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Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder.

Methods

A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews.

Results

The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD.

Conclusions

A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.

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Acknowledgments

This research was made possible in part by a grant from the National Institute of Mental Health (RO1MH073687) and the Ohio Board of Regents. Dr. Hall was supported by the National Institute of Mental Health T32 in Psychiatric Epidemiology (T32MH014592-35) and through the Fogarty Global Health Fellows Program (1R25TW009340-01). Sarah Murray was supported by National Institute of Mental Health National Research Service Award (F31 5F31MH099959-02).

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Faculty of Social Sciences, Department of Psychology, University of Macau (E21), Avenida Da Universidade, Taipa, Macau (SAR), People’s Republic of China

    Brian J. Hall

  2. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

    Sarah M. Murray

  3. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA

    Sandro Galea

  4. School of Political Science, University of Haifa, Haifa, Israel

    Daphna Canetti

  5. Department of Behavioral Sciences, Rush University Medical Center, Chicago, USA

    Stevan E. Hobfoll

Authors
  1. Brian J. Hall
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  2. Sarah M. Murray
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  3. Sandro Galea
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  4. Daphna Canetti
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  5. Stevan E. Hobfoll
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Corresponding author

Correspondence to Brian J. Hall.

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Hall, B.J., Murray, S.M., Galea, S. et al. Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority. Soc Psychiatry Psychiatr Epidemiol 50, 561–568 (2015). https://doi.org/10.1007/s00127-014-0984-z

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  • DOI: https://doi.org/10.1007/s00127-014-0984-z

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