Can people remain engaged and vigorous in the face of trauma? Palestinians in the West Bank and Gaza.

This is the first study to investigate how actively engaged and vigorous people remain in their life tasks in the midst of chronic exposure to significant traumatic events. We sought to identify risk and protective factors for engagement within the context of ongoing exposure to political violence and social upheaval. We randomly identified and interviewed 1,196 adult residents of the West Bank and Gaza during a period of violent conflict on 3 occasions: (1) September-October 2007, (2) April-May 2008, and (3) October-November 2008. Participants were asked about their exposure to political violence, symptoms of depression, and posttraumatic stress (PTS) symptoms, their level of social support, psychosocial resource loss, and positive engagement in life tasks. Path modeling revealed that trauma exposure indirectly affected engagement through its impact on resource loss and PTS and depression symptoms. PTS symptoms at Wave 2 were modestly related to greater engagement at Wave 3, and depression symptoms did not independently predict engagement at Wave 3. Psychosocial resource loss at Wave 1 and Wave 2 was the best overall predictor of engagement at Wave 3, through its direct and indirect effects via PTS symptoms. Greater engagement was also predicted by greater social support, being more educated, being younger, and being more religious. The relative independence of psychological distress and engagement was noted as a critical finding supporting a key tenet of positive psychology. The relationship of resource loss and social support with engagement suggests that bolstering psychosocial resources may offer a route for primary and secondary prevention amidst chronic traumatic conditions.