A longitudinal study of changes in psychological responses to continuous terrorism.
OBJECTIVE
The impact of ongoing terror over time has received little attention. This study assesses longitudinally prevalence and predictors of posttraumatic stress symptoms' trajectories, namely resistance, resilience, late-onset and chronicity in the course of intensive and ongoing terror.


METHODS
Two surveys were performed at a two-year interval among 153 Jewish Israeli adults.


RESULTS
Results show probable PTSD prevalence, number of traumatic stress related symptoms (TSRS), and rate of severe posttraumatic symptomatology (PTSS) to increase over time (from 18.2% to 31.2%). With this, many (66.7% of those with PTSD and 39.3% of those with PTSS at wave 1) recovered. Late-onset of severe PTSS (19.6% of the sample) was predicted by income reduction, a major lifetime traumatic event, sense of threat, dissociation, coping via disengagement and low mood. Chronicity was predicted by sense of threat, pessimism, dissociation and disengagement.


CONCLUSIONS
Continuous exposure to terror has a strong negative impact on mental health. Secondly, even within a chronic situation of terror, a large proportion of individuals with elevated levels of posttraumatic symptomatology recover over time; third, prolonged exposure to terror may also exacerbate symptomatology, but not per-se trigger new PTSD cases.
The Department of Community Mental Health, University of Haifa, Israel NATAL: The Israel Trauma Center for Victims of Terror and War, Tel Aviv, Israel.
Marc
M
Gelkopf
Zahava
Z
Solomon
Avraham
A
Bleich
D000328:Adult; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D023481:Terrorism / Q000523:psychology*