Coping with war captivity: The role of sensation seeking

Long-Term Consequences of War Captivity in Military Veterans

Numerous studies on the health and functioning of veterans and former prisoners of war have shown that the experience of war captivity is one of the most difficult human experiences. Captivity is often characterized by extremely difficult and inhumane conditions, as well as exposure to various forms of both psychological and physical abuse. Such traumatic experiences can lead to serious psychological consequences that can last for years, even decades after release from captivity. The aim of this paper is to present a brief overview of research that points to the specifics of wartime captivity and the long-term psychological consequences in veterans of former camp detainees, as well as the consequences suffered by their families and factors that, apart from the intensity of the trauma, contribute to the emergence and persistence of psychological disorders. From the presented research, it can be concluded that former prisoners of the camp represent an extremely vulnerable group of the social community and require long-term appropriate treatment, while the needs of veterans' families should not be neglected, with the necessity of including spouses and children in psychological and psychosocial treatments.

The Role of Time Perspectives and Impulsivity Dimensions in Coping Styles

Both time perspectives and impulsivity dimensions are groups of traits that are connected to self-control abilities and might be important for coping styles. However, to date, no study has systematically investigated their utility in predicting coping styles with regard to their multidimensional nature. The current study was correlational and exploratory, aiming to discover what amount of variance in each of the three coping styles, problem-oriented, active emotion-oriented, and avoidant, is accounted for by two groups of predictors: time perspectives and impulsivity dimensions. N = 397 young adults aged 18-35 from the general population took part in the study. Results of a multiple linear regression testing both groups of predictors separately and of hierarchical regression analysis introducing the two predictor groups in subsequent steps suggested that time perspectives accounted for more variance in adaptive coping styles: problem-oriented and active emotion-oriented coping. For avoidant coping, both time perspectives and impulsivity dimensions accounted for a similar amount of variance. The results provide evidence that time perspectives should be investigated in domains related to coping (e.g., mental health issues, substance abuse, and risk-taking behaviors), for which impulsivity has been considered an important predictor. Moreover, impulsivity ought to be tested with regard to its multidimensionality.

The Relationship between Nightmare Experience and Athletes' Personality Traits and Anxiety

OBJECTIVE

Frequent nightmare behavior or deep nightmare experiences may harm the physical and mental health and performance of athletes. This study explores the nightmare experiences of athletes, and includes non-athletes with similar experiences for comparison.

METHODS

The Nightmare Experience Questionnaire (NEQ); Zuckerman-Kuhlman-Aluja Personality Questionnaire, Shortened Form (ZKA-PQ/SF); and Self-Rating Anxiety Scale (SAS) were used. The subjects were 187 athletes (mean age = 20.44 years, SD = 0.85; 91 females, 96 males) and 90 non-athletes (mean age = 20.34 years, SD = 1.65; 52 females, 38 males) who reported having nightmares.

RESULTS

A total of 87 athletes (46.5%) reported having nightmare experiences. The athlete nightmare group scored significantly higher in neuroticism than the non-nightmare group, and their anxiety scores were significantly higher than those of non-athletes, who scored higher in aggressiveness, neuroticism, and sensation seeking. Moreover, anxiety, neuroticism, and sensation seeking positively predicted athletes' nightmare experiences.

CONCLUSIONS

Personality traits and anxiety levels can be effectively applied to predict athletes' nightmare experiences.

Posttraumatic stress and risky sex in trauma-exposed college students: the role of personality dispositions toward impulsive behavior

Objectives: Posttraumatic stress disorder (PTSD) has been linked to risky sexual behavior (RSB). However, little is known regarding the role of impulsivity in this relation among college students. Participants: The present study examined the moderating role of impulsivity dispositions on the relation between PTSD symptoms and past-year RSB in a sample of 221 trauma-exposed undergraduate students (77.4% female). Results: Two separate negative binomial regression models examined each impulsivity disposition's unique moderating effect on the association between PTSD symptoms and high risk/casual sex. In the high risk model, significant interactions were found for the urgency dispositions, (lack of) premeditation and (lack of) perseverance, though the pattern of these relations differed across these dispositions. Only positive main effects for negative urgency and (lack of) premeditation emerged in the casual sex model. Conclusions: The present study expands on the limited literature on the role of impulsivity in the relation between PTSD and RSB in trauma-exposed college students.

Environmental enrichment increases cue-dependent freezing and behavioral despair but decreases anxiety-like behavior in rats

While post-traumatic stress disorder (PTSD) can develop after exposure to severe traumatic events, data have shown that individuals with high sensation-seeking personality traits are less prone to developing PTSD. The current study used the rodent environmental enrichment preclinical model of sensation-seeking to determine if similar sensation seeking effects in animal models of PTSD-like behaviors were found. The study also attempted to determine whether environmental enrichment altered the effects of midazolam on these PTSD-like behaviors. Male Sprague-Dawley rats were received at postnatal day (PND) 21 and placed into either an enriched (EC), isolated (IC), or social (SC) condition. Beginning on PND 51, the animals underwent 3 fear conditioning trials where a tone was paired with a 2 s 0.7 mA footshock. Twenty-four hours later, rats were given 15-min i.p. pretreatments of 0, 0.5, or 1.5 mg/kg midazolam, before being placed into fear conditioning chambers for a test of expression of conditioned fear response in a novel context. Following fear conditioning, rodents were also tested in the elevated plus maze (EPM) and the forced swim task (FST) following pretreatments of midazolam. Results from fear conditioning indicated IC rats showed a significant decrease in freezing during acquisition compared to EC and SC rats. Also, during expression, IC rats had lower freezing following saline injections and 0.5 mg/kg midazolam but were equal in time freezing to EC and SC rats following 1.5 mg/kg midazolam. In the EPM there were no effects of midazolam and IC rats showed decreased time spent in the open arms compared to EC and SC rats. In FST, IC rats spent less time immobile and more time swimming compared to EC and SC rats. Overall, results suggest that the rodent environmental enrichment model of sensation-seeking seems to parallel the effects of sensation-seeking on likelihood of PTSD symptoms seen in humans.

Neural activity moderates the association between sleep and risky driving behaviors in adolescence

The biological, environmental, and psychosocial changes that occur in adolescence engender an increase in risk taking often linked to the high rates of motor vehicle crashes amongst young drivers. Most U.S. adolescents suffer from poor sleep, which is known to exacerbate the risk of driving crashes; however, research has yet to uncover a neurobiological link between sleep and risky driving in adolescence. Here, we examined potential moderators of the sleep-risk relation in fifty-six adolescents (14-18y/o) as they completed a driving task during fMRI. While poor sleep was associated with increased risky driving (i.e., running more yellow lights), good sleep emerged as a novel buffer against risky driving in lower sensation-seeking adolescents. Neural activity in the ventral striatum (VS), a key node of the risk-taking circuit, also moderated the sleep-risk association: sleep was related to risk-taking in individuals demonstrating high, but not low, VS response during risky decision-making, suggesting that reward-related neural response may underly the connection between sleep and risk-taking in adolescence. This study sheds light on the risk of driving crashes in youth by highlighting sleep as both an exacerbator and a buffer of risky driving in adolescence. Taken together, these results underscore the importance of improving adolescent sleep.

Greater prevalence of post-traumatic stress disorder and depression in deployed Canadian Armed Forces personnel at risk for moral injury

BACKGROUND

A link between moral injury (i.e., the psychological distress caused by perceived moral transgressions) and adverse mental health outcomes (AMHO) has been recently proposed. However, the prevalence of exposure to morally injurious events and the associated risk of experiencing AMHO remains understudied.

METHOD

The impact of exposure to potentially morally injurious experiences (PMIEs) was explored in relation to past-year PTSD and MDD, using the 2013 Canadian Armed Forces Mental Health Survey dataset of Afghanistan mission deployed regular force and reserve personnel. A series of logistic regressions were conducted, controlling for relevant sociodemographic, military, deployment, and trauma-related variables.

RESULTS

Over half of the deployed personnel endorsed at least one PMIE. Several demographic and military variables were associated with exposure to PMIEs. Those exposed to PMIEs demonstrated a greater likelihood of having past-year PTSD and MDD; feeling responsible for the death of Canadian or ally personnel demonstrated the strongest association with PTSD and MDD. Mental health training was not a moderator for PMIE exposure and AMHO.

CONCLUSIONS

Exposure to PMIEs during deployments is common and represents an independent risk factor for past-year PTSD and MDD. Improved training that targets moral-ethical dilemmas and treatment interventions that address moral injury expressions is warranted.

Hardiness and sensation seeking as potential predictors of former prisoners of wars' posttraumatic stress symptoms trajectories over a 17-year period

OBJECTIVE

Little is known about trajectories of posttraumatic stress symptoms (PTSS) among former prisoners of war (ex-POWs) and the predictors of those trajectories. This study aimed to assess long-term PTSS trajectories among ex-POWs and comparable veterans and the role of hardiness and sensation seeking in predicting PTSS trajectory.

METHOD

A sample of 189 Israeli ex-POWs and 160 comparable combatants participated in a 17 year longitudinal study with three waves of measurements following the 1973 Yom Kippur War (T1: 1991, T2: 2003, T3: 2008). Participants completed validated self-report measures.

RESULTS

Latent growth mixture modeling (LGMM) identified four longitudinal PTSS trajectories. Among ex-POWs, the majority of participants were classified in trajectories with "low-increasing" or "medium-increasing" levels of PTSS. Among the comparable veterans, however, the majority of participants were classified in a trajectory with "low" levels of PTSS. Ex-POWs with high levels of hardiness were less likely to belong to the "high" or "medium-increasing" PTSS trajectories, compared to the low-fluctuating trajectory.

CONCLUSIONS

The long-term course of PTSS is heterogeneous among both veterans and ex-POWs, with chronic and increasing symptom patterns being more prevalent amongst ex-POWs. Ex-POWs should be considered an at-risk population for exacerbated PTSS trajectories that is related to hardiness personality construct.

Facets of psychopathy in relation to trauma-exposure and posttraumatic stress symptomology in a sample of incarcerated male offenders

Purpose The purpose of this paper is to investigate the moderating role of psychopathy facets on the relationship between traumatic exposure and posttraumatic stress disorder (PTSD) symptomology. Design/methodology/approach Participants were male prisoners incarcerated in the UK. Findings The analysis revealed differential associations between the two facets of psychopathy, with potentially traumatic events and symptoms of PTSD. Specifically, neither primary psychopathy nor trauma exposure were significantly related to PTSD, while secondary psychopathy was positively and significantly related with PTSD symptoms. Furthermore, the effect of trauma exposure on PTSD was found to depend on the level of secondary psychopathy. More specifically, trauma exposure was strongly and positively associated with PTSD symptoms for low levels of secondary psychopathy and negatively associated with PTSD symptomology for individuals with high levels of secondary psychopathy. Originality/value The findings clarify linkages among psychopathy facets, trauma, and PTSD, and extend the understanding of the presentation of PTSD in male prisoners.

Posttraumatic Stress Disorder's Underlying Dimensions and Their Relation With Impulsivity Facets

Research indicates a significant relationship between posttraumatic stress disorder (PTSD) and impulsivity (Kotler, Julian, Efront, and Amir, J Nerv Ment Dis 189:162-167, 2001; Ledgerwood and Petry, J Trauma Stress 19:411-416, 2006). The present study assessed relations between PTSD symptom clusters and impulsivity subscales in an effort to assess the specific impulsivity component most related to PTSD's alterations in arousal/reactivity and alterations in mood/cognitions symptoms. In the current study, the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, and the UPPS Impulsivity Scale were administered to a sample of 412 nonclinical subjects with a trauma history. Results indicated that PTSD's alterations in arousal/reactivity and mood/cognition factors were most related to impulsivity's sensation-seeking tendency compared with other impulsivity components. Results highlight the importance of assessing and addressing (1) sensation-seeking tendencies and (2) urges to act impulsively when experiencing negative affect in trauma treatment. Furthermore, it is possible that sensation-seeking tendencies are primarily driving the comorbidity between PTSD and certain impulsive behaviors.

Connecting the pathology of posttraumatic stress and substance use disorders: monoamines and neuropeptides

Posttraumatic stress disorder (PTSD) co-occurs highly with substance use disorders (SUDs), yet the neurobiological basis for this comorbid relationship remains unclear. PTSD and SUDs result in similar pathological states including impulsive behavior, reward deficiency, and heightened stress sensitivity. Hence, PTSD and SUD may depend on overlapping dysfunctional neurocircuitry. Here we provide a short overview of the relationship between comorbid PTSD and SUD, as well as the potential role of select neurotransmitter systems that may underlie enhanced vulnerability to drug abuse in the context of PTSD.

The relative and unique contributions of emotion dysregulation and impulsivity to posttraumatic stress disorder among substance dependent inpatients

BACKGROUND

Despite elevated rates of posttraumatic stress disorder (PTSD) among substance use disorder (SUD) patients, as well as the clinical relevance of this co-occurrence, few studies have examined psychological factors associated with a PTSD-SUD diagnosis. Two factors worth investigating are emotion dysregulation and impulsivity, both of which are associated with PTSD and SUDs. Therefore, this study examined associations between PTSD and facets of emotion dysregulation and impulsivity within a sample of trauma-exposed SUD inpatients.

METHODS

Participants were an ethnically diverse sample of 205 SUD patients in residential substance abuse treatment. Patients were administered diagnostic interviews and completed a series of questionnaires.

RESULTS

Patients with PTSD (n=58) reported significantly higher levels of negative urgency (i.e., the tendency to engage in impulsive behaviors when experiencing negative affect) and lower sensation seeking, as well as higher levels of emotion dysregulation and the specific dimensions of lack of emotional acceptance, difficulties engaging in goal-directed behavior when upset, difficulties controlling impulsive behaviors when distressed, limited access to effective emotion regulation strategies, and lack of emotional clarity. Further, overall emotion dysregulation emerged as a significant predictor of PTSD status, accounting for unique variance in PTSD status above and beyond facets of impulsivity (as well as other relevant covariates).

CONCLUSIONS

Results suggest that emotion dysregulation may contribute to the development, maintenance, and/or exacerbation of PTSD and highlight the potential clinical utility of targeting emotion dysregulation among SUD patients with PTSD.

Effects of combat deployment on risky and self-destructive behavior among active duty military personnel

Although research has documented negative effects of combat deployment on mental health, few studies have examined whether deployment increases risky or self-destructive behavior. The present study addressed this issue. In addition, we examined whether deployment effects on risky behavior varied depending on history of pre-deployment risky behavior, and assessed whether psychiatric conditions mediated effects of deployment on risky behavior. In an anonymous survey, active duty members of the U.S. Marine Corps and U.S. Navy (N = 2116) described their deployment experiences and their participation in risky recreational activities, unprotected sex, illegal drug use, self-injurious behavior, and suicide attempts during three time frames (civilian, military pre-deployment, and military post-deployment). Respondents also reported whether they had problems with depression, anxiety, or PTSD during the same three time frames. Results revealed that risky behavior was much more common in civilian than in military life, with personnel who had not deployed, compared to those who had deployed, reporting more risky behavior and more psychiatric problems as civilians. For the current time period, in contrast, personnel who had deployed (versus never deployed) were significantly more likely to report both risky behavior and psychiatric problems. Importantly, deployment was associated with increases in risky behavior only for personnel with a pre-deployment history of engaging in risky behavior. Although psychiatric conditions were associated with higher levels of risky behavior, psychiatric problems did not mediate associations between deployment and risky behavior. Implications for understanding effects of combat deployment on active duty personnel and directions for future research are discussed.

Sensation seeking and visual selective attention in adults with HIV/AIDS

The association between sensation seeking and visual selective attention was examined in 31 adults with the Human Immunodeficiency Virus (HIV). Sensation seeking was measured with Zuckerman's Sensation Seeking Scale Form V (SSS-V). Selective attention was assessed with a perceptual span task, where a target letter-character must be identified in a quickly presented array of nontarget letter-characters. As predicted, sensation seeking was strongly associated (R(2) = .229) with perceptual span performance in the array size 12 condition, where selective attention demands were greatest, but not in the easier conditions. The Disinhibition, Boredom Susceptibility, and Experience Seeking subscales of the SSS-V were associated with span performance. It is argued that personality factors such as sensation seeking may play a significant role in selective attention and related cognitive abilities in HIV positive adults. Furthermore, sensation seeking differences might explain certain inconsistencies in the HIV neuropsychology literature.

Posttraumatic stress disorder and posttraumatic growth among Israeli ex-pows

In this article, the authors present a prospective study that dealt with pathological (posttraumatic stress disorder; PTSD) and salutary (posttraumatic growth; PTG) outcomes of captivity and the correlates of those outcomes among a sample of ex-prisoners of war (POWs) and a control group of combat veterans. Posttraumatic stress disorder and its correlates were assessed in 1991 and 2003, and PTG was assessed in 2003. The results indicate that ex-POWs exhibited higher levels of PTSD and PTG than did the controls. In addition, both linear and quadratic associations between PTSD and PTG were found. The authors discuss some unresolved issues related to assessment of PTG and salutary outcomes, and outline directions for future research.

Sensation seeking and the aversive motivational system

Sensation seeking (SS) has traditionally been viewed as a phenomenon of the appetitive motivational system. The limited SS research exploring contributions from the aversive motivational system reveals greater anxious reactivity to dangerous activities among low sensation seekers. The present study extends this line of work by comparing levels of fear and anxiety during anticipation of predictable and unpredictable aversive stimuli across high- and low-SS groups. Low sensation seekers displayed greater fear-potentiated startle (FPS) to predictable aversive stimuli, and only those low on SS showed FPS and skin conductance response effects during experimental contexts in which aversive stimuli were delivered unpredictably. Findings implicate enhanced apprehensive anticipation among those low on SS as a potential deterrent for their participation in intense and threatening stimulus events.

SENSATION SEEKING AND PEDESTRIAN CROSSING COMPLIANCE

Seventy-nine students were stopped by researchers after crossing a pedestrian crossing when the light was either green or red in conjunction with 4 different conditions: with or without the presence of a policeman and hurrying or not hurrying. Later, these participants were administered the Sensation Seeking Scale V (SSS; Zuckerman, 1994). No difference was found in the rate of pedestrians crossing against the red light either with or without the presence of a policeman. Among those who crossed against a red light there were more high than there were low sensation seekers. In addition, more males than females crossed against the red light disregarding the presence of the policeman. Interactions were found between gender and hurrying and between sensation seeking and stress of time in relation to crossing against a red light.

A multiple-indicator multiple-cause model for posttraumatic stress reactions: personality, coping, and maladjustment

OBJECTIVE

This study aimed to develop a multiple-indicator multiple-cause model (MIMIC) to describe the relationship among posttraumatic stress (PTSD) responses, general health problems, death anxiety, personality factors, and coping strategies among community residents exposed to the technological disasters of aircraft and train crashes.

MATERIALS AND METHODS

One hundred forty-eight community residents, after exposure to the aircraft or train crash, were assessed using the Impact of Event Scale, the General Health Questionnaire-28, the Death Anxiety Scale, the Eysenck Personality Questionnaire, and the Ways of Coping Checklist. The control group (n = 90) comprised members of the general public, who had not been exposed to the disasters, from another city.

RESULTS

The model showed significant associations between the impact of the disaster and general health problems, which varied depending on where community residents lived in relation to the disaster site, whether they were present when the disaster occurred, and the type of disaster. The model also suggested that death anxiety was associated with type of disaster and neuroticism. The model supported the interactive model in that personality factors interacted with coping strategies in maintaining or generating PTSD and general health problems.

CONCLUSIONS

After exposure to technological disasters, community residents could develop PTSD and general health problems; however, increased death anxiety was a separate psychological reaction. The interaction between certain personality traits and coping strategies was one reason for PTSD and general health problems.

Social network as a moderator in the relation between trauma exposure and trauma reaction: a survey among UN soldiers and relief workers

Social network as a moderator between trauma exposure and post-trauma symptomatology was studied. Two samples--relief workers and UN soldiers--were assessed on trauma exposure, social network and three dependent measures related to post-trauma reactions. Regression analysis and interaction plots were used to determine the presence of interaction effects between trauma exposure and social network. All four network variables moderated the relationship between trauma exposure and post-trauma reactions among relief workers, while among UN soldiers only two such buffer effects were found. Furthermore, among UN soldiers one of these interaction effects was reversed, indicating social support to be important for those low on trauma exposure, while among relief workers support was important in the high-exposure condition. The results indicate a difference with respect to the importance of social network as a moderator between groups exposed to different kinds of war trauma. Differences in motivational systems may also exist. However, further research will have to establish this.

Time does not heal all wounds: quality of life and psychological distress of people who survived the holocaust as children 55 years later

The present study assessed posttraumatic stress disorder (PTSD) symptoms, psychological distress, and subjective quality of life (QoL) in a group of 43 child Holocaust survivors and a community sample of 44 persons who had not personally experienced the Holocaust. The participants were administered the PTSD-Scale, the SCL-90, and the WHOQOL-Bref. Results showed that the child survivors had higher PTSD symptom scores, higher depression, anxiety, somatization, and anger-hostility scores; and lower physical, psychological, and social QoL than did the comparison group. The findings suggest that the psychological consequences of being a child during the Holocaust can be long lasting.

Sensation seeking and startle modulation by physically threatening images

The potential moderating effect of sensation seeking on anxious reactivity to threatening experiences was assessed using the affective modulation of startle-blink paradigm. Startle blinks, as measured by electromyographic (EMG) activity in response to loud (100 dB) white-noise stimuli, were elicited during the presentation of positive, neutral, and threatening visual images. Unlike participants low in sensation seeking who showed blink potentiation during threatening versus neutral images, participants high in sensation seeking showed equal magnitudes of startle to neutral and threatening images. The results suggest that individuals high compared with low on sensation seeking are less anxiously reactive to physically threatening visual stimuli. No attenuation in startle magnitude was elicited by positive images among low or high sensation seekers suggesting that the positive images employed in the current study were not arousing enough to activate the appetitive arousal system.

Post-traumatic symptoms, emotional distress and quality of life in long-term survivors of breast cancer: a preliminary research

The present study is a preliminary study assessing long-term psychological effects in survivors of breast cancer. Thirty-nine long-term female survivors of breast cancer were compared with 39 matched women who had not been exposed to any chronic disease regarding post-traumatic stress disorder (PTSD), quality of life (QoL), emotional distress and coping styles. Survivors revealed significantly higher rates of full and partial PTSD, scored significantly higher on emotional distress, scored significantly lower on physical and psychological QoL and exhibited coping styles significantly different from those of the control group. PTSD was associated with the coping style of suppression. Multiple regression analysis showed that receiving chemotherapy and disease stage, as well as the interaction between chemotherapy and disease stage, were significant predictors of hyperarousal. The findings show that post-traumatic symptoms are a common sequel after recovery from cancer. Furthermore, finding suggest a conceptual distinction between PTSD symptoms and QoL in the study of long-term effects of cancer.

RISK EVALUATION AND RISKY BEHAVIOR OF HIGH AND LOW SENSATION SEEKERS

This study was aimed at achieving a better understanding of the role of the mediation of risk valuation between personality and risk-taking behavior. A sample of 55 females and 20 males completed the Sensation Seeking Scale (SSS) and self-report inventory of risk-taking in one session and a risk evaluation inventory in another session. The results show a positive correlation between risk taking and sensation seeking and a negative correlation between risk evaluation and sensation seeking. High sensation seekers are found to be higher in risk taking than in risk evaluation while the low sensation seekers are higher in risk evaluation than in risk taking. The meaning and possible implications of these results to the relationship between risk taking and sensation seeking are discussed.

Psychological impact and prevalence of traumatic events in a student sample in Israel: the effect of multiple traumatic events and physical injury

The prevalence of exposure and the psychological impact of traumatic events were studied in 983 Israeli university students. The psychological effects of exposure to single versus multiple traumatic events, and the effects of trauma-related physical injury were also examined. It was found that 67% of the respondents reported having been exposed to at least one traumatic event. Of those exposed, 6% were diagnosed as having posttraumatic stress disorder (PTSD). Men were more at risk for exposure, but women were more at risk for PTSD. Women and the physically injured showed more psychological distress following exposure. Being exposed to one type of traumatic event was associated with increased psychological distress, but being exposed to multiple types of traumatic events was associated with lowering of distress. The results are discussed in comparison with similar studies from the United States.

Debriefing with brief group psychotherapy in a homogenous group of non-injured victims of a terrorist attack: a prospective study

This study describes a follow-up of 15 non-injured women, all from the same socio-economic background, who were exposed to a terrorist attack in Israel. All of the women participated in group debriefing with brief group psychotherapy, involving six meetings during the first 2 months following the event. Two days after the attack, and 2 months and 6 months after the event, the women were administered a post-traumatic stress disorder (PTSD) diagnostic scale, the Impact of Event Scale (IES) and the SCL-90. At 6 months, four subjects (27%) were diagnosed with full PTSD. The IES showed significantly higher scores at the first measure than at the other two measures. Furthermore, the phobic anxiety subscale score immediately after the event was significantly associated with the General Severity Index of the SCL-90 and the severity of PTSD symptomatology at 6 months. The present paper discusses the effectiveness of psychological intervention following trauma, and raises questions concerning the need to invest public resources in this kind of intensive intervention. Suggestions are proposed regarding the desired emphasis of the psychological treatment in order to improve its benefits to victims.