Mental Health and Posttraumatic Growth in Civilians Exposed to Ongoing Terror

How Does Parenthood Moderate Paths Between Personal and Community Resources and Distress following Collective Trauma?

This study examines the moderating role of parenthood in associations between personal and community resources and psychological distress and somatization following collective exposure to security threats. The research questions were guided by Terror Management Theory that posits that parenthood involves heightened anxiety when children are in danger yet may also provide an existential resource that can reduce the individuals' distress. The study was conducted following the 2014 Israel-Gaza conflict and included 1014 Israelis. The participants completed a questionnaire assessing levels of trauma exposure (the predictors), sense of mastery (personal resource), engagement in community activities and trust in leaders (community resources), and psychological distress and somatization (the outcomes). Results indicated that parenthood moderated several associations between trauma exposure and personal and community resources as well as paths between these resources and psychological distress. In almost all these cases, these paths were statistically significant only among parents in two different directions. Parenthood was associated with more psychological distress through lower sense of mastery and greater engagement in community activities. On the other hand, parenthood was related to lower psychological distress through greater trust in local leaders. In addition, only among parents, lower levels of mastery mediated the association between trauma exposure and somatization. These results offer significant implications for practitioners. Although parents and non-parents can be similarly affected by trauma exposure with respect to trauma-related outcomes, the way to assist them to reduce these negative outcomes should be conducted through different paths involving their personal and community resources.

Media Exposure to Armed Conflict: Dispositional Optimism and Self-Mastery Moderate Distress and Post-Traumatic Symptoms among Adolescents

BACKGROUND

Rapid technological developments enable the immediate transmission of armed conflict events through a variety of media channels, inducing mass anxiety, fear, and helplessness. Youth are particularly vulnerable and face new challenges as a result of this exposure. The effects of media exposure to such events on psychological distress and post-traumatic symptoms were examined.

METHODS

A total of 161 participants aged 13-18 years completed a questionnaire battery that included measures of media exposure to armed conflict events, previous direct exposure to armed conflict events, psychological distress, post-traumatic symptoms, dispositional optimism, and self-mastery. A structural equation model (SEM) approach was employed for data analysis.

RESULTS

The extent of media exposure to armed conflict was directly associated with psychological distress and post-traumatic symptoms. Dispositional optimism moderated the association between media exposure and psychological distress, while self-mastery moderated the association between media exposure and post-traumatic symptoms. The effects of the Internet factor of media exposure, which included social media, were particularly disturbing as neither of the resilience factors moderated negative outcomes.

CONCLUSIONS

The findings suggest that clinical interventions to enhance dispositional optimism and self-mastery as well as other potential resilience factors can protect adolescents from the severe effects of media exposure to violent armed conflict events. Developmental and public health implications related to vulnerabilities and resilience during adolescence are discussed.

The Role of Coping Strategies in Post-Traumatic Growth among Syrian Refugees: A Structural Equation Model

The Syrian conflict has led to a mass migration of Syrians to other countries and exposed them to many possible traumatic events and stressors in their country of origin and in the resettlement process. The possibility of positive psychological effects of adverse life events is less documented among Syrian refugees. Thus, the current study aimed to develop preliminary evidence for the identifying factors: traumatic experiences, post-migration stressors and coping strategies that are associated with post-traumatic growth (PTG) of Syrian refugees residing in Turkey. Structural equation modeling (SEM) was used in the current study to assess the associations among these factors. Data were obtained from Syrian refugees residing in the governorates of Hatay and Mardin. A total of 528 Syrians, aged between 18-77 years (M = 35.60, SD = 11.65) participated in this cross-sectional study. Results from the SEM indicated that past traumatic experiences and post-migration stressors were indirectly related to PTG. The results from the current study provide support for that the association between refugees' traumatic experiences, post-migration stressors and PTG appear to be explained through the presence of coping strategies which could be addressed in the psychotherapies and psychosocial interventions for refugees to promote positive psychological change. Future studies should address the effects of post-migration stressors on PTG in detail.

Mastery, Social Support, and Sense of Community as Protective Resources Against Psychological Distress Among Israelis Exposed to Prolonged Rocket Attacks

We investigated the psychological toll of exposure to rocket attacks as experienced by residents of central and southern Israel during the 2014 Israel-Gaza conflict. Participants completed an online survey assessing their life-threatening experiences, the availability of psychosocial resources, and symptoms of both PTSD (PCL-5) and nonspecific psychological distress (K6) 2-3 months posttrauma. Guided by the conservation of resources theory, we focused on the distress-protective functions of person- and community-oriented resources: mastery, perceived social support, and sense of community. Hierarchical regression analyses revealed that elevated exposure to rocket attacks predicted higher levels of PTSD but not psychological distress. All 13 predictors (i.e., sociodemographic factors, trauma exposure, personal and community resources) and three interactions between rocket attack-related trauma exposure and each of the resources accounted for a significant amount of the variance in PTSD, R² = .251, adjusted R² = .235, and nonspecific psychological distress, R² = .280, adjusted R² = .264. Predictably, higher levels of mastery and perceived social support were associated with lower PCL-5 and K6 scores. Unexpectedly, respondents who reported a higher sense of community exhibited more PTSD symptoms. Supplementary analyses indicated that among individuals with lower levels of mastery, sense of community was related to higher PCL-5 scores. Psychosocial resources are important for coping with community-wide stressors, but their roles are complex. Maintaining a sense of community among individuals who experience shared trauma is undoubtedly critical, yet potential downsides of collective coping among those with lower levels of mastery should be recognized and further investigated.

Discrimination and Posttraumatic Growth Among Muslim American Youth: Mediation via Posttraumatic Stress Disorder Symptoms

Muslim Americans increasingly have been targets of discrimination. Previous research has provided preliminary evidence that higher perceived discrimination is associated with higher symptoms of discrimination-related posttraumatic stress disorder (PTSD) symptoms and higher discrimination-related posttraumatic growth (PTG). Further research in other contexts has shown that PTSD symptoms mediate the relationship between event severity and PTG. However, no existing studies have explored discrimination-related PTG and whether PTSD symptoms mediate the relationship between perceived discrimination and discrimination-related PTG among Muslim Americans. The current study included 110 Muslim American college students who completed an online survey assessing perceived discrimination, discrimination-related PTSD symptoms, and discrimination-related PTG. Higher perceived discrimination was significantly associated with higher discrimination-related PTG at the bivariate level. In a multivariable mediation model, the indirect effect of perceived discrimination on discrimination-related PTG via discrimination-related PTSD was statistically significant. The results suggest that clinicians working with Muslim American college students should attend to the ways in which their discriminatory experiences could foster PTG, in addition to helping them cope with PTSD symptoms.

Grief intensity, coping and psychological health among family members and friends following a terrorist attack

This study investigates the association of psychological health with grief intensity and coping style among family members and friends of terror victims. The data was collected from 164 bereaved individuals, on average, 18 months after the bombings occurred. The results demonstrated the significant role of problem-focused social support, and religious coping in dealing with grief intensity and contributing to the psychological health. The findings may be of considerable importance in therapeutic situations by providing direction for coping with both the effects of traumatic event and a traumatic loss, and for maintaining emotional stability through reworking relationships with the deceased.

Engagement in community activities and trust in local leaders as concomitants of psychological distress among Israeli civilians exposed to prolonged rocket attacks

BACKGROUND AND OBJECTIVES

Present study, conducted in the aftermath of the 2014 Israel-Gaza conflict, investigated psychological toll of exposure to rockets attacks in a sample of residents of central and southern Israel. Analyses focused on the distress-protective functions of collectively grounded resources: engagement in community activities and trust in local leadership.

DESIGN

This cross-sectional study was conducted between 2 and 3 months after the hostilities.

METHOD

Participants (N = 764) were recruited by an online survey company that distributed a questionnaire assessing, in addition to focal predictors, sociodemographic factors and prior exposure to trauma. The outcome variables were post-traumatic stress disorder (PTSD) and nonspecific distress symptoms.

RESULTS

Conservative regression analyses revealed that greater exposure to rocket attacks was predictive of higher levels of posttraumatic stress symptoms. Higher engagement in community activities exhibited a partial trauma-buffering function. However, higher levels of trust in local leaders appeared to exacerbate, rather than diminish, negative impact of rocket exposure on PTSD. Symptoms of psychological distress were not influenced neither by trauma exposure nor by stressor interactions with resources. Trust in local leadership exerted a beneficial main effect on distress.

CONCLUSIONS

Collectively based resources are important for coping in times of community-wide stressors, yet their role is complex.

Maintaining helper wellness and competence in a shared trauma reality

As shared trauma reality becomes more common in Israel and other countries, this commentary argues that we need more research to inform how to best assist mental health professionals who are both victims and helpers in the aftermath of traumatic events. Typical remedies for the occupational hazards of working with trauma survivors may not apply for those who are exposed to a prolonged terror threat. Research-informed self-care strategies need to be identified and practiced.

Personally important posttraumatic growth in adolescents: The effect on self-esteem beyond commonly defined posttraumatic growth

Research on posttraumatic growth (PTG), positive psychological changes that may occur as a result of highly stressful life events, reveals adolescents are able to experience PTG. The current study tests individual differences among adolescents in relative importance of PTG and examines the relationships among personally important PTG, commonly defined PTG, and self-esteem. Adolescents (N = 145) with the mean age of 15.75 (SD = 1.13) completed the Rosenberg Self-Esteem Scale and PTG Inventory, and then reported which items on the PTG Inventory were personally important to them. Results indicated within-scale differences in item importance on the PTG Inventory. Personally important PTG was a better predictor of adolescent self-esteem than commonly defined PTG, measured as total PTGI score or each of the five factors. These findings suggest future research should look at both short-term and long-term effects of personally important PTG as well as commonly defined PTG.