The authors conducted a large-scale study of terrorism in Israel via telephone surveys in September 2003 with 905 adult Jewish and Palestinian citizens of Israel (PCIs). Structural equation path modeling indicated that exposure to terrorism was significantly related to greater loss and gain of psychosocial resources and to greater posttraumatic stress disorder (PTSD) and depressive symptoms. Psychosocial resource loss and gain associated with terrorism were, in turn, significantly related to both greater PTSD and depressive symptoms. PCIs had significantly higher levels of PTSD and depressive symptoms than Jews. Further, PTSD symptoms in particular were related to greater authoritarian beliefs and ethnocentrism, suggesting how PTSD may lead to a self-protective style of defensive coping.

Recent studies related to global terrorism have suggested the potential of posttraumatic growth (PTG) following experiences of terror exposure. However, investigations of whether psychological distress is reduced or increased by PTG in other trauma contexts have been inconsistent. Results from our studies conducted in New York following the attacks of 11 September 2001 and in Israel during recent tumultuous periods of violence and terrorism, the Al Aqsa Intifada, have found posttraumatic growth to be related to greater psychological distress, more right-wing political attitudes, and support for retaliatory violence. Only when individuals were deeply involved in translating growth cognitions to growth actions in our research on the forced disengagement of settlers from Gaza did we find positive benefit in posttraumatic growth. Findings are considered within the framework of a new formulation of actionfocused growth.De récentes recherches en rapport avec le terrorisme international ont souligné le potentiel du développement post-traumatique (PTG) découlant de la confrontation à la terreur. Toutefois, les travaux cherchant à savoir si la détresse psychologique était atténuée ou accentuée par le PTG dans d'autres contextes traumatiques se sont révélés contradictoires. Nos investigations à New York après l'attentat du 11 septembre 2001 et en Israël durant des périodes récentes de violence et de terrorisme, la seconde Intifada, ont montré que le développement post-traumatique était plutôt lié à une grande détresse psychologique, à des opinions politiques de droite et à une attente de représailles. On a observé lors du déménagement obligatoire des colons de Gaza que ce n'est que lorsque les individus étaient profondément impliqués dans la transformation des cognitions de développement en actions de développement que le développement post-traumatique avait des retombées positives. Ces résultats sont appréhendés dans le cadre d'une nouvelle approche du développement centré sur l'action.

This is the 1st longitudinal examination of trajectories of resilience and resistance (rather than illbeing) among a national sample under ongoing threat of mass casualty. The authors interviewed a nationally representative sample of Jews and Arabs in Israel (N = 709) at 2 times during a period of terrorist and rocket attacks (2004)(2005). The resistance trajectory, exhibiting few or no symptoms of traumatic stress and depression at both time points, was substantially less common (22.1%) than has previously been documented in studies following single mass casualty events. The resilience trajectory, exhibiting initial symptoms and becoming relatively nonsymptomatic, was evidenced by 13.5% of interviewees. The chronic distress trajectory was documented among a majority of participants (54.0%), and a small proportion of persons were initially relatively symptom-free but became distressed (termed delayed distress trajectory; 10.3%). Less psychosocial resource loss and majority status (Jewish) were the most consistent predictors of resistance and resilience trajectories, followed by greater socioeconomic status, greater support from friends, and less report of posttraumatic growth. Research on terrorism and war and other mass casualty events has overwhelmingly focused on pathological responding, most typically symptoms related to traumatic stress (Bleich, Gelkopf, & Solomon, 2003;Galea et al., 2002;Hobfoll, Canetti-Nisim, & Johnson, 2006;Punamäki, Komproe, Qouta, Elmasri, & de Jong, 2005) and, to a lesser extent, depression (Hobfoll, Tracy, & Galea, 2006). However, emerging research has suggested that in the aftermath of mass casualty, the majority of persons do not report psychological distress and may be termed resistant (Bonanno, Galea, Bucciarelli, & Vlahov, 2006. Because we have only begun to study resistance, and in limited contexts, we know little about its prevalence or predictors (Bonanno, 2005;Bonanno, Rennicke, & Dekel, 2005).We longitudinally studied symptoms related to traumatic stress and depression among a national sample of Israeli Jews and Arabs during the latter period of the Second Intifada, when there was ongoing terrorism and likelihood of war because mass casualty exposure weighs heavily on such populations (Shalev, Tuval, Frenkiel-Fishman, Hadar, & Eth, 2006;Somer, Ruvio, Soref, & Sever, 2005). Our aim was to estimate the prevalence of resistance, resilience, chronic distress, and a failure to remain resistant (i.e., delayed symptom onset) and to predict these outcomes. We believe this is the first longitudinal study of resilience and related trajectories in the face of terrorism and war during a period of ongoing conflict.Building on the work of Bonanno et al. (2007);Layne, Warren, Shalev, and Watson (2007); and Norris, Stevens, Pfefferbaum, Wyche, and Pfefferbaum (2007), we outline four key symptom trajectories, over time, after traumatic event exposure. In the first trajectory, termed the resistance trajectory (Layne et al., 2007), individuals never develop symptoms of disorder. A se...

Israel has faced ongoing terrorism since the beginning of the Al

The Israeli government's decision to remove settlers in the Gaza Strip forcibly produced a situation of traumatic stress, resulting from confrontation and conflict for settlers. The authors examined the effects of the Gaza disengagement, that occurred following prolonged terrorist exposure, on rates of probable major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) diagnosis in a representative sample of Gaza settlers (N = 190). Predictors of probable MDD in multivariate models were being female, and experiencing greater economic and psychosocial resource loss. Predictors of probable PTSD were being older and experiencing greater psychosocial resource loss. Posttraumatic growth was significantly related to a reduction in the odds of having probable PTSD. This latter finding is interpreted within our conceptualization of action-focused growth.With the rise of war, conflict, and terrorism worldwide, there has been increased interest in studying their effects on civilian populations. Posttraumatic stress disorder (PTSD) has been found to be a product of direct exposure, proximity to an attack, knowing someone injured or killed, or having concern that a loved one might have been hurt or killed (Bleich, Gelkopf, & Solomon, 2003;Galea et al., 2002;Hobfoll, Canetti-Nisim, & Johnson, 2006;Silver, Holman, Mcintosh, Poulin, & Gil-Rivas, 2002).We examined rates of probable PTSD and MDD among Israeli settlers who, after having been exposed to ongoing terrorism, were forced to evacuate their homes and in many cases their livelihoods due to political exigencies. Settlers moved to Gaza, in part, for economic © 2008 International Society for Traumatic Stress Studies.Correspondence concerning this article should be addressed to: Stevan E. Hobfoll, 378 Kent Hall, Kent State University, Kent, OH 44242. E-mail: E-mail: shobfoll@kent.edu. We used Conservation of Resources (COR) theory as an organizing model for this study (Hobfoll, 1989;1998). According to COR theory, stress occurs when people's psychosocial or material resources are threatened with loss, are actually lost, or when individuals must invest resources without obtaining reasonable resource gain. Under periods of major or traumatic stress, a spiral of loss often develops, as resource loss begets further resource loss (Benight et al., 1999;Hobfoll, 1989;Norris & Kaniasty, 1996). NIH Public AccessStudies of terrorism and other mass casualty events have found resource loss to be a principle predictor of PTSD and depression (Benight et al., 1999;Galea et al., 2002;Ironson et al., 1997). Janoff-Bulman (1992) suggested that trauma is exacerbated if it results in shattered assumptions about people's worldview. According to her model, individuals hold three basic assumptions: the benevolence of the world, the meaningfulness of the world, and a sense of self-worth. Integrating COR theory with Janoff-Bulman's (1992) concept of shattered assumptions leads to the prediction that trauma exposure and resultant resource loss would lead to PTSD and depression ...

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Although there is abundant evidence that mass traumas are associated with adverse mental health consequences, few studies have used nationally representative samples to examine the impact of war on civilians, and none have examined the impact of the Israel-Hezbollah War, which involved unprecedented levels of civilian trauma exposure from July 12-August 14, 2006. The aims of this study were to document probable post-traumatic stress disorder (PTSD), determined by the PTSD Symptom Scale and self-reported functional impairment, in Jewish and Arab residents of Israel immediately after the Israel-Hezbollah War and to assess potential risk and resilience factors. A telephone survey was conducted August 15-October 5, 2006, following the cessation of rocket attacks. Stratified random sampling methods yielded a nationally representative population sample of 1,200 adult Israeli residents. The rate of probable PTSD was 7.2%. Higher risk of probable PTSD was associated with being a woman, recent trauma exposure, economic loss, and higher psychosocial resource loss. Lower risk of probable PTSD was associated with higher education. The results suggest that economic and psychosocial resource loss, in addition to trauma exposure, have an impact on post-trauma functioning. Thus, interventions that bolster these resources might prove effective in alleviating civilian psychopathology during war. KeywordsIsrael; war; trauma; post-traumatic stress disorder (PTSD); risk factors; resilience factors; IsraeliHezbollah war; mental health Correspondence to: Patrick A. Palmieri, palmierp@summa-health.org. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. 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. , 2006). Work and social life were severely disrupted as only evacuation or shelters were safe. Perhaps most disconcerting to Israelis, the Israel Defense Forces, who are often seen as nearly infallible, were unable to cause a cessation of the attacks, or even limit their frequency. This has been interpreted by many Israelis as a critical weakness in the defensive shield upon which they depend for their very survival (Feldman, 2006). NIH Public AccessFew studies have examined the impact of war on civilian populations, and to our knowledge no study examined a nationally representative sample of a country that had actually been under active attack. Rates of depression were found to be elevated in Lebanese communities that sustained a high degree of exposure to the Lebanon Wars, even after controlling for pre-war depression (Karam, Howard, Karam, Ashkar, Shaaya, Melhem, et al., 1998). Rates of PTSD and general psychiatric morbidity among reside...

Does exposure to terrorism lead to hostility toward minorities? Drawing on theories from clinical and social psychology, we propose a stress-based model of political extremism in which psychological distress—which is largely overlooked in political scholarship—and threat perceptions mediate the relationship between exposure to terrorism and attitudes toward minorities. To test the model, a representative sample of 469 Israeli Jewish respondents was interviewed on three occasions at six-month intervals. Structural Equation Modeling indicated that exposure to terrorism predicted psychological distress (t1), which predicted perceived threat from Palestinian citizens of Israel (t2), which, in turn, predicted exclusionist attitudes toward Palestinian citizens of Israel (t3). These findings provide solid evidence and a mechanism for the hypothesis that terrorism introduces nondemocratic attitudes threatening minority rights. It suggests that psychological distress plays an important role in political decision making and should be incorporated in models drawing upon political psychology.