Israeli civilians under heavy bombardment: prediction of the severity of post-traumatic symptoms.

CONTEXT: The military conflict that occurred between Lebanon and Israel in July and August of 2006 was characterized by the heavy bombardment of specific geographic regions in Israel, resulting in considerable civilian casualties and property damage. OBJECTIVE: Israeli civilians directly and indirectly exposed to bombardment were compared on exposure to the recent bombardment, trauma history, perceived life threat and peri-traumatic dissociation during the recent bombardment, and current post-traumatic stress disorder (PTSD) symptom severity. DESIGN, SETTING, AND PARTICIPANTS: Following the conflict, data were collected by telephone from 317 Israeli residents randomly selected from two towns that were subject to differing levels of exposure to the bombardment. INTERVENTION(S): None MAIN OUTCOME MEASURE(S): Exposure to trauma during the Second Lebanon War, prior trauma exposure, PTSD symptom severity, perceived life threat, and peri-traumatic dissociation. RESULTS: The residents directly affected by the bombardment (Kiryat Shmona; KS) endorsed more trauma exposure, (p <0.01); more prior trauma, (p <0.01); more life threat, (p <0.01); and greater PTSD symptomatology (12 % of KY participants and 38% of KS participants had probable PTSD), compared to residents in the comparison town (Kfar Yona; KY). Both groups reported a similar degree of peri-event dissociation (KS: M = 7.2 +/-3.7; KY: M = 7.3 +/-3.0). Perceived life threat mediated the relationship between exposure to bombardment and PTSD symptomatology. Time spent in bomb shelters was not associated with PTSD symptom severity. Prior shelling-related trauma negatively predicted PTSD. CONCLUSIONS: The terror of bombardment is a risk factor for PTSD among civilians. Although there is considerable resilience in chronically threatened communities, it is prudent to develop and implement public health approaches to prevent those most distressed during and after attacks from developing PTSD. Because, to a small degree, prior trauma exposure buffers the response to bombardment, interventions should consider leveraging citizens' past successful coping.

Factor structure of the Tonic Immobility Scale in female sexual assault survivors: an exploratory and Confirmatory Factor Analysis.

Tonic immobility (TI) is an involuntary component of the fear response that is characterized by freezing or immobility in situations involving extreme fear coupled with physical restraint. The present investigation evaluated the factor structure of the Tonic Immobility Scale (TIS; Forsyth, J. P., Marx, B., Fusé, T. M. K., Heidt, J., & Gallup, G. G., Jr. (2000). The Tonic Immobility Scale. Albany, NY: Authors)--a newly developed measure to assess components of TI in female sexual assault survivors. Study 1 (N=88) consisted of an Exploratory Factor Analysis of sexual assault survivors' responses on the TIS, whereas Study 2 (N=191) involved a Confirmatory Factor Analysis (CFA) with a second independent sample of female sexual assault survivors. Findings from both studies suggest that the TIS is comprised of two independent factors: physical immobility and fear. Findings are discussed in terms of the theoretical and practical implications of the factor solution obtained, particularly with regard to evaluating TI in adult survivors of sexual assault.

Heart rate of motor vehicle accident survivors in the emergency department, peritraumatic psychological reactions, ASD, and PTSD severity: a 6-month prospective study.

This small-scale study investigates the relationships between the heart rate of motor vehicle accident survivors presenting in the emergency department (ED) and acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) symptom severity. It also examines the relationships between the survivor's heart rate in the ED and peritraumatic dissociation and peritraumatic distress reported 2 weeks posttrauma. Fifty motor vehicle accident (MVA) survivors were assessed 2 weeks, 1 (N = 42), 3 (N = 37), and 6 months (N = 37) post-MVA. The heart rate in the ED predicted self-reported ASD symptom severity and clinician-rated PTSD symptom severity at 6 months but not at 1 or 3 months. Survivors' heart rate in the ED was significantly correlated with peritraumatic dissociation but not peritraumatic distress. These findings support the role of elevated ED heart rate as a predictor of both ASD and chronic PTSD symptom severity and may help to clarify the discrepant findings of previous research.