Yael Benyamini | Tel Aviv University (original) (raw)

Papers by Yael Benyamini

Journal of Psychosomatic Research, Mar 1, 2022

OBJECTIVES Despite the well-documented negative effects of posttraumatic stress symptoms followin... 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).

Infant mental health journal, Aug 6, 2018

Recollections of own maternal care measured by parental bonding were found to be important in the... more Recollections of own maternal care measured by parental bonding were found to be important in the pregnant woman's construction of herself as a mother. Although these recollections were studied with regard to various variables, there is a dearth of studies associated with pregnancy and childbirth. In this cross-sectional study, 341 pregnant women were recruited. Measures included a Sociodemographics-Obstetric History Questionnaire; the Childbirth Choices Questionnaire (H. Preis, M. Gozlan, U. Dan, & Y. Benyamini, 2018); the Parental Bonding Instrument (G. Parker, H. Tupling, & L.B. Brown, 1979); a question regarding the planned presence of the woman's mother at delivery; and the Maternal-Fetal Attachment Scale (M.S. Cranley, 1981). Parental recollections of Care were associated with fewer natural birth choices (hence, a more "medicalized" delivery), lower maternalfetal attachment, and a wish for the mother's mother to be present at the birth. Parental recollections of Encouragement of Behavioral Freedom in childhood were associated with more natural choices regarding childbirth. In addition, women with higher scores on the parental bonding Denial of Autonomy factor reported stronger maternal-fetal attachment. Thus, early recollections of experiences with caregivers as manifested in parental bonding may be a possible influence on the transition to motherhood, and working through possible difficulties associated with these recollections may improve adjustment to motherhood.

Journal of Crohn's and Colitis, Jan 26, 2017

to good for nocturnal diarrhea and bloody stools in UC. Agreement on GWB was low to very low. P-r... more to good for nocturnal diarrhea and bloody stools in UC. Agreement on GWB was low to very low. P-reported GWB were well correlated with IBDQ (CD: r=0.65, UC: r=0.67), SF-36 physical (PCS) (CD: r=0.52, UC: r=0.58) an SF-36 mental (MCS) component scores (CD: r=0.47, UC: r=0.46). Correlation of PCS resp. IBQD with HCPreported CD-GBW was moderate at t <1 and 2-3 months (r=−0.45 and −0.53, resp. −0.43 and −0.48), but correlation with MCS remained low (r<0.40) whatever t. For UC, HCP-reported GBW moderately correlated with IBDQ at t<1 and 1-2 months (r=−0.48 and −0.47), but was low when t >2. Correlation with PCS and MCS remained low whatever t. Conclusions: The agreement was low for many scores' items, except two per disease. Among scores' items with high weight, eg CDAI AT or GWB, agreement was surprisingly low. P-GWB correlated with HRQoL scores better than HCP, especially for scores related to mental or emotional aspects.

BMC Pregnancy and Childbirth, Sep 5, 2018

Background: Fear of childbirth (FOC) could have significant impact on women's childbearing choice... more Background: Fear of childbirth (FOC) could have significant impact on women's childbearing choices and experience. Culture affects the way women conceptualize childbirth, influencing the fears and expectations they may hold in relation to it. In the current study, we examined differences in childbirth preferences of cesarean section and use of epidural analgesia between Norwegian and Israeli pregnant women. Later, we used the Norwegian six-factor solution of the widely-used Wijma Delivery Expectancy Questionnaire (W-DEQ-A) to compare levels of the different FOC factors. Finally, we investigated differences in the associations between FOC and childbirth preferences between the two countries. Methods: Secondary analysis of two large surveys. Women from Israel (n = 490) and Norway (n = 2918) were recruited during prenatal checkups in community clinics and a university hospital. At around 32 weeks of gestation, all participants filled out questionnaires, including the W-DEQ-A. Statistical analysis included exploratory factor analysis, confirmatory factor analysis, M/ANOVA, Spearman's Rho and Fisher's Z tests for the significance of the difference between independent correlations. Results: The Norwegian six-factor solution of the W-DEQ fit well with the Israeli data. Norwegian women were more concerned about loneliness, feeling less self-efficacy, negatively appraising birth, and lacking positive anticipation. Israeli women were more concerned about negative outcomes for the child and experienced greater general fear and fear of pain. Norwegian women preferred more cesarean sections compared to Israeli women, who preferred more epidural use than Norwegians. FOC factors were more strongly related to childbirth preferences among Norwegians. Conclusions: Cultural differences between Israel and Norway are reflected by the differences seen in the levels of fear reported across the six factors. In Israel, birth culture is very medicalized, motherhood is highly revered, and there is an emphasis on having "perfect babies". In contrast, Norwegian women have fewer children, and birth is considered more natural. This could explain why Israeli women were more concerned that their child might be harmed during birth, while Norwegian women were more concerned with the physical and emotional expectations of birth.

Journal of Adult Development, Oct 23, 2015

Abstract We present the concept of aintegration (not integrated, maintaining incongruence), defin... 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.

The European health psychologist, Dec 31, 2015

Background: In the modern world women’s perceptions of birth are shaped by culture, myths and abu... 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.

Journal of Psychosomatic Research, Jun 1, 2014

European Journal of Pain, Jul 7, 2022

BackgroundThe effectiveness and long‐term outcomes of spinal cord stimulation (SCS) are not fully... 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.

Women and Birth, Oct 1, 2017

Rates of medical interventions in childbirth have greatly increased in the Western world. Backgro... more Rates of medical interventions in childbirth have greatly increased in the Western world. Background: Women's attitudes affect their birth choices. Aim: To assess women's attitudes towards the medicalization of childbirth and their associations with women's background as well as their fear of birth and planned and unplanned modes of birth. Methods: This longitudinal observational study included 836 parous woman recruited at women's health centres and natural birth communities in Israel. All women filled in questionnaires about attitudes towards the medicalization of childbirth, fear of birth, and planned birth choices. Women at <28 weeks gestation when filling in the questionnaire were asked to fill in a second one at 34weeks.Phonefollowupwasconducted34 weeks. Phone followup was conducted 34weeks.Phonefollowupwasconducted6 weeks postpartum to assess actual mode of birth. Findings: Attitudes towards medicalization were more positive among younger and less educated women, those who emigrated from the former Soviet Union, and those with a more complicated obstetric background. Baseline attitudes did not differ by parity yet became less positive throughout pregnancy only for primiparae. More positive attitudes were related to greater fear of birth. The attitudes were significantly associated with planned birth choices and predicted emergency caesareans and instrumental births. Discussion: Women form attitudes towards the medicalization of childbirth which may still be open to change during the first pregnancy. More favourable attitudes are related to more medical modes of birth, planned and unplanned. Conclusion: Understanding women's views of childbirth medicalization may be key to understanding their choices and how they affect labour and birth.

Journal of Family Issues, Jun 17, 2020

Little is known about the psychological processes of pregnant women in different family structure... more Little is known about the psychological processes of pregnant women in different family structures. Aiming to fill this gap, the present study examined the prenatal maternal expectations (common cultural beliefs about what women can expect during the transition to motherhood) of women from lesbian (n = 51), single (n = 57), and heterosexual (n = 893) parented families. The results suggest that maternal expectations differ by family structure. While single women reported relatively high levels of natural-fulfillment maternal expectations, women from lesbian parented families reported relatively low levels of these expectations. Single women reported the highest levels of sacrifice (a belief that parenting requires significant sacrifices from the self) and infant-reflects-mothering maternal expectations (a belief that the infant's behavior reflects one's maternal skills). These differences may reflect the different social pressures and personal challenges each group encounters in the process of deciding to become a mother and implementing the decision.

The European health psychologist, Dec 1, 2014

Background: To assess changes in pain levels, self-rated health (SRH) and identity of a pain pati... 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.

Family Practice, Oct 28, 2017

Purpose. Patients with coronary heart disease (CHD) experience reduced quality of life which may ... more Purpose. Patients with coronary heart disease (CHD) experience reduced quality of life which may be associated with mortality in the longer term. This study explores whether patient-rated physical and mental health status was associated with mortality at 6-year follow-up among patients with CHD attending primary care in Ireland and Northern Ireland. Methods. This study is a secondary data analysis of patients with CHD recruited to a cluster randomized controlled trial from 2004 to 2010. Data collected included patient-rated physical component summary (PCS) and mental component summary (MCS) scores of health status (from the 12-Item Short-Form Health Survey (SF-12)), demographics and clinical parameters at baseline, and all-cause mortality at 6-year follow-up. Multivariate regression was conducted using generalized estimating equations (GEE) with a log-link function. Results are presented as odds ratios (ORs) and 95% confidence intervals (CIs). Results. The study consisted of 762 individuals with mean age 67.6 years [standard deviation (SD): 9.8], and was 29% female. Mean baseline SF-12 mental (MCS) and physical (PCS) component scores were 50.0 (SD: 10.8) and 39.6 (SD: 11.2), respectively. At 6-year follow-up, the adjusted OR for the baseline MCS for mortality was 0.97 (95% CI: 0.95-0.99) and for the PCS 0.97 (95% CI: 0.95-0.99). For every five-point increase in MCS and PCS scores, there was a 14% reduction in the likelihood of all-cause mortality. Conclusions. Overall, the magnitude of effect for both mental health status and physical health status was similar; higher scores were significantly associated with a lower risk of mortality at 6-year follow-up.

Risk Analysis, Aug 17, 2021

The present study examined the relationship between risk experience and risk perceptions in relat... 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.

Cambridge University Press eBooks, 2001

Birth-issues in Perinatal Care, Sep 15, 2017

Background: Women perceive what birth is even before they are pregnant for the first time. Part o... more Background: Women perceive what birth is even before they are pregnant for the first time. Part of this conceptualization is the basic belief about birth as a medical and natural process. These two separate beliefs are pivotal in the decision-making process about labor and birth. Adapting Engel's biopsychosocial framework, we explored the importance of a wide range of factors which may contribute to these beliefs among first-time mothers. Method: This observational study included 413 primiparae ≥24 weeks' gestation, recruited in medical centers and in natural birth communities in Israel. The women completed a questionnaire which included the Birth Beliefs Scale and a variety of biopsychosocial characteristics such as obstetric history, birth environment, optimism, health-related anxiety, and maternal expectations. Results: Psychological dispositions were more related to the birth beliefs than the social or biomedical factors. Sociodemographic characteristics and birth environment were only marginally related to the birth beliefs. The basic belief that birth is a natural process was positively related to optimism and to conceiving spontaneously. Beliefs that birth is a medical process were related to pessimism, health-related anxiety, and to expectations that an infant's behavior reflects mothering. Expectations about motherhood as being naturally fulfilling were positively related to both beliefs. Conclusion: Psychological factors seem to be most influential in the conceptualization of the beliefs. It is important to recognize how women interpret the messages they receive about birth which, together with their obstetric experience, shape their beliefs. Future studies are recommended to understand the evolution of these beliefs, especially within diverse cultures.

PubMed, Apr 1, 2015

Background: A single self-rated health (SRH) assessment is associated with clinical outcome and m... 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.

Midwifery, Aug 1, 2018

Objective: Perceptions about the nature of the birth process are important in determining women's... more Objective: Perceptions about the nature of the birth process are important in determining women's birth choices regarding labour and delivery but are scarcely the subject of empirical research. The aim of the current study was to assess women's beliefs about birth as a natural and safe or medical and risky process and study the associations of these beliefs with fear of childbirth and planned birth choices. Design: An observational study using self-administered questionnaires during pregnancy. Setting: 1. Community women's health centres in a metropolitan area in Israel; 2. Purposeful sampling of women who plan to birth naturally, through home midwives and targeted internet forums. Participants: 746 women with a singleton pregnancy in their second and third trimester. Measurements: Beliefs about birth as a natural and a medical process, fear of childbirth, and a range of natural birth choices. Findings: The birth beliefs were associated with women's birth intentions. The more women believed birth to be natural and the less they believed it to be medical, the more likely they were to make more natural birth-related choices. In the presence of the birth beliefs, fear of childbirth no longer had an independent association with birth choices. The beliefs interacted with each other, revealing a stronger association of viewing birth as natural with planning more natural choices among women who did not view birth as very medical. Key conclusion: It is important to recognize women's beliefs about birth and how they may affect their fear of childbirth and birth intentions. Further studies on the origin of such beliefs and their development are needed. Implications for practice: Women should be allowed to choose how they would like to birth in accordance with their beliefs. At the same time, strengthening women's belief in the natural birth process and their body's ability to perform it, could help lower fear of childbirth and medical intervention rates.

Evidence-Based Nursing, May 11, 2023

The European health psychologist, Dec 31, 2016

Aims: This symposium set out to a) investigate the development of physical activity and well-bein... 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.

Midwifery, 2021

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.