Protective factors and predictors of vulnerability to chronic stress: A comparative study of 4 communities after 7 years of continuous rocket fire
Protective factors and predictors of vulnerability to chronic stress: A comparative study of 4 communities after 7 years of continuous rocket fire
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DOI：
10.1016/j.socscimed.2011.10.022
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发表时间：
2012-03-01
影响因子：
5.4
通讯作者：
Silver, Roxane Cohen
中科院分区：
文献类型：
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作者：
Gelkopf, Marc;Berger, Rony;Silver, Roxane Cohen
世界各地的许多社区长期遭受极端暴力。来自以色列南部城市和农村社区的居民的反应，都暴露于7年的日常迫击炮射击，比较居民从人口，社会经济和地理上可比的非暴露对照样本，以检查保护因素和预测因素的脆弱性，以慢性战争相关的攻击。2007年，使用随机数字拨号法从一个高暴露城市（Sderot）和一个高暴露农村社区地区（Otef Aza）沿着一个人口统计学上可比较的非暴露城市（Ofakim）和非暴露农村社区地区（Hevel Lachish）获得了样本。总共有740人（81.8%的参与率）接受了关于创伤暴露，心理健康，功能和卫生保健利用的采访。在高度暴露的Sderot市，97.8%的居民曾在坠落的火箭弹附近;在高度暴露的Otef Aza农村社区地区，95.5%的居民受到类似的暴露。尽管长期遭受火箭袭击，Otef Aza的居民几乎没有表现出精神病：只有一人（1.5%）报告了与可能的创伤后应激障碍（PTSD）相一致的症状，功能水平与未受影响的社区没有差异。相比之下，创伤后应激反应、痛苦、功能障碍和保健利用率在高度暴露的斯德洛特市大大高于其他三个社区。缺乏资源与城市居民的脆弱性增加有关;所有样本的ITS预测因子包括女性、老年人、直接接触火箭、创伤史、遭受经济损失和缺乏社会支持。社区团结、归属感和对当局的信心的增强可能对农村社区居民起到了保护作用，尽管他们长期受到攻击。(C)2011爱思唯尔有限公司保留所有权利。
Many communities across the world are chronically exposed to extreme violence. Responses of residents from a city and rural community in Southern Israel, both exposed to 7 years of daily mortar fire, were compared to residents from demographically, socio-economically and geographically comparable non-exposed control samples to examine protective factors and predictors of vulnerability to chronic war-related attacks. Samples from a highly exposed city (Sderot) and a highly exposed rural community region (Otef Aza), along with a demographically comparable comparison non-exposed city (Ofakim) and non-exposed rural community region (Hevel Lachish), were obtained in 2007 using Random Digit Dialing. In total, 740 individuals (81.8% participation rate) were interviewed about trauma exposure, mental health, functioning and health care utilization. In the highly exposed city of Sderot, 97.8% of residents had been in close proximity to falling rockets; in the highly exposed rural community region of Otef Aza, 95.5% were similarly exposed. Despite exposure to chronic rocket attacks, residents of Otef Aza evidenced little symptomatology: only one person (1.5%) reported symptoms consistent with probable posttraumatic stress disorder (PTSD) and functioning levels did not differ from those of non-exposed communities. In contrast, posttraumatic stress (PTS), distress, functional impairment and health care utilization were substantially higher in the highly exposed city of Sderot than the other three communities. Lack of resources was associated with increased vulnerability among city residents; predictors of ITS across all samples included being female, older, directly exposed to rockets, history of trauma, suffering economic loss, and lacking social support. Increased community solidarity, sense of belonging and confidence in authorities may have served a protective function for residents of rural communities, despite the chronic attacks to which they were exposed. (C) 2011 Elsevier Ltd. All rights reserved.