The Mediating Role of Psychosocial Resources in Mental Health Outcomes in Contexts of Mass Violence

Background and Purpose: The Al Aqsa Intifada was a period of intense violence in Israel between 2000-2005 during which time civilians were exposed to repeated mass casualty events. Our study uses the Conservation of Resources Theoryto expand the literature connecting prolonged exposure to violence with the development of negative mental health sequelae. We highlight the role of resource depletion in the relationship between environment and psychological stress; and further suggests that this relationship is intensified by social status within society. To that end, we explore the relationship between perceived threat to psychosocial resources and the development of PTSD among two minority groups within Israel; Foreign Born Jews (FBJ) and Palestinian Citizens of Israel (PCI).

Hypothesis 1: Both minority groups will perceive a greater threat to resources than the majority ethnic group.

Hypothesis 2: A more vulnerable social status will also increase the risk for developing PTSD.

Hypothesis 3: The vulnerability to developing PTSD is mediated by the perceived loss of resources.

Methods: Data was collected across three measurement periods (2004 and 2005). Sampling was stratified by region to ensure a representative sample of Jewish and PCI were obtained. The sample consists of 1613 respondents. Seemingly unrelated regressions were used to estimate two versions of a mediation model. Each model tested the predictive utility of social status on the development of PTSD one year later (i.e., at follow up wave III). This relationship was mediated by perceived loss of psychosocial resources, perceived loss of economic resources, and satisfaction with social support.

Results: Findings suggest belonging to a minority group was predictive of higher levels of PTSD symptom severity (b = 3.02 p < 0.001; b = 11.02, p < 0.001). Membership in the majority racial/ethnic group was predictive of higher satisfaction with social support, which attenuated the severity of PTSD symptom severity. There were differences among the minority groups, such that membership in the FBJ group predicted lower PTSD symptom severity as compared to Palestinian counterparts (b = -8.00, p < 0.001). This relationship was partially mediated by psychosocial resource loss, in that FBJs reported less psychosocial resource loss as compared to PCIs (b = -2.30, p < 0.001). Palestinian respondents were more likely to report psychosocial resource loss, and were less likely to report satisfaction with social support (b = 2.80, p < 0.001; b = -0.45, p < 0.001); both losses mediated the relationship between PCI group membership and PTSD symptom severity.

Implications and Conclusion: Our findings suggest that marginalized group differ in their risk of negative mental health sequelae, and that the perceived loss of psychosocial resources may play a critical role in negative mental health outcomes. These findings have implications for the ways in which we allocate resources to support communities in the wake of mass-trauma and disaster, in particular suggesting that a one-size-fits all approach to intervening would be misguided. Lastly, we suggest that efforts to build resilience among vulnerable groups should focus on psychosocial resource acquisition, with a particular emphasis on strengthen social ties.