Our lab is dealing with a variety of research topics, all related to life changing events. Below are examples of research topics for which we had published.
Prolonged Disorder of Consciousness (DOC). Loss of consciousness is a key feature associated with severe brain injury. While most patients regain consciousness completely, others may continue to exhibit a prolonged DOC. Patients with DOC are physically present but lack conscious awareness, resulting in psychological absence. Caregivers’ persistent state of caring for a loved one who’s neither fully dead nor fully alive, which accords with Ambiguous Loss, has become a subject of literary interest. However, while most studies concerned caregivers` burden and emotional outcome, we aimed at operationalizing their experience of psychological/emotional limbo.
In one study, we compared the grief responses among family members of individuals suffering DOC, to that of bereaved following death. Enhanced by their state of ambiguity, the results (as measured by the Two-Track Model of Bereavement), showed that their grief is just as high and intense as in the aftermath of death, a finding that is disturbing given that their loved one`s condition can remain stagnant for years (Yehene, Zaksh, et al., 2019). A subsequent research showed that grief response is largely affected by an anxious attachment style, and degree of familial relatedness (Yehene, Zaksh, et al., 2020), leading to continuous attempts to restore the lost relationship with someone who is physically present but psychologically absent. As a derivative of this project, we also mapped the different caregivers` typology with respect to their grief, optimism, and hope for recovery (Yehene, Neeman, et al., 2022). We showed that even after five years, both groups, regardless of their hope for patient recovery, continued to reject palliative care.
Acquired Brain injury (ABI) in Adults.
People with moderate to severe acquired brain injuries can experience dramatic changes in their cognitive functioning, behavior and personality. Life partners who are also primary caregivers must adapt to a newfound caregiving role, as well as to the loss of the “old” partner they once had, which adversely impacts their dire reality post-injury. Currently, we have completed collecting data for a project addressing spousal caregiving after a partner`s brain injury.
Male perspectives on psychological adaptation to adversity are underrepresented in most studies. Despite similarities in the experienced emotions between man and women, man mourn in more ‘instrumental’ ways, leading them to display fewer outward symptoms of distress and evaluate their experiences cognitively rather than emotionally (Doka & Martin, 2014; Scourfield & Evans, 2015). As a result of socialization processes, man tend to expresses grief through anger or somatic expressions, uses problem-solving activities rather than expressing their emotions, and values solitude and self-reliance to cope with loss (Baum, 2003; Doka & Martin, 2014; Ridge et al., 2011). Consequently, their grief often goes unnoticed (Doka, 1989), making its study rather important.
Recently, we published a paper on soldiers’ experiences of military bereavement following the loss of a comrade (Yehene & Eitam, 2022), showing how their grief experiences are socially under-recognized. In another complementary paper (Yehene, Martin, & Goldzweig, 2022) where we quantitatively validated how male-role norms, social acknowledgement and military dis-encouragement to grieve, perpetuate traumatic-stress and grief, both together and independently.
While most literature on parental coping and grief experiences following child non-death losses are qualitative and refer mostly to children with developmental disabilities, we began publishing on parental grief after child medical trauma, particularly pediatric acquired brain injury (pABI). In the first paper, we quantitatively validated parental grief as a clinical phenomenon and its unique non-finite characteristics relative to parental bereavement (Yehene, Brezner, et al., 2021). In a subsequent paper, we demonstrated that it is the parents` subjective perception (rather than the objective changes) of the child`s behavioral changes post injury that largely explain their grief (Yehene, Golan, et al., 2019). Moreover, based on 43 interviews with parents, we published another paper where we formulated a new grief theory on parents’ unique nonfinite loss experience (Yehene, Steinberg, et al., 2021), hoping also to refresh outdated theoretical conceptualizations geared toward developmental rather than acquired disabilities.
Influenced by integrative psychotherapy, in a paper recently accepted for publication by the APA (Yehene, Ben-Asher, et al., 2022), we applied Kohut`s self-psychology to the field of pediatric rehabilitation. We empirically validated the theoretical concept of “parental narcissistic needs”, showing how their self-worth suffers after their child’s permanent medical trauma, compared to controls. We also published the first paper in the field showing how parental perfectionism and personality traits (Big Five) adversely impact their bio-psychosocial adaptation to child pABI (Yehene, Zuckerman, et al., 2022).
Health care professionals, especially nurses, are at greater risk of being affected by stress at work. Continuous work-loads, diverse responsibilities and constant exposure to traumatic experiences significantly contribute to reduced work satisfaction and high turnover rates. Pediatric nurses, who adhere to the Family-Child Centered Care (FCC) may be more susceptible such adversity, given struggles in collaborating with parents and setting emotional boundaries while watching children suffer, and observing parents’ agony.
In one study, we investigated how pediatric nurses interpret and conceptualize theoretical underpinnings and daily practice scenarios pertaining to their role in pediatric care. We created a questionnaire that uniquely unraveled pediatric nurses’ struggles with setting various emotional and professional boundaries (Yehene, Goldzweig, et al., 2022), suggesting a focal point for intervention. This paper is part of a larger research project involving approximately 200 nurses, with studies addressing nurses’ professional quality of life (ProQOL), emotional labor, and the impact of peer/organizational support.
In spite of the objective severity of a medical condition, patients’ subjective perceptions can impact their ability to cope and adapt positively to it. Such notions were tested on two populations:
Mild traumatic brain injury (mTBI) is one of the most common neurological conditions, constituting 70–90% of all traumatic brain injuries. While most patients return to fully normal functioning in the first three months following the incident, approximately 5–15% continue to report a variety of cognitive, physical and emotional persisting symptoms over a year later (McMahon et al., 2014; Ponsford et al., 2012). The discrepancy between patients’ subjective complaints and symptoms in the absence of significant neurological findings in imaging has become a focal point of interest and controversy. The latter was examined in a paper we published on individuals who sustained mTBI (Yehene, Lichtenstern, et al., 2019), showing how one`s belief in his/her capability to cope (i.e., self-efficacy) lower depression level and increase quality of life via enhancing acceptance of disability.
Another recent study examined how individuals with Crohn’s disease or Ulcerative Colitis perceive the event of chronic illness diagnosis and how that affects their long-term adaptation.
This line of research on male’s grief was continued, in a project on post-divorce adaptation among fathers. Divorce has been recognized as a distressing, life-changing event that affects the functioning and well-being of the entire family. It also involves multiple losses and grief as it affects relationships with ex-spouses, children, past lives, friends, and future hopes among many others. However, little is known about the psychological adaptation of fathers to divorce-related loss, beyond their psychological distress. In this project, prolonged grief disorder (PGD) was examined among divorced fathers in relation to divorce circumstances and personality characteristics as internal resources.
We currently work on a large national research project addressing Spousal Caregiving and Children Caring for their Aging Parents and the functional as well as the psychological and emotional challenges such experience may entail.
An additional related project examines the experience of grief and loss among middle-aged children (35-64), who have lost a parent alongside the changes in their “assumptive world”.
The number of family members caring and caregiving for a loved one undergoing physical and mental changes continues to increase dramatically. In the United States alone, this number has increased by 9.5 million from 2015 to 2020 and is now 53 million (The National Alliance for Caregiving Mission, 2020). In Israel 1 out of 3 people is a caregiver. For many, this ongoing experience not only involves the “burden of caregiving” but also the “burden of grief” as their loved-one`s newfound medical condition can result in the loss of the person they previously knew. Dramatic cognitive, behavioral and personality changes often leave caregivers bereft of the significant relationship they shared with the affected person prior to the illness or injury.
Recently, these entire understandings were integrated and formulated into a theoretical model published on caregivers` grief in Non-Death Interpersonal Loss (NODIL) (Yehene, Manevich, & Rubin, 2022), enabling us to understand these types of losses not only through death-related theoretical frameworks, as still happens. This model offers clinicians an updated tool for analyzing the emotional and practical tasks that must be addressed with their clients.