Exposure to Terrorism, Stress-Related Mental Health Symptoms, and Coping Behaviors Among a Nationally Representative Sample in Israel
CONTEXT The terrorist attacks on Israeli society have been ongoing since September 2000. However, few studies have examined the impact of terrorism on nationally representative population samples, and no study has examined the psychological impact of ongoing terrorism in Israel. OBJECTIVES To determ...
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| creator | Bleich, Avraham Gelkopf, Marc Solomon, Zahava |
| description | CONTEXT The terrorist attacks on Israeli society have been ongoing since September
2000. However, few studies have examined the impact of terrorism on nationally
representative population samples, and no study has examined the psychological
impact of ongoing terrorism in Israel. OBJECTIVES To determine the level of exposure to terrorist attacks and the prevalence
of traumatic stress–related (TSR) symptoms, symptoms of posttraumatic
stress disorder (PTSD), and sense of safety after 19 months of terrorism in
Israel, and to identify correlates of the psychological sequelae and the modes
of coping with the terrorism. DESIGN, SETTING, AND PARTICIPANTS Telephone survey conducted April-May 2002, using a strata sampling method,
of 902 eligible households and a representative sample of 742 Israeli residents
older than 18 years (82% contact rate) and a final participation of 512 (57%). MAIN OUTCOME MEASURES Number of TSR symptoms, rates of those with symptom criteria for PTSD
and acute stress disorder assessed by the Stanford Acute Stress Reaction Questionnaire,
self-reported feelings of depression, optimism, sense of safety, help-seeking,
and modes of coping. RESULTS Of 512 survey participants, 84 (16.4%) had been directly exposed to
a terrorist attack and 191 (37.3%) had a family member or friend who had been
exposed. Of 510 participants who responded to questions about TSR symptoms,
391 (76.7%) had at least 1 TSR symptom (mean, 4.0 [SD, 4.5]; range, 0-23;
mean intensity, 0.8; range, 0-4). Symptom criteria for PTSD were met by 48
participants (9.4%) and criteria for acute stress disorder, by 1 participant;
299 (58.6%) reported feeling depressed. The majority of respondents expressed
optimism about their personal future (421/512 [82.2%]) and the future of Israel
(307/509 [66.8%]), and expressed self-efficacy with regard to their ability
to function in a terrorist attack (322/431 [74.6%]). Most expressed a low
sense of safety with respect to themselves (307/509 [60.4%]) and their relatives
(345/507 [67.9%]). Few reported a need for professional help (27/506 [5.3%]).
Female sex, sense of safety, and use of tranquilizers, alcohol, and cigarettes
to cope were associated with TSR symptoms and symptom criteria for PTSD; level
of exposure and objective risk were not. The most prevalent coping mechanisms
were active information search about loved ones and social support. CONCLUSIONS Considering the nature and length of the Israeli traumatic experience,
the psychological im |
| doi_str_mv | 10.1001/jama.290.5.612 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_73549824</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ama_id>197036</ama_id><sourcerecordid>411094281</sourcerecordid><originalsourceid>FETCH-LOGICAL-a358t-a2c4e91b6453a4aa7b795ab60a566105c027b09f3aad084d5060e81950e603073</originalsourceid><addsrcrecordid>eNpd0d9rFDEQB_BFFHutvgq-SBD0qXtONr82j_WotlAVevV5md2bs3tkN9skW7w_oP-3kZ4UzMsQ8pkvzKQo3nBYcgD-aYcDLisLS7XUvHpWLLgSdSmUrZ8XCwBbl0bW8qg4jnEH-XBhXhZHPHdUQstF8XD-e_JxDsSSZzcUgg99HE7ZOgWKsbwmh4k27BuNCR27IHTplq33w5T8EE8Zjhu28lM__mKf6Rbvex8iOxt8viP7jqn3Izq3Z9c05by_Iam_J7bGYXLE-pFdxoDkXhUvtugivT7Uk-Lnl_Ob1UV59ePr5ersqkSh6lRi1UmyvNVSCZSIpjVWYasBldYcVAeVacFuBeIGarlRoIFqbhWQBgFGnBQfH3On4O9miqkZ-tiRcziSn2NjhJK2rmSG7_-DOz-HPEtsKs4lgLEio3cHNLcDbZop9AOGffNvuxl8OACMHbptwLHr45NTwA1ont3bR5c_8-nVGhBa_AGn9ZEK</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211400793</pqid></control><display><type>article</type><title>Exposure to Terrorism, Stress-Related Mental Health Symptoms, and Coping Behaviors Among a Nationally Representative Sample in Israel</title><source>MEDLINE</source><source>American Medical Association Journals</source><creator>Bleich, Avraham ; Gelkopf, Marc ; Solomon, Zahava</creator><creatorcontrib>Bleich, Avraham ; Gelkopf, Marc ; Solomon, Zahava</creatorcontrib><description>CONTEXT The terrorist attacks on Israeli society have been ongoing since September
2000. However, few studies have examined the impact of terrorism on nationally
representative population samples, and no study has examined the psychological
impact of ongoing terrorism in Israel. OBJECTIVES To determine the level of exposure to terrorist attacks and the prevalence
of traumatic stress–related (TSR) symptoms, symptoms of posttraumatic
stress disorder (PTSD), and sense of safety after 19 months of terrorism in
Israel, and to identify correlates of the psychological sequelae and the modes
of coping with the terrorism. DESIGN, SETTING, AND PARTICIPANTS Telephone survey conducted April-May 2002, using a strata sampling method,
of 902 eligible households and a representative sample of 742 Israeli residents
older than 18 years (82% contact rate) and a final participation of 512 (57%). MAIN OUTCOME MEASURES Number of TSR symptoms, rates of those with symptom criteria for PTSD
and acute stress disorder assessed by the Stanford Acute Stress Reaction Questionnaire,
self-reported feelings of depression, optimism, sense of safety, help-seeking,
and modes of coping. RESULTS Of 512 survey participants, 84 (16.4%) had been directly exposed to
a terrorist attack and 191 (37.3%) had a family member or friend who had been
exposed. Of 510 participants who responded to questions about TSR symptoms,
391 (76.7%) had at least 1 TSR symptom (mean, 4.0 [SD, 4.5]; range, 0-23;
mean intensity, 0.8; range, 0-4). Symptom criteria for PTSD were met by 48
participants (9.4%) and criteria for acute stress disorder, by 1 participant;
299 (58.6%) reported feeling depressed. The majority of respondents expressed
optimism about their personal future (421/512 [82.2%]) and the future of Israel
(307/509 [66.8%]), and expressed self-efficacy with regard to their ability
to function in a terrorist attack (322/431 [74.6%]). Most expressed a low
sense of safety with respect to themselves (307/509 [60.4%]) and their relatives
(345/507 [67.9%]). Few reported a need for professional help (27/506 [5.3%]).
Female sex, sense of safety, and use of tranquilizers, alcohol, and cigarettes
to cope were associated with TSR symptoms and symptom criteria for PTSD; level
of exposure and objective risk were not. The most prevalent coping mechanisms
were active information search about loved ones and social support. CONCLUSIONS Considering the nature and length of the Israeli traumatic experience,
the psychological impact may be considered moderate. Although the survey participants
showed distress and lowered sense of safety, they did not develop high levels
of psychiatric distress, which may be related to a habituation process and
to coping mechanisms.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.290.5.612</identifier><identifier>PMID: 12902364</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Adaptation, Psychological ; Adult ; Aged ; Biological and medical sciences ; Depression - epidemiology ; Depression - etiology ; Female ; Health Surveys ; Humans ; Israel - epidemiology ; Male ; Medical sciences ; Mental health ; Middle Aged ; Nervous system (semeiology, syndromes) ; Nervous system as a whole ; Neurology ; Patient Acceptance of Health Care - statistics & numerical data ; Post traumatic stress disorder ; Prevalence ; Regression Analysis ; Sex Factors ; Stress Disorders, Post-Traumatic - epidemiology ; Studies ; Surveys and Questionnaires ; Terrorism ; Terrorism - psychology</subject><ispartof>JAMA : the journal of the American Medical Association, 2003-08, Vol.290 (5), p.612-620</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright American Medical Association Aug 6, 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a358t-a2c4e91b6453a4aa7b795ab60a566105c027b09f3aad084d5060e81950e603073</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.290.5.612$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.290.5.612$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,780,784,3340,27924,27925,76489,76492</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15017061$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12902364$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bleich, Avraham</creatorcontrib><creatorcontrib>Gelkopf, Marc</creatorcontrib><creatorcontrib>Solomon, Zahava</creatorcontrib><title>Exposure to Terrorism, Stress-Related Mental Health Symptoms, and Coping Behaviors Among a Nationally Representative Sample in Israel</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT The terrorist attacks on Israeli society have been ongoing since September
2000. However, few studies have examined the impact of terrorism on nationally
representative population samples, and no study has examined the psychological
impact of ongoing terrorism in Israel. OBJECTIVES To determine the level of exposure to terrorist attacks and the prevalence
of traumatic stress–related (TSR) symptoms, symptoms of posttraumatic
stress disorder (PTSD), and sense of safety after 19 months of terrorism in
Israel, and to identify correlates of the psychological sequelae and the modes
of coping with the terrorism. DESIGN, SETTING, AND PARTICIPANTS Telephone survey conducted April-May 2002, using a strata sampling method,
of 902 eligible households and a representative sample of 742 Israeli residents
older than 18 years (82% contact rate) and a final participation of 512 (57%). MAIN OUTCOME MEASURES Number of TSR symptoms, rates of those with symptom criteria for PTSD
and acute stress disorder assessed by the Stanford Acute Stress Reaction Questionnaire,
self-reported feelings of depression, optimism, sense of safety, help-seeking,
and modes of coping. RESULTS Of 512 survey participants, 84 (16.4%) had been directly exposed to
a terrorist attack and 191 (37.3%) had a family member or friend who had been
exposed. Of 510 participants who responded to questions about TSR symptoms,
391 (76.7%) had at least 1 TSR symptom (mean, 4.0 [SD, 4.5]; range, 0-23;
mean intensity, 0.8; range, 0-4). Symptom criteria for PTSD were met by 48
participants (9.4%) and criteria for acute stress disorder, by 1 participant;
299 (58.6%) reported feeling depressed. The majority of respondents expressed
optimism about their personal future (421/512 [82.2%]) and the future of Israel
(307/509 [66.8%]), and expressed self-efficacy with regard to their ability
to function in a terrorist attack (322/431 [74.6%]). Most expressed a low
sense of safety with respect to themselves (307/509 [60.4%]) and their relatives
(345/507 [67.9%]). Few reported a need for professional help (27/506 [5.3%]).
Female sex, sense of safety, and use of tranquilizers, alcohol, and cigarettes
to cope were associated with TSR symptoms and symptom criteria for PTSD; level
of exposure and objective risk were not. The most prevalent coping mechanisms
were active information search about loved ones and social support. CONCLUSIONS Considering the nature and length of the Israeli traumatic experience,
the psychological impact may be considered moderate. Although the survey participants
showed distress and lowered sense of safety, they did not develop high levels
of psychiatric distress, which may be related to a habituation process and
to coping mechanisms.</description><subject>Adaptation, Psychological</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Depression - epidemiology</subject><subject>Depression - etiology</subject><subject>Female</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>Israel - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Nervous system as a whole</subject><subject>Neurology</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Post traumatic stress disorder</subject><subject>Prevalence</subject><subject>Regression Analysis</subject><subject>Sex Factors</subject><subject>Stress Disorders, Post-Traumatic - epidemiology</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>Terrorism</subject><subject>Terrorism - psychology</subject><issn>0098-7484</issn><issn>1538-3598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0d9rFDEQB_BFFHutvgq-SBD0qXtONr82j_WotlAVevV5md2bs3tkN9skW7w_oP-3kZ4UzMsQ8pkvzKQo3nBYcgD-aYcDLisLS7XUvHpWLLgSdSmUrZ8XCwBbl0bW8qg4jnEH-XBhXhZHPHdUQstF8XD-e_JxDsSSZzcUgg99HE7ZOgWKsbwmh4k27BuNCR27IHTplq33w5T8EE8Zjhu28lM__mKf6Rbvex8iOxt8viP7jqn3Izq3Z9c05by_Iam_J7bGYXLE-pFdxoDkXhUvtugivT7Uk-Lnl_Ob1UV59ePr5ersqkSh6lRi1UmyvNVSCZSIpjVWYasBldYcVAeVacFuBeIGarlRoIFqbhWQBgFGnBQfH3On4O9miqkZ-tiRcziSn2NjhJK2rmSG7_-DOz-HPEtsKs4lgLEio3cHNLcDbZop9AOGffNvuxl8OACMHbptwLHr45NTwA1ont3bR5c_8-nVGhBa_AGn9ZEK</recordid><startdate>20030806</startdate><enddate>20030806</enddate><creator>Bleich, Avraham</creator><creator>Gelkopf, Marc</creator><creator>Solomon, Zahava</creator><general>American Medical Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QL</scope><scope>7QP</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20030806</creationdate><title>Exposure to Terrorism, Stress-Related Mental Health Symptoms, and Coping Behaviors Among a Nationally Representative Sample in Israel</title><author>Bleich, Avraham ; Gelkopf, Marc ; Solomon, Zahava</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a358t-a2c4e91b6453a4aa7b795ab60a566105c027b09f3aad084d5060e81950e603073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adaptation, Psychological</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Depression - epidemiology</topic><topic>Depression - etiology</topic><topic>Female</topic><topic>Health Surveys</topic><topic>Humans</topic><topic>Israel - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Nervous system as a whole</topic><topic>Neurology</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Post traumatic stress disorder</topic><topic>Prevalence</topic><topic>Regression Analysis</topic><topic>Sex Factors</topic><topic>Stress Disorders, Post-Traumatic - epidemiology</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>Terrorism</topic><topic>Terrorism - psychology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bleich, Avraham</creatorcontrib><creatorcontrib>Gelkopf, Marc</creatorcontrib><creatorcontrib>Solomon, Zahava</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bleich, Avraham</au><au>Gelkopf, Marc</au><au>Solomon, Zahava</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exposure to Terrorism, Stress-Related Mental Health Symptoms, and Coping Behaviors Among a Nationally Representative Sample in Israel</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>2003-08-06</date><risdate>2003</risdate><volume>290</volume><issue>5</issue><spage>612</spage><epage>620</epage><pages>612-620</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT The terrorist attacks on Israeli society have been ongoing since September
2000. However, few studies have examined the impact of terrorism on nationally
representative population samples, and no study has examined the psychological
impact of ongoing terrorism in Israel. OBJECTIVES To determine the level of exposure to terrorist attacks and the prevalence
of traumatic stress–related (TSR) symptoms, symptoms of posttraumatic
stress disorder (PTSD), and sense of safety after 19 months of terrorism in
Israel, and to identify correlates of the psychological sequelae and the modes
of coping with the terrorism. DESIGN, SETTING, AND PARTICIPANTS Telephone survey conducted April-May 2002, using a strata sampling method,
of 902 eligible households and a representative sample of 742 Israeli residents
older than 18 years (82% contact rate) and a final participation of 512 (57%). MAIN OUTCOME MEASURES Number of TSR symptoms, rates of those with symptom criteria for PTSD
and acute stress disorder assessed by the Stanford Acute Stress Reaction Questionnaire,
self-reported feelings of depression, optimism, sense of safety, help-seeking,
and modes of coping. RESULTS Of 512 survey participants, 84 (16.4%) had been directly exposed to
a terrorist attack and 191 (37.3%) had a family member or friend who had been
exposed. Of 510 participants who responded to questions about TSR symptoms,
391 (76.7%) had at least 1 TSR symptom (mean, 4.0 [SD, 4.5]; range, 0-23;
mean intensity, 0.8; range, 0-4). Symptom criteria for PTSD were met by 48
participants (9.4%) and criteria for acute stress disorder, by 1 participant;
299 (58.6%) reported feeling depressed. The majority of respondents expressed
optimism about their personal future (421/512 [82.2%]) and the future of Israel
(307/509 [66.8%]), and expressed self-efficacy with regard to their ability
to function in a terrorist attack (322/431 [74.6%]). Most expressed a low
sense of safety with respect to themselves (307/509 [60.4%]) and their relatives
(345/507 [67.9%]). Few reported a need for professional help (27/506 [5.3%]).
Female sex, sense of safety, and use of tranquilizers, alcohol, and cigarettes
to cope were associated with TSR symptoms and symptom criteria for PTSD; level
of exposure and objective risk were not. The most prevalent coping mechanisms
were active information search about loved ones and social support. CONCLUSIONS Considering the nature and length of the Israeli traumatic experience,
the psychological impact may be considered moderate. Although the survey participants
showed distress and lowered sense of safety, they did not develop high levels
of psychiatric distress, which may be related to a habituation process and
to coping mechanisms.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>12902364</pmid><doi>10.1001/jama.290.5.612</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0098-7484 |
| ispartof | JAMA : the journal of the American Medical Association, 2003-08, Vol.290 (5), p.612-620 |
| issn | 0098-7484 1538-3598 |
| language | eng |
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| source | MEDLINE; American Medical Association Journals |
| subjects | Adaptation, Psychological Adult Aged Biological and medical sciences Depression - epidemiology Depression - etiology Female Health Surveys Humans Israel - epidemiology Male Medical sciences Mental health Middle Aged Nervous system (semeiology, syndromes) Nervous system as a whole Neurology Patient Acceptance of Health Care - statistics & numerical data Post traumatic stress disorder Prevalence Regression Analysis Sex Factors Stress Disorders, Post-Traumatic - epidemiology Studies Surveys and Questionnaires Terrorism Terrorism - psychology |
| title | Exposure to Terrorism, Stress-Related Mental Health Symptoms, and Coping Behaviors Among a Nationally Representative Sample in Israel |
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