The relationship between demographic/educational parameters and perceptions, knowledge and earthquake mitigation in Israel.

Perceptions, knowledge and mitigation are factors that might play a role in preventing injury and loss of life during a major earthquake.(2) Little is known about the relationships between different demographic and educational parameters and these factors. A national representative sample of 495 adults was investigated in order to determine the relationship between demographic and educational parameters in terms of the perceived threat, perceived coping, knowledge and mitigation of earthquakes in Israel. Compared to females, males perceived the threat of earthquakes to be lower (t = 3.183, p = 0.002), manifested higher levels of perceived coping (t = 2.55, p = 0.011), and had higher levels of earthquake related knowledge (t = 2.047, p = 0.041). We conclude that there are gender differences in perceptions and knowledge regarding earthquakes.

Pre-Traumatic Vaccination Intervention: can dissociative symptoms be reduced?

The Pre-Traumatic Vaccination Intervention (PTV) has been developed in an attempt to help rescue personnel cope with anticipated and non-anticipated disasters, and to prevent trauma-related mental disorders during and after a traumatogenic exposure. Contrary to the generally accepted approach of treating trauma after it has occurred, the PTV has been designed to be administered prior to the potentially traumatic event. Based on empirical findings, the PTV training techniques were designed to prepare the participants for distressful situations. Trainees were gradually exposed to increasingly severe sights using cognitive-behavioral techniques along with foreseen situations relating to their profession. Various interventions were aimed at normalizing using personal resources and implementing relaxation techniques. The PTV was administrated as part of the Israeli Defense Forces rescue personnel's and military police training courses. The results of an uncontrolled, preliminary study suggest that the intervention reduced the level of dissociation leading to more awareness to the traumatic event's details, less suffering, lower probability of making mistakes, and increased likelihood of returning to normal functioning. Lower dissociation may suggest a lower probability to be diagnosed with post-traumatic stress disorder among rescue personnel.

Changes in post-traumatic symptom pattern during and after exposure to extreme war stress: an uncontrolled, preliminary study supporting the dose-response model.

INTRODUCTION: Exposure to prolonged war stress is understudied. While there is debate regarding the empirical data of the dose-response model for posttraumatic stress disorder (PTSD), little is known about how weekly changes in external stress influences the level of PTSD symptoms. The purpose of this study was to measure the relation between objective external stress and PTSD symptoms across time, and thus, gain a deeper understating of the dose-response model. HYPOTHESIS: The study hypothesis postulates that the more severe the external stressor, the more severe the exhibition of traumatic symptoms. METHODS: Thirteen special army administrative staff (SAAS) members from the Rambam Medical Center in Haifa attended seven intervention meetings during the war. These personnel answered a battery of questionnaires regarding demographics and PTSD symptoms during each session. A non-parametric test was used in order to measure the changes in PTSD symptoms between sessions. Pearson correlations were used in order to study the relationship between the magnitude of external stressors and the severity of PTSD symptoms. RESULTS: The results suggested that there was a significant relationship between the magnitude of external stressors and the severity of PTSD symptoms. These results are in line with the dose-response model. CONCLUSIONS: The results suggest that a pattern of decline in PTSD symptoms confirm the dose-response model for PTSD.

The effect of prolonged exposure to war stress on the comorbidity of PTSD and depression among hospital personnel.

The relationship between exposure to war stress and to traumatic and depressive symptoms among hospital personnel is understudied. Hospital personnel who were exposed to frequent missile attacks and casualties of war, both military and civilians (n=106), were assessed for posttraumatic stress disorder (PTSD) symptoms and depression a month after the war between Lebanon and Israel erupted. Increased risk for PTSD symptoms was found to be highly associated with increased risk for depression. Logistic regression analysis showed that hospital personnel with increased risk for PTSD symptoms had a significantly elevated risk for depression in comparison to hospital personnel without increased risk for PTSD symptoms (odds ratio=18.86, 95%CI=4.08-87.07). These findings show that hospital personnel exposed to prolonged war stress exhibited higher levels of depression in comparison to previous single exposure researches. No profession differences were found in the levels of depression, but physicians were found to be less vulnerable than other hospital staff to develop PTSD symptoms. PTSD symptoms were significantly associated with depression. The results warrant further longitudinal study.

Acute stress symptoms, dissociation, and depression among rescue personnel 24 hours after the Bet-Yehoshua train crash in Israel:the effect of gender.

INTRODUCTION: The effect of immediate exposure to traumatic events and gender differences is under-studied in the literature. Most studies focus on acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) phases in order to measure gender differences, and tend to neglect the immediate exposure to the disaster. HYPOTHESIS: The main hypothesis was that female rescue personnel would exhibit higher levels of acute stress symptoms, dissociation, and depressive symptoms in the 24 hours following a traumatic event. METHODS: Twenty-three rescue personnel participated in a search and rescue operation at the Bet-Yehoshua train crash in Israel. The rescue personnel group was divided based on gender. Each participant completed a demographic questionnaire including questions that assessed psychological symptoms and issues such as perceived threat to life, the Impact of Event Scale Revised (IES-R), the Dissociative Experience Scale (DES), and the Center of Epidemiologic Studies Depression questionnaire (CES-D). Statistical inferences were calculated using t-tests and chi-square tests, along with testing of covariance (MANCOVA) in order to indentify which factors are related to psychiatric symptomatology following the immediate exposure to disaster. RESULTS: The results suggest that among rescue personnel, women did not differ in their levels of acute stress, dissociation, and depressive symptoms from men. CONCLUSIONS: These results suggest the possibility that the gender differences in reactions to traumatic events do not emerge in the acute stress reactions (ASR) phase (up to 24 hours after the event), but later on when people have time to process the trauma. Another possibility that may explain the discrepancy between this study and the common knowledge in the literature is that women rescue personnel are considered a highly selected group, which does not reflect on the general population of women. More studies are needed in order to substantiate these results.

Acute stress symptoms, dissociation, and depression among rescue personnel 24 hours after the Bet-Yehoshua train crash: the effects of exposure to dead bodies.

INTRODUCTION: The immediate impact of exposure to severe wounds, dead bodies, and immediate threat to life has been understudied. Most studies focus on the acute stress disorder and/or post-traumatic stress disorder phases in order to assess rescue personnel's symptomatology, and tend to neglect the immediate exposure to elements of the disaster. HYPOTHESIS: Rescue personnel who had a history of previous exposure to dead bodies would exhibit higher levels of acute stress symptoms, dissociation, and depressive symptoms within the 24 hours following a traumatic event. METHODS: Twenty-three rescue personnel participated in the search and excavation of dead and mutilated bodies following the Bet-Yehoshua train crash in Israel. The rescue personnel group was divided based on previous exposure to dead bodies. Each participant completed a demographic questionnaire, which included a question on perceived threat to life, the impact of event scale revised, the dissociative experience scale, and the center of epidemiologic studies depression questionnaire. Student's t-tests, along with multivariate analysis of covariance (MANCOVA) were conducted in order to learn which factors are related to psychiatric symptomatology following the immediate exposure to such stressors. RESULTS: Among rescue personnel, those with previous exposure to dead bodies did not differ in their levels of acute stress symptoms, dissociation, and depressive symptoms from those who were not previously exposed to dead bodies. CONCLUSIONS: These results may suggest the possibility that the impact of exposure to dead bodies does not emerge in the acute stress reactions (ASR) phase (up to 24 hours after the event), but later when people have time to process the trauma. Another possibility is that the rescue coping mechanisms of detachment may serve as a buffer for the horrific sights encountered during the ASR period.

Impact of war stress on posttraumatic stress symptoms in hospital personnel.

OBJECTIVE: This study examines the relationship between exposure to war stress and posttraumatic symptoms among nurses and physicians in a general hospital targeted by missiles. METHOD: Hospital staff who were exposed to missile attacks and casualties of war, both military and civilians (n=80), were assessed for posttraumatic stress disorder (PTSD) symptoms a month after the war between Lebanon and Israel erupted (during the last days of the war). RESULTS: High levels of PTSD symptoms were found in 10.5% of physicians and 35.7% of nurses. Logistic regression analysis showed that nurses had an increased risk for PTSD in comparison to physicians (odds ratio=5.28). CONCLUSION: These findings show that nurses suffered from more severe posttraumatic symptoms compared to physicians after exposure to prolonged war stress. The gap between physicians and nurses warrants further study.