ABSTRACT
This study evaluates the effectiveness of virtual reality (VR) as a novel tool for mood induction, specifically for inducing joy, and examines the role of interactivity and prior mood. We conducted an experiment using a 2 × 2 factorial design with 124 participants who were randomly assigned to either a neutral or negative prior mood condition, and an interactive or noninteractive joy induction condition. Prior mood was experimentally manipulated using a VR scenario that simulated a terror attack at a train station (negative mood condition) compared with a control condition in which no incidents occurred at the train station (neutral mood condition). Subsequently, participants entered a virtual park scenario that either allowed for playful interaction with objects in the park (interactive condition) or not (noninteractive condition). We found that interactive VR experiences lead to lower levels of negative affect compared with a noninteractive experience irrespective of participants' prior mood, but playful interaction in VR only increased joy when participants were in a neutral (not negative) prior mood. We suggest interactivity as a design principle for effective negative mood reduction, but further research is required on how to successfully transform a prior negative mood into joy.
Subject(s)
Virtual Reality Exposure Therapy , Virtual Reality , Humans , AffectABSTRACT
Background: Does exposure to events that transgress accepted norms, such as killing innocent civilians, prompt the psychological and emotional consequences of moral injury among soldiers? Moral injury is associated with negative emotions such as guilt, shame and anger, and a sense of betrayal and is identified among veterans following exposure to potentially morally injurious events (PMIE). Objective: We experimentally investigate how PMIE characteristics affect the intensity of MI and related negative moral emotions in participants with varied military experience. Method: We conducted three controlled, randomized experiments. Each exposed male respondents with active combat experience (Study 1) and varied military experience (Study 2) to four textual vignettes describing PMIE (child/adult and innocent/non-innocent suspect) that transpire at an Israeli checkpoint in the West Bank. In study 3, we exposed participants to two scenarios, where descriptions of police officers enforcing COVID 19 restrictions confronted lockdown violators. Results: Participants assigned to vignettes describing killing an innocent civilian exhibited more intense levels of shame and guilt than those assigned to vignettes describing killing a person carrying a bomb. Religiosity and political ideology were strong predictors of guilt and shame in response to descriptions of checkpoint shootings. These effects disappeared in Study 3, suggesting that political ideology drives MI in intergroup conflict. Conclusions: Background and PMIE-related characteristics affect the development of moral injury. Additionally, lab experiments demonstrate the potential and limitations of controlled studies of moral injury and facilitate an understanding of the aetiology of moral injury in a way unavailable to clinicians. Finally, experimental findings and methodologies offer further insights into the genesis of moral injury and avenues for therapy and prophylaxis.
Antecedentes: ¿La exposición a eventos que transgreden las normas aceptadas, como matar a civiles inocentes, provocan las consecuencias psicológicas y emocionales del daño moral entre los soldados? El daño moral (DM) se asocia con emociones negativas como la culpa, la vergüenza y la ira, y un sentido de traición y es identificado entre los veteranos después de la exposición a eventos potencialmente dañinos moralmente (EPDM).Objetivo: Investigamos experimentalmente cómo las características de EPDM afectan la intensidad del DM y emociones moralmente negativas relacionadas en participantes con vasta experiencia militar.Método: Realizamos tres experimentos controlados y aleatorizados. Cada varón expuesto respondió con experiencia en combate activo (Estudio 1) y vasta experiencia militar (Estudio 2) a cuatro viñetas textuales que describen EPDM (niño/adulto y sospechoso inocente/no inocente) que suceden en un puesto de control israelí en Cisjordania. En el estudio 3, expusimos a los participantes a dos escenarios, donde las descripciones de los agentes de policía que aplicaban las restricciones de COVID-19 enfrentaron a los infractores del confinamiento.Resultados: Los participantes asignados a viñetas que describen el asesinato de un civil inocente exhibieron niveles más intensos de vergüenza y culpa que los asignados a las viñetas que describen el asesinato de una persona llevando una bomba. La religiosidad y la ideología política fueron fuertes predictores de culpa y vergüenza en respuesta a descripciones de tiroteos en puestos de control. Estos efectos desaparecieron en el Estudio 3, lo que sugiere que la ideología política impulsa al DM en los conflictos intergrupales.Conclusiones: Los antecedentes y las características relacionadas con el EPDM afectan el desarrollo del daño moral. Adicionalmente, los experimentos de laboratorio demuestran el potencial y las limitaciones de los estudios de daño moral y facilitan una comprensión de la etiología del daño moral de una manera no disponible para los clínicos. Por último, los hallazgos y las metodologías experimentales ofrecen perspectivas adicionales en la génesis del daño moral y las vías para la terapia y la profilaxis.
Subject(s)
Military Personnel/psychology , Stress Disorders, Post-Traumatic/psychology , Veterans/psychology , Adult , Anger , COVID-19/epidemiology , Child, Preschool , Guilt , Humans , Israel/epidemiology , Male , Pandemics/legislation & jurisprudence , Shame , Stress Disorders, Post-Traumatic/epidemiology , Surveys and QuestionnairesABSTRACT
OBJECTIVE: The current paper uses the Conservation of Resources Theory to frame an examination of the impact of exposure to political violence on posttraumatic stress symptomology among three groups within Israeli society: (1) Native Born Jews; (2) Foreign Born Jews; and (3) Palestinian Citizens of Israel. METHODS: The study population was a large nationally representative sample of 1613 respondents collected during The Second Intifada. The sample consists of approximately 40% Jews born in Israel (n = 652), 30% (n = 484) were Jews who immigrated to Israel, and close to 30% (n = 477) were Palestinian Citizens of Israel. Mediation analyses explored the role of resource loss in the relationship between social status and posttraumatic stress disorder (PTSD) symptom severity. RESULTS: Compared to native born Jews, foreign born Jews and Palestinian Citizens of Israel reported greater PTSD symptom severity at wave III. These relationships were not mediated by psychosocial resource loss or economic resource loss. CONCLUSIONS: We discuss the importance of tailored interventions with minority groups in the context of ongoing political violence.
Subject(s)
Stress Disorders, Post-Traumatic , Arabs/psychology , Humans , Israel/epidemiology , Jews/psychology , Longitudinal Studies , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Violence/psychologyABSTRACT
To what extent does exposure to cyberterrorism arouse negative emotions? Cyberterrorism has developed the potential to cause similarly lethal consequences to conventional terrorism, especially when targeted at critical infrastructures. But like conventional terrorism, cyberterrorism aims to terrorize, and exposure to cyberterror attacks can affect emotional responses. This article is based on an experiment that explores emotional responses to cyberterrorism using specially designed news reports showing major cyber attacks against critical water infrastructure. Our findings indicate that cyberterrorism arouses heightened reactions of anger and stress (measured physiologically through cortisol levels, and through self-report measures). Our findings also reveal that (a) exposure to cyberterror attacks is associated with higher levels of stress than of anger; (b) that these emotional responses do not differ from the emotions triggered by conventional terrorism; and (c) these responses are not dependent on the lethality of the attack. Finally, cortisol levels remained constant across conditions. This study covers new ground as it explores the distinctive role of anger after cyberterrorism, while affirming studies that describe the presence of stress.
Subject(s)
Emotions/physiology , Stress, Psychological/psychology , Terrorism/psychology , Adult , Anger/physiology , Computer Simulation , Female , Humans , Hydrocortisone/analysis , Male , Saliva/chemistry , Self Report , Students/psychologyABSTRACT
External collective political efficacy (PE) is an individual's perception of the extent to which the government is responsive to the needs of his or her group or community or to its collective actions. Does PE play a role in the association between exposure to political violence and posttraumatic stress? The current study aimed to examine whether such PE may help explain why exposure to political violence results in posttraumatic stress for some people but not others. Based on the conservation of resource theory, research has found that residents of some types of communities are less likely to suffer from posttraumatic stress when exposed to political violence, due to the economic and psychological resources these communities provide. Political efficacy, as an individual-level factor that relates to the community, may help predict who will suffer more or less posttraumatic stress from exposure to political violence within a given community. Based on a panel study conducted immediately before and after the 2008-2009 Gaza conflict (N = 650) and hierarchical linear modeling analyses, we found that type of community indeed moderated the association between exposure to political violence and posttraumatic stress, Δ-2 log likelihood = 30.4, p < .001. In addition, we found that PE mitigated the psychological distress resulting from exposure to political conflict in disadvantaged communities, Δ-2 log likelihood = 22.8, p < .001. This study not only further untangled the association between exposure and distress during times of war but also identified the role that governments can play in preventing conflict-induced distress beyond offering physical protection.
Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) ¿La eficacia política amortigua el mayor riesgo de estrés postraumático en las comunidades desfavorecidas? EL EFECTO AMORTIGUADOR DE LA EFICACIA POLÍTICA La eficacia política colectiva externa (EP) es la percepción que tiene un individuo de la medida en que el gobierno responde a las necesidades de su grupo o comunidad o a sus acciones colectivas. ¿La EP juega un papel en la asociación entre la exposición a la violencia política y el estrés postraumático? El estudio actual tuvo como objetivo examinar si tal EP puede ayudar a explicar por qué la exposición a la violencia política produce estrés postraumático para algunas personas, pero no para otras. Sobre la base de la teoría de la conservación de los recursos, la investigación ha encontrado que los residentes de algunos tipos de comunidades tienen menos probabilidades de sufrir estrés postraumático cuando están expuestos a la violencia política, debido a los recursos económicos y psicológicos que estas comunidades proporcionan. La EP, como un factor a nivel individual que se relaciona con la comunidad, puede ayudar a predecir quién sufrirá más o menos estrés postraumático por la exposición a la violencia política dentro de una comunidad determinada. Sobre la base de un estudio de panel realizado inmediatamente antes y después del conflicto de Gaza de 2008-2009 (N = 650) y los análisis de modelos lineales jerárquicos, encontramos que el tipo de comunidad efectivamente moderó la asociación entre la exposición a la violencia política y el estrés postraumático Δ-2loglikelihood = 30.4, p <.001. Además, encontramos que la EP mitigó el malestar psicológico resultante de la exposición al conflicto político en comunidades desfavorecidas, Δ-2loglikelihood = 22.8, p <.001. Este estudio no solo desenredó más la asociación entre la exposición y malestar en tiempos de guerra, sino que también identificó el papel que los gobiernos pueden desempeñar en la prevención del malestar provocado por el conflicto más allá de ofrecer protección física.
Subject(s)
Exposure to Violence/psychology , Residence Characteristics , Stress Disorders, Post-Traumatic/psychology , Adult , Female , Government , Humans , Israel , Male , Middle Aged , Surveys and Questionnaires , Vulnerable Populations/psychologyABSTRACT
How do wars shape emotions and attitudes in intractable conflicts? In two studies conducted in the aftermath of the 2014 Gaza War in the Middle East, we tested a new theoretical model wherein the ability to regulate emotions is central in determining the influence of war exposure on emotions (i.e., group-based humiliation) and support for militancy, through posttraumatic stress symptoms (PSS). Results supported our model: (a) higher exposure to the war predicted group-based humiliation in both studies and in Study 2 also greater support for militancy; in both studies, (b) higher exposure predicted more PSS only among participants high in emotion dysregulation, and, for them, (c) higher exposure predicted greater group-based humiliation, through increased levels of PSS. Results from Study 2 suggest that (d) group-based humiliation will ultimately lead to greater support for militancy. The findings' contribution to the different literatures and their integration is discussed.
Subject(s)
Armed Conflicts/psychology , Emotions , Adolescent , Adult , Aged , Female , Humans , Israel , Male , Middle Aged , Middle East , Psychological Tests , Surveys and Questionnaires , Violence/psychology , Young AdultABSTRACT
Do cyberattacks fuel the politics of threat? By what mechanism does it do so? To address these questions, we employ a technological and physiological experiment (2 × 2) involving a simulated cyberattack. Participants were randomly assigned to "cyberattack" (treatment) or "no attack" (control) conditions. We find that cyber-attacks make people more likely to express threat perceptions; we suggest salivary cortisol, a measure of stress, as the mechanism bridging cyber and the politics of threat. Contrary to existing evidence, salivary cortisol is the mechanism that translates simulated exposure to cyberattacks into political threat perceptions.
Subject(s)
Computer Security , Hydrocortisone/analysis , Stress, Psychological/physiopathology , Terrorism/psychology , Humans , Saliva/chemistryABSTRACT
BACKGROUND AND OBJECTIVE: This study tested three alternative explanations for research indicating a positive, but heterogeneous relationship between self-reported posttraumatic growth (PTG) and posttraumatic stress symptoms (PSS): (a) the third-variable hypothesis that the relationship between PTG and PSS is a spurious one driven by positive relationships with resource loss, (b) the growth over time hypothesis that the relationship between PTG and PSS is initially a positive one, but becomes negative over time, and (c) the moderator hypothesis that resource loss moderates the relationship between PTG and PSS such that PTG is associated with lower levels of PSS as loss increases. DESIGN AND METHOD: A nationally representative sample (N = 1622) of Israelis was assessed at three time points during a period of ongoing violence. PTG, resource loss, and the interaction between PTG and loss were examined as lagged predictors of PSS to test the proposed hypotheses. RESULTS: Results were inconsistent with all three hypotheses, showing that PTG positively predicted subsequent PSS when accounting for main and interactive effects of loss. CONCLUSIONS: Our results suggest that self-reported PTG is a meaningful but counterintuitive predictor of poorer mental health following trauma.
Subject(s)
Self Report , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Terrorism/psychology , Warfare , Adult , Arabs/psychology , Arabs/statistics & numerical data , Emigration and Immigration/statistics & numerical data , Female , Humans , Interviews as Topic , Israel/epidemiology , Jews/psychology , Jews/statistics & numerical data , Male , Russia/ethnology , Survivors/psychology , Survivors/statistics & numerical data , Terrorism/statistics & numerical dataABSTRACT
Can the onset of PTSD symptoms and depression be predicted by personality factors and thought control strategies? A logical explanation for the different mental health outcomes of individuals exposed to trauma would seem to be personality factors and thought control strategies. Trauma exposure is necessary but not sufficient for the development of PTSD. To this end, we assess the role of personality traits and coping styles in PTSD vulnerability among Israeli and Palestinian students amid conflict. We also determine whether gender and exposure level to trauma impact the likelihood of the onset of PTSD symptoms. Five questionnaires assess previous trauma, PTSD symptoms, demographics, personality factors and thought control strategies, which are analyzed using path analysis. Findings show that the importance of personality factors and thought control strategies in predicting vulnerability increases in the face of political violence: the higher stress, the more important the roles of personality and thought control strategies. Thought control strategies associated with introverted and less emotionally stable personality-types correlate positively with higher levels of PTSD symptoms and depression, particularly among Palestinians. By extension, because mental health is key to reducing violence in the region, PTSD reduction in conflict zones warrants rethinking.
Subject(s)
Personality , Stress Disorders, Post-Traumatic/psychology , Violence/psychology , Warfare , Adaptation, Psychological , Adult , Arabs , Depression/complications , Emotions , Female , Humans , Israel , Male , Personality Disorders , Risk Factors , Surveys and Questionnaires , Young AdultABSTRACT
OBJECTIVE: Adolescents living in Israel and the Palestinian authority are exposed to political violence. This review examines psychosocial risk factors for posttraumatic stress disorder (PTSD) organized within an ecological framework. METHOD: Relevant articles were identified through PubMed and PsycINFO. Studies measuring risk and/or protective factors for PTSD in the Palestinian and/or Israeli adolescent populations because of conflict exposure from 1990 to present were included. RESULTS: A total of 20 studies met inclusion criteria. Greater violence exposure, poor economic resources, living in rural compared with urban areas, poor family and peer relations, and poor coping skills were associated with PTSD symptoms. CONCLUSIONS: The ecological framework is a useful approach to understanding factors affecting adolescent PTSD. Future research should focus on socioecological levels that have received limited attention. (PsycINFO Database Record
Subject(s)
Adolescent Development , Armed Conflicts/psychology , Exposure to Violence/ethnology , Stress Disorders, Post-Traumatic/ethnology , Adolescent , Humans , Israel/ethnology , Risk FactorsABSTRACT
When ordinary citizens think of cyber threats, most are probably worried about their passwords and banking details, not a terrorist attack. The thought of a shooting in a mall or a bombing at an airport is probably more frightening than a cyber breach. Yet terrorists aim for mental as well as physical destruction, and our research has found that, depending on who the attackers and the victims are, the psychological effects of cyber threats can rival those of traditional terrorism.
ABSTRACT
Can different political ideologies explain policy preferences regarding asylum seekers? We focus on attitudes regarding governmental policy towards out-group members and suggest that perceptions of threat help to shape these policy attitudes. Study 1 compared public opinion regarding asylum policy in Israel (N = 137) and Australia (N = 138), two countries with restrictive asylum policies and who host a large number of asylum seekers; Study 2, a longitudinal study, was conducted during two different time periods in Israel-before and during the Gaza conflict. Results of both studies showed that threat perceptions of out-group members drive the relationship between conservative political ideologies and support for exclusionary asylum policies among citizens. Perceptions of threat held by members of the host country (the in-group) towards asylum seekers (the out-group) may influence policy formation. The effect of these out-groups threats needs to be critically weighed when considering Israeli and Australian policies towards asylum seekers.
ABSTRACT
BACKGROUND: This study examined the prevalence and critical predictors of anxiety and depressive symptoms and self-rated health, following the Umbrella Movement in Hong Kong. METHODS: Random digit dialing recruited a population-representative sample of 1208 Chinese Hong Kong citizens (mean age=46.89 years; 63% female) in the first two weeks of February 2015. Respondents gave their informed consent and reported personal, social, and economic resource loss since the Umbrella Movement (Conservation of Resources-Evaluation), current anxiety symptoms (State-Trait Anxiety Inventory) and depressive symptoms (Patient Health Questionnaire-9), and self-rated health (1=very good, 4=very bad). RESULTS: A total of 47.35% (95% CI=44.55, 50.17) respondents reported moderate/severe anxiety symptoms and 14.4% (95% CI=12.54, 16.50) reported moderate/severe depressive symptoms; 9.11% (95% CI=7.61, 10.86) reported "poor" or "very poor" health. Multivariable regressions revealed that personal and social resource loss was associated with higher anxiety and depressive symptoms and greater odds of "very poor" health (adjusted odds ratios/incidence rate ratios=5-102%), independent of lower education level and income and being unmarried. LIMITATIONS: This study was cross-sectional in nature and thus could not determine causality from the associations between resource loss and outcome variables. Second, the telephone survey relied on self-reports; response bias and social desirability could influence respondents' answers and discount data validity. Third, potential confounders such as preexisting mental and physical health issues and concurrent predictors like exposure to the Umbrella Movement were not assessed. CONCLUSIONS: This is one of the first studies following any recent political movement (e.g., The Arab Spring) to quantify distress and the associated correlates of distress among affected citizens. Perceived psychosocial resource losses were critical predictors of poor outcomes.
Subject(s)
Anxiety/epidemiology , Democracy , Depression/epidemiology , Health Status , Adult , Cross-Sectional Studies , Female , Hong Kong/epidemiology , Humans , Male , Middle Aged , PrevalenceABSTRACT
OBJECTIVES: Meta-analytic evidence based on cross-sectional investigations between posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) demonstrates that the two concepts are positively related and that ethnic minorities report greater PTG. Few longitudinal studies have quantified this relationship so the evidence is limited regarding the potential benefit PTG may have on post-traumatic adjustment and whether differences between ethnic groups exist. METHODS: The current study attempts to fill a substantial gap in the literature by exploring the relationship between PTG and PTSD symptom clusters longitudinally using a nationally representative cohort of 1613 Israelis and Palestinian Citizens of Israel (PCI) interviewed via telephone on three measurement occasions during one year. Latent cross-lagged structural models estimated the relationship between PTG and each PTSD symptom cluster, derived from confirmatory factor analysis, representing latent and statistically invariant PTSD symptom factors, best representing PTSD for both ethnic groups. RESULTS: PTG was not associated with less PTSD symptom severity in any of the four PTSD clusters, for Jews and PCI. In contrast, PTSD symptom severity assessed earlier was related to later reported PTG in both groups. CONCLUSIONS: This study demonstrates that PTSD symptoms contribute to greater reported PTG, but that PTG does not provide a salutatory benefit by reducing symptoms of PTSD.
Subject(s)
Arabs , Jews , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Violence , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Culture , Female , Humans , Israel/epidemiology , Longitudinal Studies , Male , Middle Aged , Models, Statistical , Risk Factors , Young AdultABSTRACT
Experiencing stress and exposure to terrorism may have an adverse effect on health risk behaviors. Few studies have examined alcohol use among adults living in Israel under chronic, stressful terrorism-related conditions. In this study, we examined the relationships of demographics, past stressful events, and terrorism exposure to the frequency of alcohol use and the mediating roles of depressive and post-traumatic stress disorder (PTSD) symptoms. We used three waves of data from a 2007-2008 nationally representative sample of Jewish and Palestinian adults in Israel. We assessed past stressful events, in addition to direct and indirect exposures to terrorism. Results indicated that past stressful events and exposure to terrorism were not directly associated with alcohol use, but were indirectly associated and mediated by depressive and PTSD symptomology. Mental health symptoms were differentially associated with alcohol use. More frequent drinking was mediated by higher levels of depression, including for women and Palestinians; however, PTSD symptom severity was related to less frequent drinking. Mental health may play a prominent role in the frequency of alcohol use among adults exposed to terrorism in Israel. Alcohol use, as a coping mechanism, may differ by demographic characteristics (gender and ethnicity) and psychological symptomology for adults living in a conflict zone in Israel.
Subject(s)
Alcohol Drinking/psychology , Arabs/psychology , Armed Conflicts/psychology , Jews/psychology , Adolescent , Adult , Age Distribution , Aged , Arabs/ethnology , Depressive Disorder/ethnology , Depressive Disorder/psychology , Female , Humans , Israel/ethnology , Jews/ethnology , Male , Middle Aged , Stress Disorders, Post-Traumatic/ethnology , Stress Disorders, Post-Traumatic/psychology , War Exposure , Young AdultABSTRACT
BACKGROUND: Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder. METHODS: A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews. RESULTS: The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD. CONCLUSIONS: A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.
Subject(s)
Arabs/psychology , Health Resources , Stress Disorders, Post-Traumatic/epidemiology , Violence/psychology , Adult , Anxiety/epidemiology , Anxiety/psychology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , Humans , Incidence , Male , Middle Aged , Middle East , Prevalence , Stress Disorders, Post-Traumatic/psychology , Young AdultABSTRACT
The physiological impact on citizens of prolonged exposure to violence and conflict is a crucial, yet underexplored, issue within the political science and biology literature. We examined the effect of high levels of exposure to rocket and terrorist attacks on biological markers of immunity and inflammation in a sample of 92 Israelis. A stratified random sample of individuals was drawn from a pool of subjects in Israel who had previously been interviewed regarding their stress exposure and psychological distress during a period of active rocket and terrorist attacks. These individuals were reinterviewed and blood samples were collected to assess antibodies to cytomegalovirus (CMV antibodies) and C-reactive protein (CRP). Posttraumatic stress disorder (PTSD) was significantly related to CRP, ß = .33, p = .034, with body mass index, depression, and exposure to terrorism included in the model. Depression scores were not significantly associated with CRP or CMV antibody levels. In contrast to the established convention that psychological distress is the sole outcome of terrorism exposure, these findings reveal that individuals exposed to terrorism experience higher levels of both PTSD/depression, and inflammation. This study has important ramifications for how policy makers and medical health professionals should formulate public health policies and medically treat individuals living in conflict zones.
Subject(s)
Antibodies, Viral/blood , C-Reactive Protein/metabolism , Cytomegalovirus/immunology , Stress Disorders, Post-Traumatic/immunology , Stress, Psychological/immunology , Terrorism/psychology , Warfare , Adult , Body Mass Index , Depression/etiology , Depression/immunology , Female , Humans , Inflammation/blood , Inflammation/etiology , Interview, Psychological , Israel , Male , Middle Aged , Stress Disorders, Post-Traumatic/etiology , Stress, Psychological/etiologyABSTRACT
BACKGROUND: Social support is consistently associated with reduced risk of depression. Few studies have investigated how this relationship may be modified by alcohol use, the effects of which may be particularly relevant in traumatized populations in which rates of alcohol use are known to be high. METHODS: In 2008 a representative sample of 1622 Jewish and Palestinian citizens in Israel were interviewed by phone at two time points during a period of ongoing terrorism and war threat. Two multivariable mixed effects regression models were estimated to measure the longitudinal association of social support from family and friends on depression symptoms. Three-way interaction terms between social support, alcohol use and time were entered into the models to test for effect modification. RESULTS: Findings indicated that increased family social support was associated with less depression symptomatology (p=<.01); this relationship was modified by alcohol use and time (p=<.01). Social support from friends was also associated with fewer depression symptoms (p=<.01) and this relationship was modified by alcohol use and time as well (p=<.01). Stratified analyses in both models revealed that the effect of social support was stronger for those who drank alcohol regularly than those who did not drink or drank rarely. CONCLUSIONS: These findings suggest that social support is a more important protective factor for depression among regular drinkers than among those who do not drink or drink rarely in the context of political violence. Additional research is warranted to determine whether these findings are stable in other populations and settings.
Subject(s)
Alcohol Drinking/psychology , Depression/psychology , Social Support , Terrorism , Warfare , Adult , Ethnicity , Female , Health Status , Humans , Israel , Male , Middle Aged , Religion , Socioeconomic Factors , Stress Disorders, Post-Traumatic/psychologyABSTRACT
OBJECTIVE: Sleep disturbances, including trouble falling and remaining asleep and recurrent nightmares, are symptoms of posttraumatic stress. A growing body of literature indicates that sleep disturbance may also convey vulnerability for the continuation of other symptoms of posttraumatic stress, including fear, anxiety, and heightened arousal. However, longitudinal research, which could help understand how these relationships unfold over time, has been limited. METHOD: The longitudinal relationships between sleep disturbance and posttraumatic stress were investigated in 779 Palestinian adults randomly selected and interviewed twice during the period from April 2008 to November 2008, amid ongoing violent political turmoil. The recruitment method produced a representative sample and excellent retention. Cross-panel structural equation modeling was used to examine relationships between sleep and distress across two study periods. RESULTS: Results indicated that initial sleep problems were associated with increased posttraumatic stress disorder (PTSD), depression, and intrapersonal resource loss at follow-up 6 months later, but initial PTSD, depression, and intrapersonal resource loss were not associated with increased sleep problems at follow-up. CONCLUSIONS: Sleep problems may confer vulnerability to longer-term distress in the presence of ongoing political violence. Future research should examine whether interventions targeting trauma-related sleep problems may improve prevention and treatment for PTSD and related disorders.