Ebook: Resiliency: Enhancing Coping with Crisis and Terrorism

Research on psychosocial resilience has a history of almost fifty years, beginning within the context of developmental psychopathology. Pioneering scholars on individual resilience like Garmezy [1], Werner and Smith [2], Rutter [3], Masten [4], Ungar [5], and Luthar [6] recognized that among children who grow in highly adverse circumstances there is a subgroup who manage to develop well and thrive. Antonovsky [7] was among the pioneer scholars who studied resilience in adults and recognized that surviving the most horrible experiences may not result in psychopathological and dysfunctional outcomes.

The key question in the early studies on resilient children focused on what made a difference in the lives of individuals who developed behavioral and mental health problems compared to those who did not despite living under similar circumstances. This question remains the same in contemporary research on resilience of populations affected by disasters, major incidents and terrorist attacks. Similarly, the ambition to identify protective factors that are relevant for resilience in children growing up in adverse circumstances remains the same for researchers who continue seeking correlates of resilience among adults who live in communities exposed to destruction and violence. Consequently, current research priorities and resource allocation focus on promoting resilience, and developing effective preventive interventions, strategies and policies.

The recent decades of increased threat of terrorist attacks and human-made disasters have facilitated a shift in the research, theory and services related to resilience from an approach focused on deficits towards a broader understanding of resilience based on strengths and resources. In other words, the field has witnessed a broadening of interest from developmental resilience of children growing up in extremely adverse environments, to resilience-building strategies that may facilitate recovery, help restore effective functioning and ensure positive outcomes in the wake of major critical events that threaten the well-being of individuals, families, communities and nations.

This shift is also evident in the changing definition of resilience over time. For example, Garmezey [1] in 1974, considered resilient children to be those who are “invulnerable,” who despite disadvantages adapt and perform competently. More recent definitions of resilience focus on a system capacity and response, such as: “Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress” [8]. Regarding disasters, Norris and colleagues have described resilience as a positive trajectory of adaptation after disturbance, stress, or adversity [9].

Studying resilience is based on two fundamental assumptions [10]: (1) There has been a threat to an individual or a social system, and (2) Resilience of an individual or a system can be assessed only in comparison to an expected level of positive adaptation and functioning. This means that we cannot truly assess the resilience of an individual or a community unless their usual functioning has been seriously disrupted. Another important methodological issue pertains to when to assess resilience after a disruption. Based on studies of individual recovery from posttraumatic stress symptoms [11], it seems that at least one year is the minimum time to wait after a traumatic event. Assessment of community resilience may require an even longer period. Shorter assessment periods may in fact assess post-exposure coping but not necessarily resilience. In any case, operationalization and measurements based on these assumptions remain a challenge. The chapters in this volume have all considered the evidence of resilience in the aftermath of major disruption or trauma affecting groups of people.

Another challenge for fully understanding resilience is that its meaning has moved from being understood as a personality trait, to being considered a dynamic process over time [12]. The assumed trait of an individual, referred to as “resiliency” [12], has no sound empirical proof. Systems theory has been helpful in understanding resilience as a process. In fact, it is considered to be an ongoing process of positive adaptive changes to threat and adversity, enabling further positive adaptive changes. This recognizes the importance of various interactions as well as a history of previous adaptations, and opens up opportunities for interventions. In a way, resilience is a process of transactions among individual, proximal and distal social environments which set the stage on which players like personality traits, physiology and genetic-environment interaction, attitudes and beliefs, individual and collective identities, cultures and values, individual and collective experiences, connectedness and alienation, all perform at a time of threat and disruption of habitual functioning. It is the outcome of an individual's interactions with that environment that protects him or her against the overwhelming influence of risk factors [13]. Masten cautions that, among other issues, the following need to be taken into account when studying resilience: (1) It is a complex group of concepts that always requires a careful conceptual and operational definition; (2) It is neither a single trait nor a process, but rather many attributes and processes are involved; (3) There are multiple pathways to resilience [10].

The main research question in studying resilience relates to the capacities of individuals, communities and societies to withstand and recover from highly adverse and potentially traumatic events, such as a mass casualty terror attack, organized violence, an economic crisis or a disaster. More resilience implies recovering or “bouncing back” quickly after such events, successfully coping with greater stress, and being less disturbed by the same amount of stress than someone less resilient or more vulnerable [14]. However, there are limitations with such a view of resilience for it rests on the idea of “restoring conditions” or “returning to normal” after major stress, reflecting the ideal of resuming functioning as if a disruption has not occurred. However, people, communities and nations who overcome disasters or mass violence do not remain the same as before. Crises generate changes that may increase resilience to future adversities. However, studies on posttraumatic growth indicate that only a minority of people show this capacity after trauma. There are no studies regarding communities and nations that “grow” in this sense.

In the last two decades, research on resilience has widely expanded from an exclusive focus on individual resilience to the broader ecological levels of the community and society. This is due to the embracing of the social systems perspective, alongside increasing threats from terrorism and human-made disasters. The ideal research paradigm regarding trauma, violence and disasters would be to assess resilience before the onset of the critical event, and then determine patterns of relations between these assessments and the outcome criteria of subsequent mental health and functioning of the affected individuals or community [15].

During the Advanced Research Workshop entitled Resilience: Enhancing coping with crisis and terrorism, the concept of resilience was examined from different perspectives. These are reflected in the chapters of the present volume. During the workshop, a multidisciplinary group of 29 scholars met in the Upper Galilee in Israel in January 2014, to discuss and share their views on the topic of enhancing resilience to crisis and terror. The first chapters in this volume present a highly qualified overview of the theoretical foundations and the state of the art knowledge about several dimensions of understanding resilience. In the first chapter Suedfeld reviewed responses to severe stress at the individual, community and mass levels and presented evidence that affirms human strength, and opposes the assumption that traumatic-level stressors cause psychological damage to almost all who survive them. Bryant reviewed major models and evidence from a neuroscience perspective about different ways people respond to trauma. He also discussed how stress, gender and attachment processes may be moderated to foster resilience. He presented arguments for a more refined definition of resilience as long-term functioning at a high level.

Most of the other chapters correspond to two main approaches in studying resilience in the context of mass violence and terrorism. The first approach is based on a long term follow-up of people who have been exposed to adversities or potentially traumatic events, and consequential monitoring of psychological and physiological stress criteria over time. The limitations of this approach are related to known difficulties of longitudinal studies, as well as frequent loss of interest among funders and researchers beyond several months of follow-up. A recent meta-analysis on the long-term effects of disasters has revealed a paucity of studies beyond 24 months [16]. However, the unique advantage of this approach is that it enables identifying different trajectories of resilient coping which is essential from the public health perspective and for prevention interventions. Cherry and Galea present data and supportive evidence on longitudinal trajectories of resilience and discuss implications for the public health field in this volume. Such studies are very seldom but yield a wealth of new knowledge.

The second approach in the research on resilience looks at mental health and behavioral functioning among individuals who have been exposed to a critical event, seeking patterns of variables that distinguish those individuals who meet criteria for resilient coping and functioning from those who do not cope well. The limitations of this approach are typical for any post-hoc cross-sectional research design: poor control of the critical variables at pre-exposure, which is a threat to internal validity, and lack of a temporal dynamic perspective which limits the knowledge about the long-term performance of resilient individuals and communities. For practical and funding reasons, this is the most common approach in studying the effects of disasters [16]. However, over the years, such studies have provided fairly consistent knowledge. In a chapter in this volume, Kauzlaskas and Želviene looked at associations with family resilience after enduring political oppression in Lithuania.

The third approach to studying resilience uses comparative groups of people who have and who have not been exposed to a critical event. If the comparative groups are sufficiently similar and the main difference between them is the exposure, we can learn a lot from the similarities and differences in the patterns of variables indicative of resilience. The limitations of such designs are primarily related to difficulties in identifying and recruiting truly comparative groups, yet this is crucial for the internal validity of the conclusions. A unique advantage of this approach is that it enables studying resilience at the various levels of the ecological systems: the individual, family, community and society. In this volume such a study design was used by Sagy, who presented findings in which the sense of coherence served as the explanatory factor of resilience in conflict areas, both in acute and chronic situations in Israel. Shamai, Enosh, Machmali-Kievitz and Tapiro compared the resilience of groups of couples with a focus on their relationship, some of who were living in Israel either under a high and prolonged threat of missile attack or a low threat. Relations among individual, community and national resilience under perceived national security threat, and differences between Jews and Arabs in Israel are presented in the chapter by Leykin, Aharonson-Daniel and Lahad.

In comparison to individual resilience, community resilience is still an under-researched area. The concept of societal or national resilience is even less well established. However, community resilience offers the most opportunities for prevention and interventions, and this scholarship may help inform public health policies. A critical consideration of the three levels of resilience, i.e. individual, community and national, and their interrelations are presented by Kimhi in a review chapter. The theoretical model of associations among these three levels is presented, and methods for increasing overall resilience in the face of terror are suggested. In the same chapter, he critically analyzed the main approaches in the study of resilience. In a chapter on the concept of national resilience, Parmak presented a view on the relations between societal cohesion, shared culture and resilience during periods of social instability and transition. She argues that diverse ethnic and religious identities are a potential threat to the national social fabric. Development of a multidimensional tool for the assessment of community resilience through a multidisciplinary collaboration is presented by Aharonson-Daniel, Lahad, Leykin, Cohen and Goldberg. This instrument standardizes measurement and in turn enables comparisons of community resilience at different times and across different locations. Lahad and Leykin present the integrative model of coping that has become known as Basic Ph and was developed about 30 years ago, and its implications for the study of resilience.

In sum, the chapters in this book illustrate a broad landscape of the current knowledge and research topics on resilience as related to mass violence and terrorism, which is one of the growing concerns of the world today.

This chapter examines responses to severe stress at the individual, community, and mass levels. The social and behavioral sciences, and their cognate helping professions, have long functioned with the assumption that traumatic-level stressors cause significant psychological damage to most, if not all, people who endure them. Concepts of indomitability, resilience, and posttraumatic growth challenge that orthodoxy, and are increasingly being supported by the evidence. In the chapter, I discuss such stressful events as major accidents, natural disasters, war, and genocide, and present data that affirm human strength.

Neuroscience has made many advances in understanding psychopathological responses to trauma. These developments have also led to promising avenues for promoting adaptation following extreme adversity. Comparable work targeting resilience has lagged behind. This chapter provides a review of the major models and evidence from a neuroscience perspective about the different ways people respond to trauma. Building on animal models, this field has learnt much about human trauma response from fear conditioning, sensitization, and memory reconsolidation models. The neural networks underpinning these processes are being mapped. Further, the roles of stress, gender, and attachment processes are being identified as key to understanding differential response to trauma. This chapter discusses how these different factors may be moderated to foster resilience. A central theme of this review is that the vast majority of evidence is inferred from studies that have compared people with and without psychiatric disorder after trauma. There is an urgent need for a more refined definition of resilience in neuroscience research that conceptualizes resilience as long-term functioning at a high level. Whereas neuroscience has shed light on many potential ways to promote resilience in people during and after adversity, there is a great need for closer study of these factors in populations that have been shown to be resilient over time and under varying conditions of stress. Only through this approach can more effective means emerge from neuroscience perspectives that can help people manage the aftermath of trauma both in the short and long terms.

Over the past several decades there has been enormous advance in the neuroscience underpinnings of how humans respond to trauma. This has led to marked improvements in how we conceptualize extreme stress reactions, such as posttraumatic stress disorder (PTSD), as well as novel treatments for helping people to recover from these reactions. Much less work has targeted the issue of neuroscientific bases for resilience in the face of trauma. Nonetheless, we can learn much from neuroscience evidence about how PTSD functions in terms of understanding the directions we need to take to understand how to understand resilience, and importantly, how to foster resilience in those exposed to trauma.

In this chapter, the authors discuss resilience after trauma exposure from a public health perspective. We begin with an overview and relevant background information on the concept of resilience to provide a context for discussion. Next we turn to longitudinal trajectories of resilience and present supportive evidence. We then consider relevance, addressing the question of why resilience matters and in doing, so we illuminate core challenges for the trauma and public health fields. We conclude with a hypothetical scenario to illustrate how public health could be improved by increasing resilience at a population level.

In this paper, I present the salutogenic paradigm in relation to coping, conflict and culture. The core concept of salutogenesis - sense of coherence (SOC) - is described as a powerful explanatory factor of resiliency, especially in conflict areas, which enables us to understand the highly resilient levels among young Israeli Jews and Arabs. The paper also relates to two cases in which the SOC does not contribute to moderating stress reactions: the first refers to acute stressful situations, while the second relates to the specific cultural-ethnic group of Bedouin-Arabs, living in the southern part of Israel.

The present paper focuses on three levels of resilience: individual, community and national. The paper presents the salient limitations of the concept of resilience and the main approaches to the study of resilience. It describes the limited knowledge regarding the associations among the above three levels of resilience and the importance of the associations between them. As a possible conclusion, the paper presents a theoretical model of associations among the three levels of resilience and the ability to withstand harsh events.

Resilience at the level of any system reflects its capacity to successfully manage unexpected pressures without losing its structure and stability. The most generic level of resilience - national resilience - is closely related with a shared vision and values in society at the level of the nation. It refers to the ability to maintain the national social fabric and cohesion when confronted by threats. During massive transitions, the established boundaries of nation-states and the definition and nature of citizenship are challenged. Risks related to diverse ethnic and religious identities may not be apparent before crises arise. In expanded societies, societal fragmentation poses a threat to national security, highlighting the importance of strategic nation-building and national resilience. Nation-building is influenced by trust and practice of communication between citizens, the state and its sub-communities. In order to mitigate security risks and enhance the capacity of multinational societies to cope with crisis, there is a vital need to develop a conceptual understanding and screening methodology for national resilience.

In recent years the question of coping and resiliency has become a crucial element in crisis intervention. This chapter will review the model developed some 30 years ago known as the BASIC Ph model, and its roots in the foundational theories of psychology and in research worldwide on coping and resiliency. Some of the concepts related to coping and resiliency will be reviewed, together with findings from our studies and suggestions for an integrated model to approach major incidents will be presented.

This chapter describes a mixed-method study aimed to explore how civilians living in the line of fire over a period of 12 years experienced and perceived the impact of their exposure to warfare on their couple relationship. In the quantitative part of the study the role of couple resilience, and loss and gain of couple resources as mediators between the level of exposure and the couple relationship was explored. Data were collected from 61 individuals living next to the border between Israel and the Gaza Strip and 112 individuals living some distance from the border. The results revealed no differences between the groups on the couple relationship. However, significant differences were found between the groups in their reporting of negative, positive, and no-implications of the security threat on the couple relationship. The high exposure group reported significantly higher negative and positive implications of the security situation on the couple relationship, whereas the limited exposure group scored significantly higher on their reporting of no-implications. Couple resilience and increased couple resources were found to be mediators between level of exposure and no-implications of the security situation on the couple relationship. Couple resilience was also found to be a mediator between the level of exposure and negative implications, whereas increased couple resources was found to be a mediator between the level of exposure and positive implications. The qualitative part aimed at exploring the way couples construct their experience of the exposure to warfare, using grounded theory methodology. Data were collected through in-depth semi-structured interviews with 14 couples. Five main themes were gathered and organized into a model constituting a continuum between no impact and an adverse impact of the security situation on the couple relationship. The significance of these results to understanding couples living under ongoing external stress was discussed.

Community resiliency is a term commonly used to describe the ability of a community to endure and survive crisis situations. It encompasses the community’s adaptability to changing circumstances and its capability to respond effectively. As such, it is considered to be an essential capacity for emergency preparedness and readiness to respond. While preparedness is often linked to immediate needs, resiliency has prospects for a longer time span, thus it is associated with sustainability and is relevant in routine as well as in emergency situations. Despite the abundance of material on this subject matter, a thorough search of the literature found no practical tools for the assessment of community resiliency. The acknowledgement that resiliency is a complex issue, entailing input from multiple perspectives is beyond the scope of any single discipline, and leads to a unique cooperation between expert professionals and community leaders (stakeholders) forming the Conjoint Community Resilience Assessment Collaboration with the aim of developing a standard measurement tool for community resiliency. This chapter outlines the evolution and the activities of the collaboration, the milestones and path to the Conjoint Community Resilience Assessment Measure - a novel multidisciplinary tool that incorporates the diverse aspects of community resiliency into a community profile. The profile includes aspects such as: leadership, collective efficacy, preparedness, place attachment, and social trust. The CCRAM standardizes measurements and facilitates comparisons of community resiliency across time and place. In this chapter we will briefly review the theoretical background, portray the elements that were considered, and illustrate the process which led to the final validated instrument.

Following the use of chemical weapons against Syrian citizens, US President Obama began making preparations for a US military attack to punish the regime of the Syrian president. With lines extending at gas-mask distribution points, nervous Israeli citizens were preparing for a possible Syrian attack. The present study explored the associations among individual, community and national resilience, and the sense of danger on perceived stress among Israeli Jews and Arabs in the midst of this security uncertainty. Methods: Using the web-based research software - Qualtrics - a community sample of 435 individuals (n = 244 Jews and n = 191 non-Jews, 57 5% males) completed brief versions of a personal resilience scale (CD-RISC 2; Vaishnavi, Connor & Davidson, 2007), a community resilience scale (CCRAM-10; Leykin, Lahad, Cohen, Goldberg & Aharonson-Daniel, 2013), a national resilience scale (Kimhi et al., 2013), a single item stress question (Elo, Leppanen & Kahkola, 2003) and 3 items from the sense of danger scale (Solomon & Prager, 1992). Results: Jews reported significantly higher levels than Arabs on measures of resilience, ηp2 = .28, p < .001, and levels of general stress and sense of danger, ηp2 = .17 & ηp2 = .10, p < .001. A multiple regression analysis revealed that for both Arabs and Jews, a sense of danger was significantly associated with stress. Individual and community resilience also interacted with ethnicity on stress: among Arabs, individual and community resilience (controlling for age and personal resilience) negatively tended to predict stress, while among Jews this effect was not evident. Discussion: During times of uncertainty, individual and community resilience can be an asset for reducing subjective stress among minority populations in Israel; therefore, it is recommended to maintain and build community capacities during routine.

Lithuania regained its independence about 20 years ago and is a member of the EU with a population of nearly three million... Traumatic experiences and coping with trauma are important topics for Lithuanians, as a large part of the population experienced persecution during the oppressive Soviet regime before these social changes began. The aim of the present study was to evaluate the relationship between psychological well-being, exposure to traumatic events, and exposure to political violence by family members during the Soviet regime in a Lithuanian sample. Method: a non-clinical sample of 626 participants (59.9% female, 40.1% male) with a mean age of 39.00 (SD = 18.13) (range: 18 to 89) participated in the present study. Self-report measures were used to assess trauma exposure and psychological well-being. Life-time trauma exposure was measured using the Brief Trauma Questionnaire (BTQ). Psychological well-being was measured using the 10-item short Psychological Well-Being Questionnaire (WBQ) developed by the authors of the study. Results: the study revealed that 69.8% of our sample experienced at least one traumatic event; 55.4% reported experiences of political violence in their families during the Soviet Regime. A family history of political violence was a more significant factor in predicting psychological well-being than personal life-time trauma exposure. Conclusion: social factors of trauma are important in understanding the resilience of individuals.