Coping strategies in civilians during air attacks

Background Coping strategies may influence the psychological outcome after a stressful event, both as coping at the time of the event and as strategies of dealing with its consequences after the event. The aim of the study was to investigate coping strategies used by civilians during the air attacks in Yugoslavia in 1999, and their association with the level of exposure, gender and psychological symptoms 1 year later. Method The sample is a non-selective group of 139 medical students from the University of Belgrade, Yugoslavia. Open questions and content analysis were used to assess coping strategies. Symptoms of intrusion and avoidance were assessed, as well as general psychological symptoms. Results Content analysis of answers to open questions revealed nine categories of coping strategies (sport and walks, leisure activities, talking and gathering, humor, avoidance, philosophical approach, getting information, work, and substance abuse). A cluster analysis identified three groups of students with different styles of coping. Students that used dominantly 'talking and gathering' had the highest, and the ones that mostly used 'leisure activities' the lowest scores on intrusion. There were significant gender differences in how coping strategies were associated with intrusive symptoms. Conclusion The type of coping strategies used during the air attacks may contribute to the level of intrusive symptoms 1 year after the event. Different coping strategies might be effective in men and women to reduce intrusive symptoms. Longitudinal and prospective studies are needed to draw definite conclusions on causal relationships between coping strategies and levels of posttraumatic stress