A longitudinal study of changes in psychological responses to continuous terrorism.

Objective: The impact of ongoing terror over time has received little attention. This study assesses longitudinally prevalence and predictors of posttraumatic stress symptoms' trajectories, namely resistance, resilience, late-onset and chronicity in the course of intensive and ongoing terror.

Method: Two surveys were performed at a two-year interval among 153 Jewish Israeli adults.

Results: Results show probable PTSD prevalence, number of traumatic stress related symptoms (TSRS), and rate of severe posttraumatic symptomatology (PTSS) to increase over time (from 18.2% to 31.2%). With this, many (66.7% of those with PTSD and 39.3% of those with PTSS at wave 1) recovered. Late-onset of severe PTSS (19.6% of the sample) was predicted by income reduction, a major lifetime traumatic event, sense of threat, dissociation, coping via disengagement and low mood. Chronicity was predicted by sense of threat, pessimism, dissociation and disengagement.

Conclusions: Continuous exposure to terror has a strong negative impact on mental health. Secondly, even within a chronic situation of terror, a large proportion of individuals with elevated levels of posttraumatic symptomatology recover over time; third, prolonged exposure to terror may also exacerbate symptomatology, but not per-se trigger new PTSD cases.