By Cindy Mindell

Dr. Golan Shahar

According to a new study by researchers at Ben-Gurion University of the Negev (BGU), exposure to media coverage of terrorist missile attacks increases pain levels in people already suffering from chronic pain.
The study, “Does War Hurt? Effects of Media Exposure after Missile Attacks on Chronic Pain,” published in the online version of the Journal of Clinical Psychology in Medical Settings, showed that exposure to the attacks through the media predicted an increase in pain intensity and in the sensory component of pain.
The study was conducted by Prof. Golan Shahar and Dr. Sheera F. Lerman of the BGU department of psychology, and Dr. Zvia Rudich of Soroka University Medical Center in Beersheba.
In addition to serving as professor of clinical health and psychology at Ben-Gurion University, Shahar is also visiting professor of psychiatry at Yale University School of Medicine. Golan completed post-doctoral training in the departments of psychiatry and psychology at Yale from 2000 to 2002 and he served as assistant professor in the department of psychiatry from 2002 to 2004. Since returning to Israel, Golan has maintained a close relationship with Yale, with frequent visits and ongoing collaborations on research grants and publications, particularly around the psychological impact of chronic stress.
Shahar spoke with the Ledger about the study.

Q: How, when, and why was the study first conceived?
A: The study was conceived following the missile attacks on the southern region of Israel and the Israeli Defense Forces’ “Cast Lead” military operation. We had a unique opportunity to be able to assess the effects of a stressful situation on individuals who were taking part in an unrelated study on psychological adjustment to chronic pain conducted as part of Dr. Sheera Lerman’s doctoral dissertation, which I was supervising. Thus, we were able to compare patients’ conditions before and after the three-week-long missile attack, making this a rare and unique prospective study on exposure to terrorism.

Q: How did you recruit subjects? Were they from one area of the country or spread out?
A: The study assessed 55 chronic pain patients at a specialty pain clinic in a large hospital in the south of Israel. Accordingly, most patients live in a radius of 80 kilometers or less from the hospital, which is the same approximate area that was affected during the missile attacks.
The patients completed self-report questionnaires regarding their pain, depression, and anxiety before and after the three-week missile attack.

Q: It seems obvious that when we take in negative images and information, negative emotional/psychological reactions can ensue. Is this study exploring new territory by investigating the physical impact?
A: There are very few studies exploring the physical impact of terrorism on individuals who were not directly injured. Exposure to the attacks through the media predicted an increase in pain intensity and in the sensory component of pain during the pre-post war period, but did not predict depression or anxiety. Intuitively, negative images and information cause more emotional distress. However, we did not find this pattern in our study. We found that individuals with chronic pain experienced more pain but not more emotional distress as a result of exposure to war-related media coverage on TV. Patients’ previous levels of emotional distress may affect their ability to cope with stressful situations, making stressors more prominent and influencing them to seek out more information about the situation.

Q: What were some of the more unexpected or surprising discoveries in the study?
A: This prospective and longitudinal study adds to the body of research on the effects of war and terrorism on suffering – specifically, the effect on individuals with chronic pain. Our results show that indirect exposure to terrorism had an adverse effect on the physical pain of chronic pain patients but not on their emotional distress. This emphasizes the importance of interventions that target this population.
Stress and media exposure were also strongly related, suggesting that the amount of television viewing related to the terrorist attacks may have influenced how much stress the individual experienced.

Q: How does this study contribute to what is already known about the effects of stress on physical and mental health?
A: Much interest has been shown in this study, since the effects of stressful situations on healthy and chronically ill individuals in Israel are an ongoing national concern.
These findings contribute to the understanding of the effects of terrorism on physical and emotional distress, and identify chronic-pain patients as a vulnerable population requiring special attention during terrorism-related stress.

Q: What conclusions and/or recommendations do you draw from the study, in terms of how and how much we should expose ourselves to upsetting media coverage? Do you think the media should play a larger role in public health?
A: The amount of media coverage one experiences as adversely negative varies from person to person. Patients’ previous levels of emotional distress may affect their ability to cope with stressful situations, making stressors more prominent and influencing them to seek out more information about the situation.
For some, seeking out as much information as they can allows them to feel more in control and reduces distress, and for others, this is not the case. But for those who do experience distress as a result of exposure to media coverage, it might be advisable for them to detach from the news. If there is something really important, the information will get to them.
Media already plays a very large role in public health. However, there should be more focus on how individuals with chronic illnesses cope with stressful situations such as war and terrorism in order to promote a better quality of life for them.