NATAL, The Israel Trauma Center for Victims of Terror and War, Tel Aviv, Israel.
Soc Sci Med. 2012 Mar;74(5):757-66. doi: 10.1016/j.socscimed.2011.10.022. Epub 2011 Nov 29.
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 PTS 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.
世界上许多社区都长期面临极端暴力。本研究比较了以色列南部一个城市和一个农村社区的居民与人口统计学、社会经济和地理位置相似的未暴露对照组居民的反应，以研究保护因素和易感性脆弱性的预测因素，这些社区居民都经历了 7 年的每日迫击炮弹袭击。2007 年，使用随机数字拨号获得了来自高度暴露城市（斯德洛特）和高度暴露农村社区地区（奥特夫阿扎）的样本，以及人口统计学上可比的未暴露对照组城市（奥法基姆）和未暴露对照组农村社区地区（赫维尔拉奇什）。总共对 740 人（81.8%的参与率）进行了创伤暴露、心理健康、功能和医疗保健利用情况的访谈。在斯德洛特这个高度暴露的城市，97.8%的居民曾近距离接触过坠落的火箭；在奥特夫阿扎这个高度暴露的农村社区地区，95.5%的居民也同样暴露在这种环境下。尽管面临着慢性火箭袭击，奥特夫阿扎的居民几乎没有表现出明显的症状：只有一个人（1.5%）报告的症状符合创伤后应激障碍（PTSD）的可能症状，而且他们的功能水平与未暴露社区的居民没有差异。相比之下，在高度暴露的斯德洛特市，创伤后应激（PTS）、痛苦、功能障碍和医疗保健利用的情况比其他三个社区都要高得多。城市居民缺乏资源与易感性增加有关；所有样本中 PTS 的预测因素包括女性、年龄较大、直接暴露于火箭弹、创伤史、经济损失和缺乏社会支持。尽管农村社区居民长期受到袭击，但社区团结、归属感和对当局的信心增加可能对他们起到了保护作用。
