Living in the shadow of terrorism: Psychological distress and alcohol use among religious and non-religious adolescents in Jerusalem

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Abstract

This study examines the effects of prolonged exposure to terrorism in 600 religious and non-religious Jewish adolescents living in Jerusalem, particularly post-traumatic stress (PTS) symptoms, depressive symptoms, alcohol use, coping strategies and social support. The youth in Jerusalem reported high exposure to terrorist acts. This exposure was associated with high PTS, depressive symptoms and alcohol use. Despite an apparently greater exposure to terrorism, religious adolescents reported lower levels of PTS and alcohol consumption, but similar levels of depressive symptoms to non-religious adolescents. Problem-solving coping predicted higher depressive symptoms for religious adolescents exposed to terrorism but not for similarly exposed non-religious adolescents. In contrast, emotion-focused coping predicted more alcohol consumption among highly exposed non-religious adolescents, while emotion-focused coping predicted more alcohol consumption among religious adolescents with low exposure. The overall findings suggest that religiosity may buffer the negative consequences of exposure in other ways than through coping or support.

Introduction

Israeli children and adolescents have been exposed to wars and terrorist attacks since the founding of the State of Israel in 1948 (Neriah et al., 1998). However, the frequency and severity of terrorist attacks increased substantially, with the outbreak of the Al-Akza Uprising in September 2000. From this time till the end of August 2005, 889 terrorist attacks within the “Green Line” (Israeli borders up to 1967) killed 1064 Israelis and injured 7441 (Israel Defense Forces, 2004), among them more than 300 children and adolescents, half of whom were 15–17 years old (Children in Israel: Statistical abstract, 2004).

Jerusalem has been the focus of terrorist activity over the 4 years of the Al-Akza Uprising (Intelligence Terrorism Information Center, 2004). By November 2004, there were 600 terror attacks in the city, of which 288 were shooting attacks and 30 were suicide bombs killing 210 people (Intelligence Terrorism Information Center, 2004). Thus, unfortunately, Jerusalem has become a natural laboratory for examining the impact of terrorism on children and youth. Because the city has a large minority of religious Jewish residents, it is possible to compare the effects of prolonged exposure to terror between religious and non-religious Jewish adolescents.

Exposure to terrorism may include physical or psychological proximity to acts of terror (Galea et al., 2002). The accumulative effect of exposure to multiple traumatic events, including terrorism, appears more harmful than experiencing one distinct terrorist act (Garbarino & Kostelny, 1996; Rutter, 1983). Furthermore, psychosocial factors such as ethnicity, religiosity and gender are associated with different levels of psychological distress following exposure to trauma and terrorism (Galea et al., 2002; Klingman & Wiesner, 1982).

Section snippets

Consequences of exposure to terrorism

Perhaps the best-known and most widespread consequences of exposure to terrorism are post-traumatic stress symptoms (PTS) and post-traumatic stress disorder (PTSD) (see Joshi & O’Donnell, 2003; Pfefferbaum et al., 2005, for reviews). Depressive symptoms are also common in children at all developmental levels exposed to war and terrorism (Gurwitch, Sitterle, Young, & Pfefferbaum, 2002; Shaw, 2003). For example, a large-scale representative sample of New York City public school children 6 months

Participants

Participants were 600 Jewish students (58.3% boys and 41.7% girls) at four religious and two large secular high schools in Jerusalem, randomly picked from the municipality list of 36 secular and 36 religious high schools. All 10th and 11th grade classes in these schools (21 10th grade classes and 9 11th grade classes; mean age=16.17, SD=.64) participated in the study in May–June 2004, almost 4 years after the beginning of the Al-Akza uprising. 817 students were enrolled in 10th and 11th grade

Exposure to terrorism

Youth in this Jerusalem sample reported high exposure to terrorist attacks (Table 1). The most frequent type of exposure was distant psychological proximity, with 75.1% of the adolescents reporting that they knew someone present at the scene of a terror attack, 62.6% knew someone injured and 52.5% knew someone killed in a terrorist attack. The median exposure was four, meaning either that adolescents experienced four different types of exposure or two different types that occurred at least

Discussion

This study examined the associations between level of exposure to terrorism, PTS symptoms, depressive symptoms and alcohol use among religious and non-religious Jewish adolescents residing in Jerusalem during a prolonged period of terrorism. It also examines whether religiosity interacts with exposure, social support and coping in predicting psychological distress and alcohol consumption. The adolescents reported high exposure to acts of terror, reflecting the hard facts of the many terrorist

Conclusion

This study shows that exposure to terrorism takes a heavy toll on youth living in Jerusalem. Negative consequences of exposure extend beyond PTS and psychological distress, with alcohol consumption a more common consequence of exposure to terrorism among youth than previously considered (Schiff et al., in press).

The negative consequences of exposure cannot be explained merely by the adolescent's coping strategies and perceived support. Cultural differences such as religiosity play an important

Acknowledgements

I would like to thank Prof. Rami Benbenishty who helped me to plan and implement the study and submit reports to the Jerusalem municipality.

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