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Israeli Civilians under Heavy Bombardment: Prediction of the Severity of Post-Traumatic Symptoms

Published online by Cambridge University Press:  28 June 2012

Eli Somer ,
Aviva Zrihan-Weitzman ,
Tiffany Fusé ,
Holly Parker ,
Ben Dickstein ,
Shira Maguen  and
Brett T. Litz
Eli Somer*
Affiliation:
University of Haifa, School of Social Work, Haifa, Israel
Aviva Zrihan-Weitzman
Affiliation:
University of Haifa, School of Social Work, Haifa, Israel
Tiffany Fusé
Affiliation:
Massachusetts Veterans Epidemiology Research and Information Center, Boston, Massachusetts, USA
Holly Parker
Affiliation:
Massachusetts Veterans Epidemiology Research and Information Center, Boston, Massachusetts, USA
Ben Dickstein
Affiliation:
The National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA Boston University, Boston, Massachusetts, USA
Shira Maguen
Affiliation:
San Francisco VA Medical Center andUniversity of California at San Francisco, San Francisco, California, USA
Brett T. Litz
Affiliation:
Massachusetts Veterans Epidemiology Research and Information Center, Boston, Massachusetts, USA The National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
*
School of Social Work, University of Haifa, Haifa, 31905 Israel, E-mail: somer@research.haifa.ac.il
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Abstract

Context:

The military conflict that occurred between Lebanon and Israel in July and August of 2006 was characterized by the heavy bombardment of specific geographic regions in Israel, resulting in considerable civilian casualties and property damage.

Objective:

Israeli civilians directly and indirectly exposed to bombardment were compared on exposure to the recent bombardment, trauma history, perceived life threat and peritraumatic dissociation during the recent bombardment, and current post-traumatic stress disorder (PTSD) symptom severity.

Design, Setting, and Participants:

Following the conflict, data were collected by telephone from 317 Israeli residents randomly selected from two towns that were subject to differing levels of exposure to the bombardment.

Intervention(s):

None

Main Outcome Measure(s):

Exposure to trauma during the Second Lebanon War, prior trauma exposure, PTSD symptom severity, perceived life threat, and peri-traumatic dissociation.

Results:

The residents directly affected by the bombardment (Kiryat Shmona; KS) endorsed more trauma exposure, (p <0.01); more prior trauma, (p <0.01); more life threat, (p <0.01); and greater PTSD symptomatology (12 % of KY participants and 38% of KS participants had probable PTSD), compared to residents in the comparison town (Kfar Yona; KY). Both groups reported a similar degree of peri-event dissociation (KS: M = 7.2 ±3.7; KY: M = 7.3 ±3.0). Perceived life threat mediated the relationship between exposure to bombardment and PTSD symptomatology. Time spent in bomb shelters was not associated with PTSD symptom severity. Prior shelling-related trauma negatively predicted PTSD.

Conclusions:

The terror of bombardment is a risk factor for PTSD among civil-ians. Although there is considerable resilience in chronically threatened commu-nities, it is prudent to develop and implement public health approaches to prevent those most distressed during and after attacks from developing PTSD. Because, to a small degree, prior trauma exposure buffers the response to bombardment, interventions should consider leveraging citizens' past successful coping.

Keywords

bombardmentdissociationIsraeli civilianspost-traumatic stress disorderresiliencewar
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 5 , October 2009 , pp. 389 - 394
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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References

1.Global Security: Hizballah rockets. Available at http://www.globalsecurity.org/military/world/para/hizballah-rockets.htm. Accessed 28 Novemeber 2007.Google Scholar
2.Israel Ministry of Foreign Affairs: The Second Lebanon War. Available at http://www.mfa.gov.il/MFA/Terrorism-+Obstacle+to+Peace/Terrorism+from+Lebanon-+Hizbullah/Hizbullah+attack+in+northern+Israel+and+Israels+response+12-Jul-2006.htm. Accessed 28 November 2007.Google Scholar
3.Berg, R: Kiryat Shmona counts cost of war. Available at http://news.bbc.co.uk/2/low/middle_east/5264594.stm. Accessed 11 October 2007.Google Scholar
4.American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th ed, Text Revision. Washington DC: Authors, 2001.Google Scholar
5.Vinck, P, Pham, PN, Stover, E, Weinstein, HM: Exposure to war crimes and implications for peace building in Northern Uganda. J Am Med Assoc 2007;298(5):543–554.CrossRefGoogle ScholarPubMed
6.Bleich, A, Gelkopf, M, Solomon, Z: Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally represen-tative sample in Israel. J Am Med Assoc 2003;290:612–620.CrossRefGoogle Scholar
7.Kaspersen, M, Matthiesen, SB: Post-traumatic stress symptoms among UN-soldiers and relief workers. Eur J Psychiatr 2003;17(2):69–76.Google Scholar
8.Maguen, S, Papa, A, Litz, BT: Coping with terror. Anxiety, Stress, & Coping. 2008;21:15–35.CrossRefGoogle Scholar
9.King, DW, Vogt, DS, King, LA: Risk and Resilience Factors in the Etiology of Chronic Posttraumatic Stress Disorder. In: Litz, BT: Early Intervention for Trauma and Traumatic Loss. New York, NY: The Guilford Press, 2004, pp 34–64.Google Scholar
10.Jeavons, S, Greenwood, KM, de L Horne, DJ: Accident cognitions and subse-quent psychological trauma. J Trauma Stress 2000;13(2):359–365.CrossRefGoogle Scholar
11.Koren, D, Norman, D, Cohen, A, Berman, J, Klein, EM: Increased post-traumatic stress disorder risk with combat-related injury: A matched comparison study of injured and uninjured soldiers experiencing the same combat events. Am J Psychiatr 2005;162(2):276–282.CrossRefGoogle ScholarPubMed
12.Shalev, AY, Peri, T, Canetti, L, Schreiber, S: Predictors of post-traumatic stress disorder in injured trauma survivors: A prospective study. Am J Psychiatr 1996;153(2):219–225.Google ScholarPubMed
13.Harvey, AG, Bryant, RA: The relationship between acute stress disorder and post-traumatic stress disorder: A prospective evaluation of motor vehicle accident survivors. J Consult Clin Psychol 1998;66(3):507–512.CrossRefGoogle ScholarPubMed
14.Ozer, EJ, Best, SR, Lipsey, TL, Weiss, DS: Predictors of posttraumatic stress dis-order and symptoms in adults: A meta-analysis. Psychol Bull 2003;129:52–73.CrossRefGoogle Scholar
15.Gil, S, Caspi, Y: Personality traits, coping style, and perceived threat as pre-dictors of posttraumatic stress disorder after exposure to a terrorist attack: A prospective study. Psychosom Med 2006;68:904–909.CrossRefGoogle Scholar
16.Holmes, TH, Rahe, RH: The Social Readjustment Rating Scale. J Psychosom Res 1967;11(2):213–218.CrossRefGoogle ScholarPubMed
17.Foa, EB, Cashman, L, Jaycox, L, Perry, K: The validation of a self-report mea-sure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psychol Assess 1997;9(4):445–451.CrossRefGoogle Scholar
18.Gilboa-Schechtman, E, Foa, EB: Patterns of recovery from trauma: The use of intraindividual analysis. J Abnorm Psychol 2001;110(3):392–400.CrossRefGoogle ScholarPubMed
19.Marmar, CR, Weiss, DS, Schlenger, WE, Fairbank, JA, Jordan, BK, Kulka, RA, Hough, RL: Peri-traumatic dissociation and posttraumatic stress in male Vietnam theater veterans. Am J Psychiatr 1994;151(6):902–907.Google Scholar
20.Cohen, J, Cohen, P, West, SG, Alken, LS: Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. 3rd ed. Mahwah, NJ: Lawrence Erlbaum Associates, Inc, 2003.Google Scholar
21.Coffey, SF: Screening for post-traumatic stress disorder in motor vehicle accident survivors using the PSS-SR and IES. J Trauma Stress 2006;19(1):119–128.CrossRefGoogle ScholarPubMed
22.Galea, S, Bucuvalas, M, Resnick, H, Boyle, J, Vlahov, D, Kilpatrick, D: Telephone-Based Research Methods in Disaster Research. In: Friedman, MJ, Watson, PJ, Norris, FH, Galea, S, (eds.): Methods for Disaster Mental Health Research. New York, NY: The Guilford Press, 2006, pp 111–128.Google Scholar