Traumatization or Habituation? A four-wave investigation of exposure to continuous traumatic stress in Israel

Exposure to ongoing violence is a worldwide predicament and may generate different adaptations than those evident in cases of past trauma. Nevertheless, such continuous traumatic stress has only recently begun to attract scientific attention. The present longitudinal study assessed Israeli populations exposed to high and medium intensities of rocket fire in urban and rural communities. Over the course of 4 years, there were 4 assessment points: prior to, proximate to, during, and after a major escalation. Two main questions were addressed. First, does continuous exposure promote habituation and greater resilience or more traumatization, as indicated by posttraumatic stress symptoms? Second, drawing on the conservation of resources theory (Hobfoll, 1989), we examined the contribution of environmental, intrapersonal, and interpersonal resources. Results indicated that a greater exposure prior to escalation was associated with more resilience during high-intensity shelling, thus suggesting a habituation effect to continuous traumatic stress. However, various indicators of personal exposure revealed that more exposure was predictive of more symptomatology. Moreover, contrary to previous studies, urban rather than rural residency was associated with more resilience, as indicated by less posttraumatic stress symptoms. Results also indicated specific risk and protective factors, including education, marital status, age, and perceived personal and community resilience. Clinical implications of the findings are underscored, and future research is encouraged within the context of the study's limitations.