This study assessed posttraumatic and psychiatric symptomatology and perception of threat among Israeli rescue workers whose work involves body handling following terrorist attacks. In addition, implications of level of exposure and repressive coping style were examined. Eighty-seven volunteer body handlers filled out a battery of self-report questionnaires. Despite high levels of exposure, results revealed considerable resilience in these men. In addition, repressors reported lower levels of psychiatric symptomatology than nonrepressors. Several explanations are suggested for body handlers' resilience, among them their strong religious beliefs, their motivation as volunteers, and self-selection factors. Implications of repressive coping style are also discussed.
Alexander, D.A. (1992). Stress among police body handlers: A long-term follow-up. British Journal of Psychiatry, 163, 806-808.
2.
Alexander, D.A., & Wells, A. (1991). Reactions of police officers to body-handling after a major disaster: A before-and-after comparison. British Journal of Psychiatry, 159, 547-555.
3.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. Washington, DC: Author.
4.
Amir, M., Kaplan, Z., Efroni, R., Levine, Y., Benjamin, J., & Kotler, M. (1997). Coping styles in post-traumatic stress disorder (PTSD) patients. Personality and Individual Differences, 23, 399-405.
5.
Beaton, R.M., Shirley, J.C., Pike, K., & Corneil, W. (1999). Coping responses and posttraumatic stress symptomatology in urban fire service personnel. Journal of Traumatic Stress , 12, 293-308.
6.
Benotsch, E.G., Brailey, K., Vasterling, J.J., Uddo, M., Cpnstans, J.I., & Stuker, P.B. (2000). War zone stress, personal and environmental resources, and PTSD symptoms in Gulf War veterans: A longitudinal perspective. Journal of Abnormal Psychology, 109, 205-213.
7.
Bleich, A., Gelkopf, M., & Solomon, Z. (2003). Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. JAMA, 290, 612-690.
8.
Bonanno, G.A., Keltner, D., Holen, A. & Horowitz, M.J. (1995). When avoiding unpleasant emotions might not be such a bad thing: Verbal autonomic response dissociation and midlife conjugal bereavement. Journal of Personality and Social Psychology, 69, 975-989.
9.
Bryant, R.A., & Harvey, A.G. (1997). Attentional bias in posttraumatic stress disorder . Journal of Traumatic Stress, 10, 635-644.
10.
Chang, C.M., Lee, L.C., Connor, K.M., Davidson, J.R.T., Jeffries, K., & Lai, T.J. (2003). Posttraumatic distress and coping strategies among rescue workers after an earthquake. Journal of Nervous and Mental Disease, 191, 391-398.
11.
Crowne, D., & Marlow, D. (1964). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24, 349-354.
12.
Derogatis, L.R., & Spencer, P.M. (1982). The Brief Symptom Inventory: Administration, scoring and procedures manual. Baltimore, MD: Clinical Psychometrics Research.
13.
Dyregrov, A., Kristoffersen, J.I., & Gjestand, R. (1996). Voluntary and professional disaster-workers: Similarities and differences in reactions. Journal of Traumatic Stress , 9, 541-555.
14.
Ellison, C.G., & Levin, J.S. (1998). The religion-health connection: Evidence, theory, and future directions. Health Education & Behavior, 25, 700-720.
15.
Ersland, S., Weisaeth, L., & Sund, A. (1989). The stress upon rescuers involved in an oil rig disaster: “Alexander L. Kielland” 1980. Acta Psychiatrica Scandinavica Supplementum, 355, 38-49.
16.
Gilbar, O., & Ben-Zur, H. (2002). Adult Israeli community norms for the Brief Symptom Inventory (BSI). International Journal of StressManagement, 9, 1-10.
17.
Ginzburg, K., Solomon, Z., & Bleich, A. (2002). Repressive coping style, acute stress disorder, and posttraumatic stress disorder after myocardial infraction. Psychosomatic Medicine, 64, 748-757.
18.
Greene, C.L. (2001). Human remains and psychological impact on police officers: Excerpts from psychiatric observations. Australasian Journal of Disaster and Trauma Studies, 5, NP.
19.
Horowitz, M.J. (1986). Stress response syndromes. Northvale, NJ: Jason Aronson.
20.
Jex, S.M., Adams, G.A., Bachrach, D.G., & Sorenson, S. (2003). The impact of situational constraints, role stressors, and commitment on employee altruism. Journal of Occupational Health Psychology, 8, 171-180.
21.
Jones, D.R. (1985). Secondary disaster victims: The emotional effects of recovering and identifying human remains. American Journal of Psychiatry,142, 303-307.
22.
Kessler, R.C. (1995). The national comorbidity survey: Preliminary results and future directions. International Journal of Methods in Psychiatric Research, 5, 139-151.
23.
Kishon-Barash, R., Midlarsky, E., & Johnson, D.R. (1999). Altruism and the Vietnam War veteran: The relationship of helping to symptomatology. Journal of Traumatic Stress , 12, 655-662.
24.
Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Academic Press.
25.
Lieberman, Z., Solomon, Z., & Ginzburg, K. (2005). The role of perceived social support, self-esteem, and adjustment in explaining suicidal ideation in young adults. Megamot, 43, 615-632.
26.
Marmar, C.R., Weiss, D.S., Metzler, T.J., Delluchi, K.L., Best, S.R., & Wentworth, K.A. (1999). Longitudinal course and predictors of continuing distress following critical incident exposure in emergency services personnel. Journal of Nervous and Mental Diseases, 187, 15-22.
27.
Marmar, C.R., Weiss, D.S., Metzler, T.J., Ronfeldt, H.M., & Foreman, C. (1996). Stress responses of emergency services personnel to the Loma Prieta earthquake Interstate 880 freeway collapse and control traumatic incidents. Journal of Traumatic Stress, 9, 63-85.
28.
McCarroll, J.E., Ursano, R.J., & Fullerton, C.S. (1993). Symptoms of posttraumatic stress disorder following recovery of war dead. American Journal of Psychiatry,150, 1875-1877.
29.
McCarroll, J.E., Ursano, R.J., & Fullerton, C.S. (1995). Symptoms of PTSD following recovery of war dead: 13-15-month follow-up. American Journal of Psychiatry,152, 939-941.
30.
McCarroll, J.E., Ursano, R.J., Fullerton, C.S., Liu, X., & Lundy, A. (2001). Effects of exposure to death in a war mortuary on posttraumatic stress disorder symptoms of intrusion and avoidance. Journal of Nervous and Mental Disease, 189, 44-48.
31.
McCarroll, J.E., Ursano, R.J., Fullerton, C.S., Liu, X., & Lundy, A. (2002). Somatic symptoms in Gulf War mortuary workers . Psychosomatic Medicine, 64, 29-33.
32.
Meichenbaum, D., & Cameron, R. (1983). Stress inoculation training: Toward a general paradigm for training in coping skills. In D. Meichenbaum & M. Jaremko (Eds.), Stress reduction and prevention (pp. 115-154). New York: Plenum Press.
33.
Mendolia, M., Moore, J., & Tesser, A. (1996). Dispositional and situational determinants of repression. Journal of Personality and Social Psychology, 70, 856-867.
34.
Mikulincer, M., & Florian, V. (1996). Coping and adaptation to trauma and loss. In M. Zeidner & N. S. Endler (Eds.), Handbook of coping: Theory, research, application (pp. 554-572). New York: Wiley .
35.
Miles, M.S., Demi, A.S., & Mostyn-Aker, P. (1984). Rescue workers' reactions following the Hyatt Hotel disaster. Death Education, 8, 315-331.
36.
Murphy, R.T., Wismar, K., & Freeman, K. (2003). Stress symptoms among African-American college students after the September 11, 2001 terrorist attacks. Journal of Nervous and Mental Disease, 191, 108-114.
37.
Mylle, J., & Maes, M. (2004). Partial posttraumatic stress disorder revisited . Journal of Affective Disorders, 78, 37-48.
38.
Neria, Y., Solomon, Z., Ginzburg, K., & Dekel, R. (2000). Sensation seeking, wartime performance, and long-term adjustment among Israeli war veterans. Personality and Individual Differences, 29, 921-932.
39.
North, C.S., Tivis, L., McMillen, J.C., Pfefferbaum, B., Cox, J., Spitznagel, E.L., et al. (2002). Coping, functioning, and adjustment of rescue workers after the Oklahoma City bombing. Journal of Traumatic Stress, 15, 171-175.
40.
Paulhus, D.L. (1984). Two-component models of socially desirable responding . Journal of Personality and Social Psychology, 46, 598-609.
41.
Phillips, A.C., Carroll, D., Ring, C., Sweeting, H., & West, P. (2005). Life events and acute cardiovascular reactions to mental stress: A cohort study. Psychosomatic Medicine, 67, 384-392.
42.
Roesch, S.C., & Weiner, B. (2001). A meta-analytic review of coping with illness: Do causal attributions matter?Journal of Psychosomatic Research , 50, 205-219.
43.
Roth, S., & Cohen, L.J. (1986). Approach, avoidance and coping with stress. American Psychologist, 41, 813-819.
44.
Saunders, T., Driskell, J.E., Johnston, J.H., & Salas, E. (1996). The effect of stress inoculation training on anxiety and performance. Journal of Occupational Health Psychology , 1, 170-186.
45.
Schwartz, C., Meisenhelder, J.B., Ma, Y., & Reed, G. (2003). Altruistic social interest behaviors are associated with better mental health. PsychometricMedicine, 65, 778-785.
46.
Sharkansky, E.J., King, D.W., King, L.A., Wolfe, J., Erickson, D.J., & Stokes, L.R. (2000). Coping with Gulf War combat stress: Mediating and moderating effects. Journal of Abnormal Psychology, 109, 188-197.
47.
Singer J.L., & Sincoff, J.B. (1990). Summary chapter: beyond repression and the defenses . In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health (pp. 471-496). Chicago: The University of Chicago Press.
48.
Solomon, Z., Benbenishty, R., Neria, Y., Abramovitz, M., Ginzburg, K., & Ohry, A. (1993). Assessment of PTSD: Validation of the revised PTSD inventory. Israel Journal of Psychiatry and Related Sciences , 30 ,110-115.
49.
Solomon, Z., Ginzburg, K., Neria, Y., & Ohry, A. (1995). Coping with war captivity: The role of sensation seeking. European Journal of Personality, 9, 57-70.
50.
Solomon, Z., Mikulincer, M., & Hobfoll S.E. (1986). Effects of social support and battle intensity on loneliness and breakdown during combat. Journal of Personality and Social Psychology, 51, 1269-1276.
51.
Solomon, Z., & Prager, E. (1992). Elderly Israeli Holocaust survivors during the Persian Gulf War: A study of psychological distress. American Journal of Psychiatry,149, 1707-1710.
52.
Sparks, G.G., Pellechia, M., & Irvine, C. (1999). The repressive coping style and fright reactions to mass media. Communication Research, 26, 176-192.
53.
Sutker, P.B., Uddo, M., Brailey, K., Vasterling, J.J., & Errera, P. (1994). Psychopathology in war-zone deployed and nondeployed Operation Desert Storm troops assigned graves registration duties. Journal of Abnormal Psychology, 103, 383-390.
54.
Taylor, J.A. (1953). A personality scale of manifest anxiety. Journal of Abnormal and Social Psychology, 48, 285-290.
55.
Thoits, P.A., & Hewitt, L.N. (2001). Volunteer work and well-being. Journal of Health & Social Behavior, 42, 115-131.
56.
Thompson, J., & Solomon, M. (1991). Body recovery teams at disasters: Trauma or challenge?Anxiety Research, 4, 235-244.
57.
Tucker, P., Pfefferbaum, B., Nixon, S.J., & Foy, D.W. (1999). Trauma and recovery among adults highly exposed to a community disaster. Psychiatric Annals, 29, 78-83.
58.
Tucker, P.M., Pfefferbaum, B.C., Doughty, D.E., Jones, D.E., Jordan, F.B., & Nixon, S.J. (2002). Body handlers after terrorism in Oklahoma City: Predictors of posttraumatic stress and other symptoms. American Journal of Orthopsychiatry, 72, 469-475.
59.
Turvey, C., & Salovey, P. (1993-1994). Measures of repression: Converging on the same construct? Imagination, Cognition andPersonality , 13, 279-289.
60.
Ullman, S.E., Townsend, S.M., Filipas, H.H., & Starzynski, L.L. (2007). Structural models of the relations of assault severity, social support, avoidance coping, self-blame, and PTSD among sexual assault survivors. Psychology of Women Quarterly, 31, 23-37.
61.
Wagner, D., Heinrichs, M., & Ehlert, U. (1998). Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. American Journal of Psychiatry,155, 1727-1732.
62.
Weinberger, D.A. (1990). The construct validity of repressive coping style . In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health (pp. 337-386). Chicago: The University of Chicago Press.
63.
Weinberger, D.A., Schwartz, G.E., & Davidson, R.J. (1979). Low-anxious, high-anxious and repressive coping styles: Psychometric patterns and behavioral and physiological responses to stress. Journal of Abnormal Psychology, 88, 369-380.
64.
Weiss, D.S., Marmar, C.R., Metzler, T.J., & Ronfeldt, H.M. (1995). Predicting symptomatic distress in emergency services personnel. Journal of Consulting and Clinical Psychology, 63, 361-368.
