Danny Brom

Construct Validation of the Dutch Version of the Impact of Event Scale

The Impact of Event Scale (ES; M. J. Horowitz, N. Wilner, & W. Alvarez, 1979) is a worldwide-used self-report measure to assess the frequency of intrusive and avoidant phenomena after a variety of traumatic experiences. The purpose of this article is to assess the psychometric value of the Dutch version of the IES (D. Brom & R. J. Kleber, 1985) in several samples of individuals who had experienced various traumatic stressors. The reliability and structure of the IES were evaluated in 3 different samples (total N = 1.588). The reliability of the Dutch version of the IES was adequate across the various stressors. The construct validity was assessed by using confirmatory factor analyses. Outcomes revealed a robust structure over the various samples, generally supporting the composition of the original IES.

Adolescent exposure to recurrent terrorism in Israel: posttraumatic distress and functional impairment.

This study examines the impact of exposure to ongoing terrorism on 695 Israeli high school students. Exposure was measured using a questionnaire developed for the security situation in Israel. Posttraumatic symptoms were measured using the UCLA PTSD Index for DSM-IV--Adolescent Version (N. Rodriguez, A. Steinberg, & R. S. Pynoos, 1999), functional impairment and somatic complaints were assessed using items derived from the Diagnostic Interview Schedule for Children (C. P. Lucas et al., 2001), and depression was measured with the Brief Beck Depression Inventory (A. T. Beck & R. W. Beck, 1972). According to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994), the prevalence of probable posttraumatic stress disorder was 7.6%. Girls reported greater severity of posttraumatic symptoms, whereas boys exhibited greater functional impairment in social and family domains. School-based screening appears to be an effective means of identifying adolescents who have been exposed to terror and are experiencing posttraumatic stress symptomatology and psychosocial impairment.

Building Resilience in Schools in the Wake of Hurricane Katrina

The Building Resilience Project (BRP), a project that was developed in Israel in the wake of terrorism and war, was implemented in Biloxi, Mississippi one year after Hurricane Katrina. The BRP is a teacher-based intervention that focuses on empowering teachers to cope with their own stressors and those of their students in the aftermath of trauma. This article examines the ecological model of the BRP, and offers a description of the teacher workshops while also providing the rationale for implementing a teacherbased intervention in Biloxi. Feedback and follow-up data from participants’ selfreports is presented, as well as recommendations for future implementation.

Are Community Studies of Psychological Trauma's Impact Accurate? A Study Among Jews and Palestinians

We evaluated the accuracy of posttraumatic stress disorder (PTSD) and major depression (MD) diagnoses using brief assessment instruments conducted by phone. PTSD and MD were assessed by telephone interview in a randomly selected sample of Jewish and Palestinian residents of Jerusalem (N = 150) during a period of marked threat of terrorism and war. We utilized the PTSD Symptom Scale Interview Format (Foa, Riggs, Dancu, & Rothbaum, 1993) and the Patient Health Questionnaire-9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001). We then conducted in-depth, in-person interviews within 2 weeks, assessing PTSD and MD using the Composite International Diagnostic Interview (CIDI; Kessler et al., 2004). The prevalence of PTSD and MD diagnosis ascertained by the 2 assessment modalities was similar. Indices of classification accuracy for the phone interview, using the in-person interview as the standard, ranged from modest to high. Brief phone and in-depth in-person measures of PTSD and MD also correlated similarly with other demographic, stress, and coping factors, suggesting convergent validity. Brief phone interviews appear useful for estimating the prevalence of psychological disorders in mass casualty contexts and may have a critical role in both epidemiologic work and guiding public health interventions.

The Trauma of Terrorism: Contextual Considerations

Summary This introductory article maps some of the key contextual issues for this volume. Stating the challenges posed by the “new normality” thrust upon the world by the September 11 attacks, it reviews historical trends and definitional distinctions, including non-state, state and state-sponsored terrorism, and the international institutional and legal structures for combating it. The introduction proposes a multidimensional, multidisciplinary, integrative framework conceptualizing the consequences of the trauma of terrorism and informing optimal interventions. It critically reviews formulations in existing nosologies and summarizes the volume, addressing consequences and mitigation of terrorisms effects on people, communities, societies, and nations.

Growing Up Under Fire: Building Resilience in Young Children and Parents Exposed to Ongoing Missile Attacks

This article presents data from a project in Sderot, Israel designed to build resilience for 255 young children and their families. During the time of the project, the area was under continual exposure to missile attacks and resulting traumatic events. The phenomenology of living under continual exposure to missiles attacks, as well as the impact of the ongoing fear and uncertainty on both the children and their parents, are presented through voices of the parents. The clinical picture for young children and their parents coping with ongoing terrorism indicated a high level of posttraumatic distress for children (33%) and for mothers (28%). An integrative model was developed and implemented with three major components: clinical screening and treatment with an adjusted dyadic therapy for peritraumatic and posttraumatic circumstances; building resilience intervention by workshops for both parents and teachers; and building local capacity and sustainability by training local therapists, parents, and teachers.

Sharing Knowledge and Shared Care

Summary This concluding article presents the main themes that emerged from this volume within a multidimensional, multidisciplinary integrative framework conceptualizing the consequences of the trauma of terrorism and informing optimal prevention and intervention methods. It reviews short- and long-term findings of the effects of terrorism on adults, children, families, communities, and societies and makes numerous research recommendations. Viewing terrorism as psychological warfare against the community, it advances community-based, culturally congruent interventions, with a public mental health approach, in an ongoing, integrated network of services promoting community and individual resilience, specialized training, international collaboration, and continued dialogue concerning the role of the media.

Stability and Change in Posttraumatic Distress: A 7-Year Follow-Up Study of Mothers and Young Children Exposed to Cumulative Trauma

In situations of cumulative trauma, it is often unclear why some people remain resilient, whereas others experience distress, and how likely these responses are to change over time. To investigate the constancy of responses to cumulative trauma, stability and change in posttraumatic distress and resistance (as defined by no evidence of clinical symptoms) were assessed twice in 140 Israeli children and mothers exposed to continual rocket attacks over approximately 7 years, when the children were 2-4 (Time 1) and 9-11 years of age (Time 2). Measures included trauma exposure, posttraumatic and depressive symptoms, and child behavioral problems. We identified 4 longitudinal courses (LCs): resilient (resistance at Time 1 and Time 2), recovered (clinical distress at Time 1 and resistance at Time 2), developed symptoms (resistance at Time 1 and clinical distress at Time 2), and chronic distress (clinical distress at Time 1 and Time 2). Results showed more stability than change in the frequencies of resistance at both times of measurement. The resilient LC was the most common longitudinal course for both mothers and children. Multinomial regression models indicated that maternal posttraumatic symptoms predicted the recovered and chronic distress LCs of the children.

Transitioning from the Battlefield to Home: An Innovative Program for Israeli Soldiers

Soldiers moving from the army to civilian life encounter significant challenges during this time of transition, both in Israel and internationally. Identifying this period of time as a critical one, the Peace of Mind program is an innovative intervention designed specifically to address the issues occurring therein. This unique model focuses on mental health and normalization of responses, as well as on the processing of traumatic experiences. It is based on the considerable experience at the Israel Center for the Treatment of Psychotrauma in the fields of resilience building and trauma treatment. After reviewing the literature on returning soldiers, the model is described and several vignettes are presented.

Somatic Experiencing for Posttraumatic Stress Disorder: A Randomized Controlled Outcome Study

This study presents the first known randomized controlled study evaluating the effectiveness of somatic experiencing (SE), an integrative body‐focused therapy for treating people with posttraumatic stress disorder (PTSD). There were 63 participants meeting DSM‐IV‐TR full criteria for PTSD included. Baseline clinical interviews and self‐report measures were completed by all participants, who were then randomly assigned to study (n = 33) or waitlist (n = 30) groups. Study participants began 15 weekly SE sessions, whereas waitlist participants waited the same period, after which the second evaluation was conducted. All participants were evaluated a third time after an additional 15 weeks, during which time the waitlist group received SE therapy. Pretreatment evaluation showed no significant differences between groups. Mixed model linear regression analysis showed significant intervention effects for posttraumatic symptoms severity (Cohens d = 0.94 to 1.26) and depression (Cohens d = 0.7 to 1.08) both pre‐post and pre‐follow‐up. This randomized controlled study of SE shows positive results indicating SE may be an effective therapy method for PTSD. Further research is needed to understand who shall benefit most from this treatment modality.