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Vulnerability and Resilience in a Group Intervention with Hospital Personnel during Exposure to Extreme and Prolonged War Stress

Published online by Cambridge University Press:  20 March 2012

Yuval Palgi*
Affiliation:
Department of Gerontology, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
Menachem Ben-Ezra
Affiliation:
School of Social Work, Ariel University Center of Samaria, Ariel, Israel
Chaya Possick
Affiliation:
School of Social Work, Ariel University Center of Samaria, Ariel, Israel
*
Correspondence: Yuval Palgi, PhD Department of Gerontology, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 31905, Israel E-mail: [email protected]

Abstract

The current study presents a pilot demonstration of a new therapeutic procedure to mitigate symptoms of post-traumatic stress disorder (PTSD). The pilot took place during the Second Lebanon War. Vulnerability and resilience statements, as well as post-traumatic symptoms, were measured among special army administrative staff (SAAS) who worked in a hospital setting during extreme and prolonged war stress. All 13 soldiers in the unit studied participated in seven group therapy intervention sessions. It was hypothesized that shifting the focus of therapeutic intervention from the scenes of the events to the personal and professional narratives of preparing for the event would change the content of the soldiers’ narratives. It was believed that subtracting the number of positive statements from the number of negative statements would yield increasingly higher “resilience scores” during and after the war. It also was believed that such a change would be reflected in reduction of post-traumatic symptoms. As expected, the participants showed a decrease in vulnerability and an increase in resilience contents, as well as a decrease in traumatic symptoms during and after the war. These findings may reflect the effects of the ceasefire, the mutually supportive attitude of the participants, and the therapeutic interventions.

Type
Brief Report
Copyright
Copyright Palgi © World Association for Disaster and Emergency Medicine 2010

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References

1.Bryant, RA, Harvey, AG. Acute Stress Disorder: A Handbook of Theory, Assessment, and Treatment. Washington, DC: American Psychological Association; 2000.CrossRefGoogle Scholar
2.Mayou, RA, Ehlers, A, Hobbs, M. Psychological debriefing for road traffic accident victims: three-year follow-up of a randomized controlled trial. Br J Psychiatry. 2000;176(6):589593.Google Scholar
3.Luce, A, Firth-Cozens, J, Midgley, S, Burges, C. After the Omaha bomb: posttraumatic stress disorder in health service staff. J Trauma Stress. 2002;15(1):2730.Google Scholar
4.Ben-Ezra, M, Palgi, Y, Essar, N. Impact of prolonged war stress on posttraumatic stress symptoms in hospital personnel. Gen Hosp Psychiatry. 2007;29(3):262264.CrossRefGoogle ScholarPubMed
5.Palgi, Y, Ben-Ezra, M, Langer, S, Essar, N. The effect of prolong exposure to war stress on the comorbidity of PTSD and depression among hospital personnel. Psychiatry Res. 2009;168(3):262264.Google Scholar
6.McNally, RJ, Bryant, RA, Ehlers, A. Does early psychological intervention promote recovery from posttraumatic stress? Psychol Sci Publ Inter. 2003;4(2):4579.CrossRefGoogle ScholarPubMed
7.Sijbrandij, M, Olff, M, Reitsma, JB, Carlier, IVE, Gersons, BPR. Emotional and educational debriefing after psychological trauma: randomized controlled trial. Br J Psychiatry. 2006;189(2):150155.CrossRefGoogle Scholar
8.Campfield, KM, Hills, AM. Effect of timing of critical incident stress debriefing (CISD) on posttraumatic symptoms. J Trauma Stress. 2001;14(2):327340.Google Scholar
9.Kaplan, Z, Iancu, I, Bodner, E. A review of psychological debriefing after extreme stress. Psychiatr Serv. 2001;52(6):824827.Google Scholar
10.Marchand, A, Guay, S, Boyer, R, Iucci, S, Martin, A, St-Hilaire, M. A randomized controlled trial of an adapted form of individual critical incident stress debriefing for victims of an armed robbery. Brief Treat Crisis Interv. 2006;6(2):122129.Google Scholar
11.Hobbs, M, Mayou, R, Harrison, B, Worlock, P. A randomised controlled trial of psychological debriefing for victims of road traffic accidents. BMJ. 1996;313:14381439.Google Scholar
12.Palgi, Y, Ben-Ezra, M. Back to the future: narrative treatment for post-traumatic, acute stress disorder in the case of paramedic Mr. G. Pragmatic Case Studies in Psychotherapy. 2010;6(1):126.CrossRefGoogle Scholar
13.Palgi, Y, Ben-Ezra, M. Prepared and still surprised. Pragmatic Case Studies in Psychotherapy. 2010;6(1):4348.CrossRefGoogle Scholar
14.Weiss, D, Marmar, C. The Impact of Event Scale-Revised. In: Wilson, J, Keane, T, eds, Assessing Psychological Trauma and PTSD. New York: Guilford; 1997:168189.Google Scholar
15.Ozer, EJ, Best, SR, Lipsey, TL, Weiss, DS. Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull. 2003;129(1):5273.CrossRefGoogle ScholarPubMed
16.Creamer, M, Bell, R, Failla, S. Psychometric properties of Impact of Event Scale—Revised. Behav Res Ther. 2003;41(12):14891496.CrossRefGoogle ScholarPubMed
17.Ben-Ezra, M, Soffer, CY. Hospital personnel reactions to Haiti’s earthquake: a preliminary matching study. J Clin Psychiatry. 2010;71:17001701.Google Scholar
18.Ben-Ezra, M, Palgi, Y, Wolf, JJ, Shrira, A. Psychiatric symptoms and psychosocial functioning among hospital personnel during the Gaza War: a repeated cross-sectional study. Psychiatry Res. 2011;189(3):392395.CrossRefGoogle Scholar
19.Fredrickson, BL, Losada, MF. Positive affect and the complex dynamics of human flourishing. Am Psychol. 2005;60(7):678686.CrossRefGoogle ScholarPubMed
20.Strauss, A. Qualitative Analysis for Social Scientists. New York: Cambridge University Press; 1987.Google Scholar
21.Ben-Ezra, M, Palgi, Y, Shrira, A, Sternberg, D, Essar, N.Changes in posttraumatic symptoms patterns during and after exposure to prolonged extreme war stress: An uncontrolled preliminary report supporting the dose-response model. Prehosp Disaster Med. 2010;25(1):3841.Google Scholar
22.Marchand, A, Guay, S, Boyer, R, Iucci, S, Martin, A, St-Hilaire, MH. A randomized controlled trial of an adapted form of individual critical incident stress debriefing for victims of an armed robbery. Brief Treatment and Crisis Intervention. 2006;6(2):122129.CrossRefGoogle Scholar
23.Herbert, JD, Sageman, M. “First do no harm:” emerging guidelines for the treatment of posttraumatic reaction. In Rosen, GM, ed, Psychotraumatic Stress Disorder: Issues and Controversies. Chichester: John Wiley & Sons; 2004:213232.Google Scholar
24.Bryant, RA, Harvey, AG, Dang, S, Sackville, T, Basten, C.Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling. J Consult Clin Psychol. 1998;66(5):862866.Google Scholar
25.Ursano, RJ, Fullerton, CS, Vance, K, Wang, L. Debriefing: its role in the spectrum of prevention and acute management of psychological trauma. In: Raphael, B, Wilson, JP, eds, Psychological Debriefing: Theory, Practice and Evidence. Cambridge: Cambridge University Press; 2000:3242.CrossRefGoogle Scholar
26.Gray, MJ, Litz, BT. Behavioral interventions for recent trauma: empirically informed practice guidelines. Behav Modif. 2005;29(1):189215.CrossRefGoogle ScholarPubMed
27.Loftus, EF, Garry, M, Feldman, J. Forgetting sexual trauma: what does it mean when 38% forget? J Consul Clin Psychol. 1994;62(6):11771181.Google Scholar
28.Seery, MD, Cohen, R, Holman, AE, Ence, WA, Chu, TQ. Expressing thoughts and feelings following a collective trauma: Immediate responses to 9/11 predict negative outcomes in a national sample. J Consult Clin Psychol 2008;76(4):657667.Google Scholar
29.Rubin, DC, Berntsen, D, Bohni, MK. A memory-based model of posttraumatic stress disorder: evaluating basic assumptions underlying the PTSD diagnosis. Psychol Rev. 2008;115(4):9851011.Google Scholar