzgerald presents her insights on older adults’ acceptability of physical activity from interviews with older adults with lower socio-economic status as well as exercise programme providers. In her meta-synthesis, Laura McGowan examines older adults’ views and perspectives on being physically active across different qualitative studies. Marlene Melon is interested in the effect of vacations on older adults’ well-being and presents a number of different vacation characteristics as well as vacation activities that predict well-being. Ewa Gruszczynska examines trajectories of well-being after transition to retirement and whether these are related to meaning in life. Yael Benyamini will discuss these findings and suggest future directions for research and for the promotion of an active ageing process with maintained well-being.
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ABSTRACT Health promotion has been expanding to include potential effects of the spouse. A randomised controlled trial examined effects of involving husbands in a self-regulation programme designed to increase wives' performance... more
ABSTRACT Health promotion has been expanding to include potential effects of the spouse. A randomised controlled trial examined effects of involving husbands in a self-regulation programme designed to increase wives' performance of a health behaviour (breast self-examination, BSE). Participants were 140 couples (women ages 24-55). At baseline, women received questionnaires, information about breast cancer and BSE, and instructions to form an action plan for BSE performance. For half the women, the instructions called for involving the husband. Three months later, all women and husbands filled in follow-up questionnaires. The programme was very effective in increasing BSE in both groups. The husband involvement intervention contributed to this increase only among husbands who reported encouraging their wives. Involving husbands in the programme also resulted in their greater knowledge of their wives' BSE performance and encouragement of wives' BSE performance, according to their own and their wives' reports. The greatest changes in women's behaviour were apparent among women who at baseline rated their husbands as not involved in issues related to their health. The findings suggest that involving spouses in health promotion interventions affects their knowledge and behaviour but may need to be tailored to the characteristics of the couple's coping with health matters.
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PurposeInfertility could be highly stressful, particularly in a pronatalist culture. We aimed to develop the concept and a measure of normalization (maintaining normal life routines and feeling “normal”) as a strategy that could enable... more
PurposeInfertility could be highly stressful, particularly in a pronatalist culture. We aimed to develop the concept and a measure of normalization (maintaining normal life routines and feeling “normal”) as a strategy that could enable women with infertility maintain their quality of life (QoL) while coping with this condition. We tested its associations with women’s well-being, distress and QoL in Israel, where being childless is socially unacceptable and highly stigmatized.MethodsOne-hundred and eighty Israeli women undergoing infertility treatment at a fertility community clinic filled in questionnaires assessing normalization-related coping strategies, QoL, and psychological adjustment (distress, wellbeing). Eight months later, 55 women conceived; 55 women who had not conceived completed a second questionnaire.ResultsAt baseline, normalization was related to higher QoL and better adjustment. Structural equation modeling showed that QoL was impaired mainly among women who felt different than others, compared, and blamed themselves. Over time, normalization was overall unrelated to conception or to changes in adjustment yet was protective against decrease in well-being among women who already had a child.ConclusionsInfertility is highly stressful in a pronatalist culture like Israel. It requires treatment yet is not disabling. Patients who manage to maintain normal routines and not feel different than other people their age may experience better QoL and psychological adjustment.
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... To locate additional studies, we searched Medline using the terms self-rated health,self-rating/s of health, self-assessment/s of health, self-assessed health, self-evaluated health, perception/s of health, perceived health,... more
... To locate additional studies, we searched Medline using the terms self-rated health,self-rating/s of health, self-assessment/s of health, self-assessed health, self-evaluated health, perception/s of health, perceived health, self-evaluation/s of health, subjective assessment/s ...
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Background Fertility treatment discontinuation is difficult as it entails accepting childlessness. In most countries, financial limitations provide sufficient justification to terminate treatment. In Israel, unlimited funding enables... more
Background Fertility treatment discontinuation is difficult as it entails accepting childlessness. In most countries, financial limitations provide sufficient justification to terminate treatment. In Israel, unlimited funding enables women to undergo multiple treatment cycles, even when the odds of success are poor, thus providing a context for studying the psychological mechanisms involved when financial constraints are set aside. The study aimed to investigate the contribution of unrealistic optimism to Israeli women’s willingness to continue fertility treatments even after repeated failures and to their psychological adjustment, comparing age groups. Methods A longitudinal study of 100 women (ages 31–45) undergoing in vitro fertilization (IVF) treatment (1–22 previous cycles), who filled in questionnaires assessing their estimates of treatment success (theirs/for same-age patient), estimates received from the physician, intentions to continue treatment, and psychological adjustment. Follow-up was conducted 17(± 4) months later, by phone ( n = 71) and/or medical records ( n = 90). Results Most women (57%) reported that they will continue as long as needed till they have a child, 13% did not know, and 25% mentioned a specific plan; 5 did not reply. Women’s estimates of treatment success showed vast unrealistic optimism, which was unrelated to their age, history of unsuccessful treatment cycles, or intentions for treatment continuation, yet was related to better psychological adjustment. At follow-up, almost all women who did not conceive were found to have continued treatments. Conclusions Unrealistic optimism helps women maintain hope and well-being along the demanding journey to (biological) parenthood, where childlessness is highly stigmatized, and contributes to perseverance in treatment, regardless of objective factors.
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Background: We aimed to develop the concept and a measure of normalization (maintaining normal routine and feeling 'normal') in the context of a long-lasting medical condition and investigate infertility patients' efforts to... more
Background: We aimed to develop the concept and a measure of normalization (maintaining normal routine and feeling 'normal') in the context of a long-lasting medical condition and investigate infertility patients' efforts to achieve normalization and their associations with quality of life (QoL). Methods: At the clinic, 180 women undergoing infertility treatment filled in questionnaires assessing normalization-related coping strategies, QoL, and psychological adjustment (distress, wellbeing). Eight months later, 55 women conceived; 55 women who had not conceived completed a second questionnaire. Findings: At baseline, normalization was related to higher QoL and better adjustment. Structural equations modeling showed that QoL was impaired mainly among women who felt different than others, compared and blamed themselves. Over time, normalization was overall unrelated to conception or to changes in adjustment yet was protective against increases in distress among women who already had a child. Discussion: Infertility is highly stressful in a pronatal culture like Israel. It requires treatment yet is not disabling. Patients who manage to maintain normal routines and not feel different than other people their age may experience better QoL and psychological adjustment.
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Background: Perceptions of control play a major role in many health psychology theories. Their definitions and methods of assessment greatly vary. Our aim was to test a multidimensional conceptualization of perceived control, adapted to... more
Background: Perceptions of control play a major role in many health psychology theories. Their definitions and methods of assessment greatly vary. Our aim was to test a multidimensional conceptualization of perceived control, adapted to the context of childbirth. We developed a model and an instrument based on Walker's (2001) unifying theory of control (including self and medical staff control), combined with anticipated and desired control of each type. Methods: Pregnant women (N=850) filled in questionnaires including: Perceptions of self- control over the process of childbirth and over the staff and the surroundings and perceptions of staff control over childbirth (each set repeated twice, for anticipated and desired control); their intentions regarding a variety of natural choices during childbirth; and fear of birth. We conducted factor analyses and regression models (using PROCESS for interactions). Findings: Greater desired and anticipated staff control, less desired and ...
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INTRODUCTION The COVID-19 pandemic posed unique challenges to medical teams in general and in the field of obstetrics in particular, where the provision of medical services could not be postponed. Optimal care during the COVID-19 outburst... more
INTRODUCTION The COVID-19 pandemic posed unique challenges to medical teams in general and in the field of obstetrics in particular, where the provision of medical services could not be postponed. Optimal care during the COVID-19 outburst required rapid adjustment to changes, ensuring staff and patients' safety while maintaining close and direct contact with patients. OBJECTIVES To explore obstetricians' experiences during the first outburst, focusing on their challenges, needs and ways of coping. METHODS Semi-structured in-depth interviews were conducted online with 13 senior physicians and residents (7 women, 6 men) from four hospitals, who worked in obstetrics. The interviews were analyzed using the Immersion/Crystallization method developed in medicine focused on their experiences. RESULTS The findings revealed that alongside the impressive mobilization of the teams during this period, physicians encountered various challenges. These included being overwhelmed with the e...
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Background: The uncertainty and lack of control involved in high-risk pregnancy (HRP) expose women to stressors beyond those experienced in low-risk pregnancies. Hence, their psychological adjustment is expected to be lower compared to... more
Background: The uncertainty and lack of control involved in high-risk pregnancy (HRP) expose women to stressors beyond those experienced in low-risk pregnancies. Hence, their psychological adjustment is expected to be lower compared to low-risk pregnancies. Dispositional optimism is known to be related to better outcomes in health risk settings. According to Carver and Scheier's theory of self-regulation, this association should be partially mediated by situated optimism, yet existing research is equivocal. Methods: Pregnant women were recruited at women's health centers and pre-natal classes (high-risk n=228; low-risk n=160). All participants filled in measures of distress and well-being; HRP also rated optimism, maternal-fetal attachment, perceived uncertainty, treatment control and personal controllability. Findings: Psychological adjustment was lower among women in HRP (ts>2, ps<.05). Dispositional optimism, lower perceived uncertainty regarding the pregnancy, trea...
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Aim: This symposium aims to promote research on women’s unique health psychology issues. We will present a variety of pregnancy and birth-related matters women deal with, highlight the social paradigms that affect them and stress the... more
Aim: This symposium aims to promote research on women’s unique health psychology issues. We will present a variety of pregnancy and birth-related matters women deal with, highlight the social paradigms that affect them and stress the importance of identifying populations at risk of health disparities. Rationale: Reproductive health matters concern women across the globe, though often choices on these issues are limited. Women’s subjective experience of these matters, their perceptions, ways of coping and decision-making processes, could affect their physical and emotional health in the short and long term. Therefore, it is imperative to study and share knowledge on these subjects. In addition, not all women are alike and it is important to recognize how reproductive issues play-out among women in different life circumstances. Summary: Issues of conception, pregnancy termination and childbirth are experienced very differently by women from diverse social groups and under changing cir...
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IntroductionVarious biopsychosocial factors affect women's preferences with respect to mode of birth, but they are usually not examined simultaneously and prospectively. In the current study, we assessed the contribution of personal... more
IntroductionVarious biopsychosocial factors affect women's preferences with respect to mode of birth, but they are usually not examined simultaneously and prospectively. In the current study, we assessed the contribution of personal characteristics of first‐time mothers, their prior prenatal perceptions, events during birth, and subjective birth experiences, on their preference about mode of second birth.MethodsThis was a secondary analysis of two prospective birth cohort studies. Participants included 832 primiparous women recruited mostly from women's health centers in Israel, and through natural birth communities and cesarean birth websites. Women completed questionnaires prenatally and were followed up at 6‐8 weeks postpartum to understand their preferences for a second birth.ResultsRegression models indicated that after vaginal first birth, being less religious, believing that birth is a medical process, and having a negative experience increased the odds of preferring ...
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Childbirth is a pivotal event for many women, and evidence suggests that women possess strong expectations regarding this experience. In a longitudinal study of 330 Israeli first-time mothers, we distinguished between physical, emotional,... more
Childbirth is a pivotal event for many women, and evidence suggests that women possess strong expectations regarding this experience. In a longitudinal study of 330 Israeli first-time mothers, we distinguished between physical, emotional, and cognitive factors and used them to assess the underlying mechanism of satisfaction, based on theoretical frameworks of stress and control. Women completed questionnaires during pregnancy and two months postpartum. The negative association between a more medicalized birth and birth satisfaction was partially mediated by perceived control. In turn, specific emotions mediated the association between perceived control and satisfaction: Greater perceived control over the birth environment predicted more positive emotions, less fear, and better perceived care; while greater perceived control over the birth process predicted more positive emotions, less fear, and less guilt. Greater incongruence between the planned and actual birth experience predicte...
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Religious coping has been found to help people in stressful situations. It takes place within a specific cultural religious/context yet its measurement has not always been adapted to the context of the study population. The aim of this... more
Religious coping has been found to help people in stressful situations. It takes place within a specific cultural religious/context yet its measurement has not always been adapted to the context of the study population. The aim of this study was to develop an instrument to measure religious coping among religious Jews—a population that has received little research attention—and assess the associations of religious coping strategies with emotional adjustment. The study was based on quantitative data gathered from 332 religious Jewish women, who were coping with stress. The findings support the utilization of three religious coping strategies by the participants: Seeking the Support of God, Seeking the Support of Rabbis, and Seeking the Support of the Community, which were found to be directly correlated with better emotional adjustment. This instrument can assist in evaluating and understanding religious coping with stressful situations and in culturally adapting psychosocial interve...