Journal of Loss and Trauma

International Perspectives on Stress & Coping

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/upil20

COVID-19 Fear Association with Israeli Medical

Student Mental Health and Substance Use

Richard Isralowitz & Alexander Reznik

To cite this article: Richard Isralowitz & Alexander Reznik (2021) COVID-19 Fear Association
with Israeli Medical Student Mental Health and Substance Use, Journal of Loss and Trauma, 26:3,
300-302, DOI: 10.1080/15325024.2021.1886802

To link to this article: https://doi.org/10.1080/15325024.2021.1886802

Published online: 17 Feb 2021.

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JOURNAL OF LOSS AND TRAUMA
2021, VOL. 26, NO. 3, 300–302
https://doi.org/10.1080/15325024.2021.1886802

LETTER TO THE EDITOR

COVID-19 Fear Association with Israeli Medical Student

Mental Health and Substance Use

Dear Dr. Harvey,

In July 2020 a Journal of Loss and Trauma letter to the editor was published titled
“Fear, Depression, Substance Misuse and Related Conditions among Multi-National
Medical Students at the Peak of the COVID-19 Epidemic” (Isralowitz et al., 2020). A
second letter appeared in January 2021 titled “First and Second Wave COVID-19
Impact on Russian Medical Student Fear, Mental Health and Substance Use”
(Isralowitz et al., 2021).
This letter to the editor reports on the association between COVID-19 fear and
Israeli medical student mental health conditions at two peak infection periods – May
and November 2020. The study methods used are detailed in the previously published
letters. In May (T1), 175 Israeli medical students (71 males and 104 females) com-
pleted the on-line questionnaire. In November (T2), there were 152 respondents (50
males, 101 females, and 1 other) with 36 students involved in the first investigation.
The Cronbach’s reliability and McDonald’s Omega scores for the Fear of COVID-19
(FCV-19S) and Brief Resilience Scales (BRS) used ranged from 0.826 to 0.840.
Two-way ANOVA for gender and COVID-19 fear show no significant T1 and T2
difference (F1,294 ¼ 1.197; p ¼ .275). Therefore, male and female Israeli medical student
respondents were combined as one group for analysis. The same was done for religious
status (i.e., secular or religious) and COVID-19 fear. No significant difference was
found (i.e., at T1  12.7 (SD ¼ 4.5) and 14.1 (SD ¼ 4.3) and T2  15.0 (SD ¼ 5.5)
and 14.4 (SD ¼ 4.6); (F1,294 ¼ 2.942; p ¼ .087); and, both groups were combined as
one. Regarding all respondents’ self-estimation of COVID-19 fear change from T1 to
T2, 29.0% reported an increase, 29.0% a decrease, and 42.0% no change. Also, no sig-
nificant fear change was reported by 36 students who participated in both T1 and T2
surveys  13.8 (SD ¼ 4.6) vs. 13.5 (SD ¼ 5.7).
At T1, the percentage of medical students reporting more than usual cigarette
smoking and alcohol use was 7.26% and 20.8%. At T2, no significant increase was
found for smoking (4.5%) and drinking (14.4%). Also, over the T1 to T2 periods, the
rate of student binge drinking remained unchanged (6.6% vs. 5.3%; n.s.).
T1 and T2 findings evidence COVID-19 fear linked to levels of depression, exhaus-
tion, loneliness, nervousness, and anger. Significant increases were found only for
depression (28.6% vs. 41.7%; p¼.020) and exhaustion (35.7% vs. 47.7%; p ¼ .040).
Students who participated in both surveys reported increased loneliness (53.9% vs.
72.2%; p¼.038). At TI and T2 study times, students who reported COVID-19 associ-
ated mental health conditions had higher fear values (T1 – t151 ¼ 4.203; p < .001; and
T2 – t128 ¼ 3.331; p ¼ .001). However, T1 and T2 results show no significant increase
or decrease over time (F1.279 ¼ 0.234; p ¼ .629).
No significant differences were found for the mean BRS values between male and
female (t121 ¼ 1.403; p ¼ .163) and secular and non-secular students (t121 ¼ 0.395;

ß 2021 Taylor & Francis Group, LLC

 JOURNAL OF LOSS AND TRAUMA 301

p ¼ .694). Students who reported COVID-19 fear associated with mental health condi-
tions had lower resilience values (t121 ¼ 2.170; p ¼ .032). One-way ANOVA shows a
higher level of resilience associated with lower COVID-19 fear values
(F2,120 ¼ 9.751; p ¼ .001).
Present study results evidence signs of resilience and coping among Israeli medical
students toward COVID-19 conditions. However, further research is needed especially
on the impact of social distancing and isolation that may be associated with student
mental health and coping behavior. Also, particular attention should be given to stu-
dents working with medical, allied health and social work personnel on the front line
of service provision in terms of any mental health conditions that may evolve from the
lingering pandemic (Carson et al., 2020; Taquet et al., 2021; WHO, 2020).

Acknowledgement
We acknowledge medical students who participated in this survey about COVID-19 fear
and its association with mental health and substance use. The survey organization efforts of
Shmaya Bender, Ethan Florentine and Ofri Karni are appreciated. Gratitude is expressed to
Drs. Toby and Mort Mower for their generous support of the Ben Gurion University of
the Negev – Regional Alcohol and Drug Abuse Research (RADAR) Center.

Notes on contributors
Richard Isralowitz, Ph.D., is a Professor (Emeritus) and Director of the Regional Alcohol
and Drug Abuse Research (RADAR) Center, Ben Gurion University of the Negev, Israel
Alexander Reznik, Ph.D., is a Senior Research Associate, Regional Alcohol and Drug Abuse
Research (RADAR) Center, Ben Gurion University of the Negev, Israel.

References
Carson, J., Eyre, H., Lavretsky, H. (2020). Dear mental health innovators: the COVID-19 honeymoon
is almost over. Psychiatric Time. https://www.psychiatrictimes.com/article/dear-mental-health-inno-
vators-covid-19-honeymoon-almost-over.
Isralowitz, R., Khamenka, N., Konstantinov, V., Gritsenko, V., & Reznik, A. (2020). Fear, depression,
substance misuse and related conditions among multi-national medical students at the peak of the
COVID-19 epidemic. Journal of Loss and Trauma, 1–4. https://doi.org/10.1080/15325024.2020.
1799521.
Isralowitz, R., Konstantinov, V., Gritsenko, V., Vorobeva, E., & Reznik, A. (2021). First and second
wave COVID-19 impact on russian medical student fear, mental health and substance use. Journal
of Loss and Trauma, 1–3. https://doi.org/10.1080/15325024.2021.1872274.
Taquet, M., Luciano, S., Geddes, J. R., & Harrison, P. J. (2021). Bidirectional associations between
COVID-19 and psychiatric disorder: Retrospective cohort studies of 62 354 COVID-19 cases in the
USA. The Lancet Psychiatry, 8(2), 130–140. https://doi.org/10.1016/S2215-0366(20)30462-4
World Health Organization (WHO). (2020). COVID-19 disrupting mental health services in most
countries. WHO survey. https://www.who.int/news/item/05-10-2020-covid-19-disrupting-mental-
health-services-in-most-countries-who-survey.
302 R. ISRALOWITZ AND A. REZNIK

Richard Isralowitz
Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben Gurion University of
the Negev, Israel
richard@bgu.ac.il

Alexander Reznik
Regional Alcohol and Drug Abuse Research (RADAR) Center, Ben Gurion University of
the Negev, Israel