Ongoing Traumatic Stress Response (OTSR) in Sderot, Israel

Gary M. Diamond, Joshua D. Lipsitz, Zvi Fajerman, Omit Rozenblat

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


In Sderot, a small city in southern Israel, seven years of continuous missile attacks have led to dramatic increases in treatment seeking for anxiety symptoms. For some clients, the clinical picture is consistent with a diagnosis of post traumatic stress disorder (PTSD). For other clients, however, the onset and constellation of symptoms are less typical of PTSD. In these cases, anxiety symptoms seem to evolve gradually and be associated with ongoing, daily stress about imminent attacks, rather than with a discrete, past traumatic event. Much of their avoidance behavior is reality based. They report hyperarousal, severe distress, and loss of control during and immediately following actual missile attacks. However, they are less likely to exhibit reexperiencing symptoms. Furthermore, in contrast to the typical presentation of PTSD, their symptoms tend to diminish dramatically or completely resolve when they are no longer within harm's way. We suggest that this clinical presentation may be best understood as an ongoing traumatic stress response (OTSR), rather than PTSD or PTSD symptoms. We consider diagnostic features which discriminate between these two phenomena as well as implications for treatment.

Original languageEnglish
Pages (from-to)19-25
Number of pages7
JournalProfessional Psychology: Research and Practice
Issue number1
StatePublished - 1 Feb 2010


  • PTSD
  • Sderot
  • anxiety
  • stress
  • war

ASJC Scopus subject areas

  • General Psychology


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