COPING WITH THE GULF-WAR - SUBCULTURE DIFFERENCES AMONG ISCHEMIC-HEART-DISEASE PATIENTS IN ISRAEL

The purpose of this study was to assess short term effects of the Gulf war on ischemic heart disease patients of different ethnic origin. Th ree dimensions of patients' reactions to the war situation were studie d: psychological, physical and behavioral. The study first focused on changes in patients' responses on these dimensions over three stages o f the war, differentiated according to degree of threat. Second, diffe rences stemming from ethnic origin were examined among patients who li ve in the same geographical region, use the same health services and w ere exposed to the same threatening life event. One hundred ischemic h eart disease patients were interviewed while waiting in outpatient hos pital clinics for a regular examination at the end of the war. The res ults of intrapersonal comparisons showed that the intensity of respons es, as expected, increased significantly on the three dimensions from the week before the war started to the first week of the war, which wa s the most stressful period for Israelis. During the last week of the war, however, when stress was significantly reduced, the expected chan ge was found primarily with regard to psychologic responses. That is, worries were significantly reduced, but no significant reduction in fr equency of anginal pain and in drug consumption followed, indicating d ifferences in the adjustment process on the psychologic and physical l evels. Subcultural differences were found in the studied responses: Pa tients of Asian or North African countries of origin reported having m ore frequent anginal pains, and consuming more drugs than patients fro m Western countries. The increase in physical symptoms indicates that a stressful event has immediate harmful physical effects on chronicall y ill people, which might increase in the long run. This supports the life events theory. The severity of these aversive responses varies am ong the different ethnic groups, probably due to cultural differences in learned coping patterns. Such findings have important practical app lications for identifying groups or individuals at risk, and for plann ing preventive intervention programs for periods of social crisis.