Trauma exposure and posttraumatic reactions in a community sample of Bedouin members of the Israel Defense Forces.
BACKGROUND
Limited available data indicate that minorities in military service face heightened risks for traumatic exposure and more severe posttraumatic reactions. This study explored traumatic exposure and impact on mental and physical health, functioning, and medical services utilization in a previously unstudied ethnic minority group of Bedouins enlisted in the Israeli Defense Forces.


METHODS
Participants were 317 community-based Bedouin servicemen recruited through community outreach efforts. Axis I psychiatric diagnoses were determined by the Structured Clinical Interview for DSM-IV Disorders; posttraumatic symptoms were measured with the Screen for Posttraumatic Stress Symptoms; and depression and anxiety symptoms were assessed by the Hopkins Symptom Checklist -25 (HSCL-25) Arabic version. Functional impairment and health service utilization were measured by a self-report questionnaire.


RESULTS
Use of a stringent definition of trauma, restricted to experiences involving physical presence at the scene of the event, revealed that 75% of respondents reported potentially traumatizing events. Cap of these nearly 20% were diagnosed with posttraumatic stress disorder (PTSD), which was mostly co-morbid with depression, alcohol abuse, or both. In spite of the widespread trauma exposure in this community, only those trauma-exposed men who developed PTSD experienced extensive impact on their health, as indicated by associations with poor health status, physician-diagnosed medical conditions, health-related impairment in daily functioning, and frequent use of primary or specialty care services. Mental health services were typically not utilized.


CONCLUSIONS
Detection of PTSD among Bedouin servicemen necessitates deliberate diagnostic efforts within primary care settings.
Caspi
Yael
Y
Department of Psychiatry, Rambam Medical Center, Haifa, Israel. y_caspi@rambam.health.gov.il
Saroff
Ortal
O
Suleimani
Najla
N
Klein
Ehud
E
D000328:Adult; D018912:Arabs / Q000706:statistics & numerical data*; D002391:Catchment Area, Health; D003710:Demography; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*