Maintaining Routine despite Ongoing Exposure to Terrorism: A Healthy Strategy for Adolescents?

Purpose: To examine the association between ongoing terrorism and Israeli adolescents' routine activities. Methods: A total of 1336 junior high and high school students from Jerusalem (46.9% boys and 53.1% girls) self-reported on measures of maintaining or reducing their level of routine activities, perceived parental monitoring, posttraumatic symptoms (PTS) and functional impairment. We used linear regressions to explore possible associations between decreasing (or maintaining) level of routine activities, parental monitoring, and PTS and functional impairment. Results: A majority of the adolescents reported that under the recurrent threat of terrorism they maintained their routine (i.e., 65.8% continued using public transportation). Similarly, more than half the students perceived their parents as encouraging them to maintain their routine activities. Furthermore, greater exposure to terrorism was associated with more PTS symptoms and functional impairment. Nonetheless, a reduced level of routine activities was a significant predictor for higher PTS and functional impairment, even after controlling for level of exposure to terrorism, gender and age. Similarly, perceived parental limiting of routine activities was a significant predictor for higher PTS and functional impairment, even after controlling for gender, age and the level of exposure to terrorism. Conclusions: Our results support practitioners' recommendations to encourage continuity in daily routine. Disruption of routine activities may result in the development of avoidance reactions that can lead to posttraumatic stress disorder.