Shaul Kimhi

Sense of coherence and socio-demographic characteristics predicting posttraumatic stress symptoms and recovery in the aftermath of the Second Lebanon War

Abstract This study investigated the role of sense of coherence (SOC) as a mediator between demographic attributes of individuals (gender, age, economic situation, and exposure to traumatic events during the war) and two war outcomes (postwar stress symptoms and perceived posttraumatic recovery). The participants were 870 adults (ages ranged between 20 and 85), who were affected by the Second Lebanon War and were evacuated from their home town. They were administered the research questionnaire approximately one year after this war. Path analysis indicated the following: gender, age, economic situation, and exposure were significantly associated with level of symptoms as well as perceived recovery. However, three of these connections (age, economic, and exposure) were partially mediated by SOC which was linked with lower levels of stress symptoms and higher levels of perceived posttraumatic recovery. Unlike our hypothesis, exposure by age interaction was not significantly associated with SOC and the two war outcomes. Results supported the hypotheses that SOC mediates between demographic characteristics and negative (symptoms) as well as positive (perceived recovery) war outcomes.

Are women at higher risk than men? Gender differences among teenagers and adults in their response to threat of war and terror

ABSTRACT The present study examined whether women are at higher risk of developing stress reactions in situations of war and terror. The study looked at gender differences within two samples–teenagers (n = 353) and adults (n = 890)–regarding the impact of stress that developed in response to a situation of threat of war and terror as a result of Israels withdrawal from Lebanon. The study tested: (1) gender differences regarding cognitive appraisal of the stressor, coping styles, psychological symptoms, and life satisfaction; (2) whether cognitive appraisal and coping styles mediated gender differences in psychological symptoms and life satisfaction; and (3) whether the two age groups differed regarding the contribution of gender to the studied variables. The results revealed that among the teenagers, gender differences were found only in cognitive appraisal and psychological symptoms, while among adults, gender differences were found in all the studied variables. The results support the mediating hypothesis with regard to psychological symptoms, but not with regard to life satisfaction. The results also show a different contribution of gender in each of the age groups regarding psychological symptoms, but not regarding life satisfaction, which leaves some doubt regarding the assumptions that women tend to be more affected by stress than men.

Elderly People Coping With the Aftermath of War: Resilience Versus Vulnerability

OBJECTIVES The present study compares coping of elderly people and two younger groups 1 year after a war. Coping was determined by stress symptoms and posttraumatic recovery and two levels of resiliency. DESIGN AND SETTING Thirty-six streets (covering most of the city streets) were sampled randomly from the map of Kiryat Shemona (a town next to the Lebanese border) about a year after the end of the Second Lebanon War. PARTICIPANTS The sample constituted 870 adult residents of the town. Participants were divided into three age groups: elderly (age 65 years and older, N = 108), adults (age 46-64 years, N = 252) and young adults (age 20-45 years, N = 462). MEASUREMENTS 1) Stress symptoms measured by short version of Brief Symptom Inventory; 2) Individual resilience measured by Sense of Coherence Inventory; 3) Posttraumatic Recovery Inventory (PTR); and 4) Public Resilience Scale (included a scale for community and national resilience). RESULTS The results indicated 1) The elderly group reported significantly higher levels of stress symptoms and lower levels of PTR; 2) Females in the three age groups reported higher levels of stress symptoms and lower levels of PTR and individual resilience than males; 3) Individual and public resilience negatively predicted stress symptoms and positively predicted posttraumatic recovery across three age groups; and 4) Public resilience has a differential effect on stress symptoms in each of the three age groups but not on PTR. CONCLUSION Results question the division of older people into a vulnerable or inoculated group, indicating that the participants responded concurrently in a more vulnerable and a more resilient manner. Older people were characterized by higher levels of postwar stress symptoms, as well as a higher sense of coherence.

Sense of Danger and Family Support as Mediators of Adolescents' Distress and Recovery in the Aftermath of War

Posttraumatic stress and recovery were investigated among 820 adolescents living on the Israeli-Lebanese border 1 year after the Second Lebanon War of 2006. It was hypothesized that most adolescents would not report serious symptoms, whereas a minority would complain about high-level prolonged postwar symptoms. Another minority would indicate posttraumatic recovery. It was also hypothesized that associations of age, gender, and exposure to war distress with postwar stress symptoms as well as posttraumatic recovery would be mediated by family support and subjective sense of danger. Results generally supported these contentions.

Teenagers Response to Threat of War and Terror: Gender and the Role of Social Systems

This study focuses on the role of gender and the way social systems (family and friends’ support, stress attributed to parents, friends and others in the community) are perceived in contributing to the reaction to stressors of war and threat of terror among teenagers living in Israel along the Lebanese border. The study was implemented shortly after Israel’s withdrawal from Lebanon with a sample of 353 teenagers. The study is based on the teenagers’ self-report. The results reveals the following: (a) gender relates significantly to level of stress but not to general life satisfaction; (b) stress attributed to the parents and to the peers has a greater contribution to the level of stress than the supportive family atmosphere and peer support; (c) stress attributed to the parents and peers was found to be a mediator between gender and level of stress; (d) supportive family atmosphere was found to be a mediator between gender and one measurement of stress, while peer support was not found to have any mediating role. Special attention is given to the finding that stress attributed to parents and friends has greater significance than the support provided by them.

Levels of resilience: Associations among individual, community, and national resilience

This article focuses on limited knowledge regarding the associations among three levels of resilience and the importance of these associations: individual, community, and national. The few studies that have examined these associations indicated the following: (a) There are significant positive low correlations among individual, community, and national resilience. (b) Some demographic variables significantly predict all three of them. (c) There is limited knowledge whether and to what degree there are mutual influences among these levels of resilience. (d) All three levels of resilience predict individual well-being and successful coping with potential traumatic events.

Youth in the Military: Gendered Experiences in the Conscript Service in the Israeli Army*

Conscript military service is a pivotal experience for young Israelis of both genders. Juxtaposing conflicting claims concerning women’s military experience—the women’s marginalization claim and the youth moratorial self-enhancing claim—we compare men’s and women’s retrospective evaluations of six aspects of their service in the Israeli army: hardship, adaptation, motivation, investment, service significance, and personal benefits. Military service was found to be as meaningful and benefiting for women no less than for men. However, the dynamics of the moratorium experience differ by gender, in keeping with the differentiated substance and gendered social construction of their military roles.

Post-traumatic Recovery to Distress Symptoms Ratio Mediates Relations of Resilience Fostering Resources and Their Predictors.

A large-scale study investigated the direct and indirect effects of demographic predictors and traumatic experiences on resilience fostering resources following a war. The sample consisted of 829 Israeli adults, living in a border town, 1 year after experiencing the 2006 war with Lebanon. Resilience was assessed by measures of individual and public resilience and low sense of danger. Results show that as hypothesized the proportion of post-traumatic recovery to post-war distress symptoms predicts these indices of resilience and partly mediates the direct links between these indices and demographic predictors (age, gender and economic condition) and exposure to war. Research of resilience has proposed several prototypical trajectories that characterize responses to potentially traumatic events. Our discussion suggests that these trajectories and their changes over time can be accounted for by the balance of post-war recovery to symptoms level. Copyright

The Missing Link in Resilience Research

Bonanno, Romero and Klein (this issue) review many aspects of individual, family and community resilience studies, highlighting the fact that resilience is a multi-dimensional, complex construct which is affected by many factors. Their review raises different options for determining resilience outcomes, and discusses the available tools as well as the timing of measurement. This article is a most comprehensive and important review of resilience research which presents an intellectual challenge to every scholar in this field. The following commentary will address some of the author’s main arguments and raise additional options and questions.

Community Resilience of Civilians at War: A New Perspective

A new concept of community resilience pertaining to the community’s post adversity strength to vulnerability ratio was associated with five determinants: individual resilience, national resilience, well-being, community size, and sense of coherence. The data was collected four months after Israel’s war in the Gaza Strip in 2014. Participants were 251 adult civilians living in southern Israel who have recently been threatened by massive missile attacks, and 259 adults living in northern Israel, which has not been under missile fire recently. The investigated variables predicted community resilience, and their effects were mediated by sense of coherence. Results which were similar for both samples were discussed in terms of the nature of resilience and in terms of proximal and distal exposure to war.