Background: Patients with COVID-19 present with a variety of clinical manifestations, ranging from mild or asymptomatic disease to severe illness and death. Whilst previous studies have clarified these and several other aspects of COVID-19, one of the ongoing challenges regarding COVID-19 is to determine which patients are at risk of adverse outcomes of COVID-19 infection. It is hypothesized that this is the result of insufficient inhibition of the immune response, with the vagus nerve being an important neuro-immuno-modulator of inflammation. Vagus nerve activity can be non-invasively indexed by heart-rate-variability (HRV). Therefore, we aimed to assess the prognostic value of HRV, as a surrogate marker for vagus nerve activity, in predicting mortality and intensive care unit (ICU) referral, in patients hospitalized with COVID-19. Methods: A retrospective cohort study including all consecutive patients (n = 271) diagnosed and hospitalized with COVID-19 between March 2020 and May 2020, without a history of cardiac arrhythmias (including atrial and ventricular premature contractions), pacemaker, or current bradycardia (heart rate 110 bpm). HRV was based on one 10s ECG recorded at admission. 3-week survival and ICU referral were examined. Results: HRV indexed as standard deviation of normal to normal heartbeat intervals (SDNN) predicted survival (H.R. = 0.53 95%CI: 0.31–0.92). This protective role was observed only in patients aged 70 years and older, not in younger patients. HRV below median value also predicted ICU referral within the first week of hospitalization (H.R = 0.51, 95%CI: 0.29–0.90, P = 0.021). Conclusion: Higher HRV predicts greater chances of survival, especially in patients aged 70 years and older with COVID-19, independent of major prognostic factors. Low HRV predicts ICU indication and admission in the first week after hospitalization.

Social workers during the COVID-19 pandemic are at risk due to exposure to varied populations in need, which may impact their resilience, burnout, secondary trauma, and compassion satisfaction. The study assessed resilience at work, burnout, secondary trauma, and compassion satisfaction among social workers in Israel during the first wave of the COVID-19 pandemic (May to June 2020). A convenience sample of 332 social workers (291 women (87.6%)) filled out an online, structured questionnaire that included demographics, a professional quality of life scale (ProQOL) (including three subscales), and resilience at work (RAW) (including seven subscales). The overall mean of the RAW was medium (M = 71, SD ± 8.9) compared to standardized scores. The mean scores of two of the subscales of the RAW, maintaining perspective and staying healthy, were low. The mean scores of the sub-scales of ProQOL were: compassion satisfaction was close to the 50th percentile (M = 48.25); burnout (M = 30.18) and secondary trauma (M = 26.27) were below the 25th percentile. Significant low to medium positive associations were found between all the dependent variables, except for staying healthy. A negative association was identified between compassion satisfaction and burnout, as well as between compassion satisfaction and secondary trauma. High levels of compassion satisfaction and contentment, low levels of secondary trauma, and having a managerial position were predicted to be 40% of the RAW. Lower levels of maintaining perspective, secondary trauma, and being younger predicted 27% of burnout. Higher levels of finding your calling, living authentically, maintaining perspective, interacting cooperatively, being older, and not being a manager predicted 58% of compassion satisfaction. Lower levels of burnout, maintaining perspective, and being younger predicted 36% of secondary trauma. As the COVID-19 pandemic still challenges most societies, policymakers should consider ways to integrate mechanisms that will enhance social workers’ resilience at work.

Anxiety and hopelessness are common reactions of citizens exposed to continuous war threats. Common interventions focus on support, calming, and emotional ventilation, with few attempts to reduce people's cognitive barriers concerning active coping, which could increase their resilience. This study tested the effects of psychological inoculation (PI), which specifically aims to challenge such barriers, on the mental resilience of Israeli citizens living in Sderot. Participants were randomly assigned to either 2 PI sessions or 2 ventilation sessions, provided over the phone. Anxiety, helplessness, pessimism, and functioning were briefly assessed at baseline and 1 week after interventions. No time, group, or group x time interactions were observed. However, a time x group x sex interaction emerged for helplessness: Men benefited from the PI whereas women benefited from ventilation, in reducing helplessness. Under chronic war stress, it seems difficult to improve people's resilience, although PI may be partly beneficial for men. Further research is needed to test the effects of PI on mental resilience.

The theoretical understanding of psychological resilience has evolved significantly over recent decades, leading to diverse conceptual frameworks that emphasize different aspects of resilient adaptation. Some frameworks focus on resilience as a personal trait, others view it as a dynamic process, while still others emphasize the role of environmental and systemic factors. This theoretical paper introduces the ART framework (Acknowledgment, Reframe, and Tailoring), which provides an integrative perspective that bridges these seemingly disparate approaches. The ART framework offers a comprehensive understanding of how various resilience mechanisms work together in real-world contexts by focusing on the dynamic interplay between resource identification, reframing threats as challenges, and adaptive tailoring between resources and challenges. The ART framework incorporates and extends existing theoretical perspectives while providing a practical structure for understanding resilience development and intervention.

Under conditions of profound stress, individuals in high-risk occupations may experience an acute stress reaction (ASR). Given that ASRs may interfere with functioning, placing the team in danger, the Israel Defense Forces developed YaHaLOM training to teach service members how to manage ASRs in team members. YaHaLOM is a novel, rapid, peer-based intervention specifically designed for use in the midst of a high-stress event. In all, 904 Israeli combat soldiers participated in the study; 76% reported having received YaHaLOM, and 24% reported that they had not. In addition to measures of knowledge about managing ASRs, confidence in managing ASRs, and stigma-related attitudes toward ASRs, questions also addressed training approach, including the use of a video and instructor type. Participants who reported receiving YaHaLOM also reported more knowledge about managing an ASR, more confidence in managing an ASR, less external stigma, and more normative views of ASRs. Being trained with a video was associated with more confidence and less self-stigma than being trained without a video. Instructor type was not associated with differences in knowledge, confidence, or stigma-related attitudes. The study is limited by cross-sectional self-report data. Nevertheless, results suggest YaHaLOM may prepare soldiers to manage ASRs in team members; future studies are needed to assess intervention efficacy and to expand this research to other high-risk occupational contexts.

The SIX Cs model, a neuropsychological framework for psychological first aid, addresses acute stress responses that may lead to functional failure and heighten the risk for posttraumatic stress disorder. Unlike emotional interventions, this model prioritizes Cognitive Communication to diminish emotional overwhelm and bolster cognitive functioning. It introduces a Challenge for active engagement, Control for cognitive management of situations, Commitment from the helper to reduce loneliness, and Continuity to ensure narrative coherence. This study evaluates the SIX Cs model's effectiveness in an experimental setup to alleviate acute stress reaction symptoms. Sixty-three participants voluntarily participated. They were randomly assigned to the SIX Cs intervention (experimental) or to supportive emotional expression (control). They listened to a 3-min audio recording of a real emergency 911 phone call. Interventions were provided before and after listening to the recording. Before, immediately after, and 5 min later (recovery), participants' anxiety, heart rate variability, and mental resilience levels were measured. For all three outcomes, the Time × Group interactions were statistically significant. Follow-up analyses revealed that the SIX Cs participants showed lower anxiety and less reductions in heart rate variability and resilience than controls immediately after the stressor. Furthermore, the SIX Cs participants recovered faster on all three outcomes compared to controls. The results demonstrate the superior effect of the psychological first aid based SIX C's protocol over control in all outcomes, immediately after a simulated stressor and 7 min later as well as possible contribution for posttraumatic stress disorder risk reduction. (PsycInfo Database Record (c) 2024 APA, all rights reserved).