Journal of Traumatic Stress

, Volume 9, Issue 2, pp 207–221 | Cite as

Psychological adaptation of anxiety disorder patients following repeated exposure to emergency situations

  • Eli Somer
  • Giora Keinan
  • Devora Carmil
Regular Articles


Thirty one patients in treatment for anxiety disorders and 31 controls were interviewed within hours after both the first and second Iraqi missile attacks on Israel during the Gulf war. After the first attack patients did not report higher anxiety levels, nor were they more pessimistic about the war and their fate in the war than the control subjects. Anxiety disorder patients tended to be engaged in cognitive-behavioral tactics for self-calming, while control subjects clearly preferred to cope by interacting with their social and physical environments. Following the second missible bombardment, patients were more inclined to retain their initial levels of anxiety and pessimism, while controls seem to have better adapted and showed significant improvements in those variables. The results are discussed in terms of coping skills and vulnerability as factors influencing adaptation to prolonged emergency situations.

Key words

emergency The Gulf war anxiety disorder adaptation coping styles 


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  1. Aldwin, C., & Revenson, T. A. (1987). Does coping help? A reexamination of the relation between coping and mental health.Journal of Personality and Social Psychology, 53 337–348.PubMedGoogle Scholar
  2. Baum, A., Gatchel, R., & Schaeffer, M. (1983). Emotional, behavioral, and physiological effects of chronic stress at Three Mile Island.Journal of Consulting and Clinical Psychology, 51 565–572.PubMedGoogle Scholar
  3. Beck, A. (1972).Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.Google Scholar
  4. Ben-Zur, H., & Zeidner, M. (1991). Anxiety and bodily symptoms under the threat of missile attacks: The Israeli scene.Anxiety Research, 4 79–95.Google Scholar
  5. Bleich, A., Dycian, A., Koslowsky, M., Solomon, Z., & Wiener, M. (1992). Psychiatric implications of missile attacks on a civilian population.The Journal of the American Medical Association, 268 613–615.Google Scholar
  6. Carver, Ch. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach.Journal of Personality and Social Psychology, 56 267–283.PubMedGoogle Scholar
  7. Collins, D. L., Baum, A., & Singer, J. E. (1983). Coping with chronic stress at Three Mile Island: Psychological and biochemical evidence.Health Psychology, 2 149–166.Google Scholar
  8. Dohrenwend, B. S., & Dohrenwend, B. P. (1981). Life stress and illness: Formulation of the issues. In B. S. Dohrenwend & B. P. Dohrenwend (Eds.),Stressful life events and their contexts. New York: Watson.Google Scholar
  9. Ellis, A. (1962).Research and emotion in psychotherapy. New York: Lyle Stuart.Google Scholar
  10. Folkman, S., & Lazarus, R.S. (1980). An analysis of coping in a middle-aged community sample.Journal of Health and Social Behavior, 21 219–239.PubMedGoogle Scholar
  11. Folkman, S., & Lazarus, R. S. (1985). If it changes it must be a process: A study of emotion and coping during three stages of a college examination.Journal of Personality and Social Psychology, 48 150–170.PubMedGoogle Scholar
  12. Fraser, R., Leslie, I., & Phelps, D. (1943). Psychiatric effects of severe personal experiences during bombing.Proceedings of the Royal Society of Medicine, 36 119–123.Google Scholar
  13. Gleser, G. C., Green, B. L., & Winget, C. (1981).Prolonged psychosocial effects of disaster: A study of Buffalo Creek New York: Academic Press.Google Scholar
  14. Hamilton, S. B., Keilin, W. G., Knox, T. A., & Naging, J. L. (1989). When thoughts turn towards nuclear war: Stress responses, coping strategies and the importance of trait anxiety in moderating effects on mental health.Journal of Applied Social Psychology, 19 111–139.Google Scholar
  15. Janis, I. L. (1969).Stress and frustration. New York: Harcourt Brace Jovanovich.Google Scholar
  16. Jenkins, C. D., Hurst, M. W., & Rose, R. M. (1979). Life changes: Do people really remember?Archives of General Psychiatry, 36 379–384.PubMedGoogle Scholar
  17. Kinston, W., & Rosser, R. (1974). Disaster: Effects on mental and physical state.Journal of Psychosomatic Research, 18 437–456.PubMedGoogle Scholar
  18. Kleber, R. J., & Brom, D. (1992).Coping with trauma. Amsterdam/Lisse: Swetz & Zeitlinger B.V.Google Scholar
  19. Klein, D. F. (1980). Anxiety reconceptualized.Comprehensive Psychiatry, 21 411–427.PubMedGoogle Scholar
  20. Lazarus, R. S. (1966).Psychological stress and the coping process. New York: McGraw-Hill.Google Scholar
  21. Lazarus, R. (1982). The psychology of stress and coping. In D. D. Spielberger, I. G. Sarason, & N. A. Milgram (Eds.),Stress and anxiety (Vol. 8, pp. 23–36). New York: Hemisphere.Google Scholar
  22. Lazarus, R. S. (1985). The costs and benefits of denial. In A. Monat & L. S. Lazarus (Eds.),Stress and coping: An anthology (pp. 154–173). New York: Columbia University Press.Google Scholar
  23. Lazarus, R. S., & Folkman, S. (1984).Stress, appraisal and coping. New York: Springer.Google Scholar
  24. Lefcourt, H. M. (1980). Locus of control and coping in life's events. In E. Staub (Ed.),Personality: Basic aspects and current research (pp. 220–236). Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  25. Logue, J. N. (1978).Long-term effects of a major natural disaster: The Hurricane Agnes flood in the Wyoming Valley of Pennsylvania. Doctoral dissertation, Columbia University.Google Scholar
  26. McFarlane, A. C. (1988). The aetiology of posttraumatic stress disorders following a natural disaster.British Journal of Psychiatry, 152 116–121.PubMedGoogle Scholar
  27. Melick, M. E. (1976).Social, psychological, and medical aspects of stress-related illness in the recovery period of a natural disaster. Doctoral dissertation, State University of New York at Albany.Google Scholar
  28. Melick, M. E., Logue, J. N., & Frederick, L. H. (1982). Stress and disaster. In L. G. Goldberger & S. Breznitz (Eds.),Handbook of stress: Theoretical and clinical aspects (pp. 613–630). New York: The Free Press.Google Scholar
  29. National Institute of Mental Health. (1976).Disaster assistance and emergency mental health. DHEW publication No. (ADM) 76-327. Washington, DC: US Government Printing Office.Google Scholar
  30. Rabkin, J. G. (1982). Stress and psychiatric disorders. In L. G. Goldberger & S. Breznitz (Eds.),Handbook of stress: Theoretical and clinical aspects (pp. 566–584). New York: The Free Press.Google Scholar
  31. Rabkin, J. G., & Klein, D. F. (1980). Stress and phobic disorders: Review of empirical findings and research recommendations. Paper prepared for the Stress and Illness Panel of the Steering Committee for Research on Stress in Health and Disease, National Academy of Sciences, Washington, DC.Google Scholar
  32. Rabkin, J. G., & Struening, E. (1976). Life events, stress and illness.Science, 5 573–624.Google Scholar
  33. Scheier, M. F., Weintraub, J. K., & Carver, Ch. S. (1986). Coping with stress: Divergent strategies of optimists and pessimists.Journal of Personality and Social Psychology, 51 1257–1264.PubMedGoogle Scholar
  34. Shore, J. H., Tatum, E. L., & Vollmer, W. M. (1986). Psychiatric reactions to disaster: The Mount St. Helens experience.American Journal of Psychiatry, 143 590–595.PubMedGoogle Scholar
  35. Spielberger, C. D. (1975). Anxiety: State-trait-process. In C. D. Spielberger & I. G. Sarason (Eds.),Stress and anxiety (Vol. 1). Washington, DC: Hemisphere.Google Scholar
  36. Stone, R. A., & Leime, A. G. (1984).Reactions to collective stress: Correlates of active citizen participation at Love Canal. Paper presented at the Annual Meeting of the American Psychological Association, Toronto.Google Scholar
  37. Wilkinson, C. B. (1983). Aftermath of a disaster: The collapse of the Hyatt Regency Hotel skywalks.American Journal of Psychiatry, 140 1134–1139.PubMedGoogle Scholar
  38. Wolitsky, D., & Wachtel, P. L. (1973). Personality and perception. In B. Wolman (Ed.),Handbook of general psychiatry Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  39. Zeidner, M., & Ben-Zur, H. (1993). Coping with a national crisis: The Israeli experience with the threat of missile attacks.Personality and Individual Differences, 14 209–224.Google Scholar

Copyright information

© International Society for Traumatic Stress Studies 1996

Authors and Affiliations

  • Eli Somer
    • 1
    • 2
  • Giora Keinan
    • 3
  • Devora Carmil
    • 4
  1. 1.Israel Institute for Treatment and Prevention of StressHaifa
  2. 2.School of Social WorkUniversity of HaifaHaifaIsrael
  3. 3.Department of PsychologyTel-Aviv UniversityTel-AvivIsrael
  4. 4.R. D. Wolfe Center for the Study of Psychological StressUniversity of HaifaIsrael

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