Observational studyPloS one2021
Development and validation of the Continuous Traumatic Stress Response scale (CTSR) among adults exposed to ongoing security threats.
Observational study in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of war-related posttraumatic stress disorder in adolescents: a systematic review and meta-analysis.European journal of psychotraumatology · 2025Pooled it
- The Effectiveness and Feasibility of Psychological Interventions for Populations Under Ongoing Threat: A Systematic Review.Trauma, violence & abuse · 2024Pooled it
- Escalation during continuous traumatic stress: the psychological impact of wartime flare-up.European journal of psychotraumatology · 2026Article
- Understanding the clinical profile of Continuous Traumatic Stress Responses: insights from the adaptation of the Continuous Traumatic Stress Response Scale (CTSR) in Ukrainian military personnel.European journal of psychotraumatology · 2026Article
- Mental health and psychosocial support during ongoing armed conflict: position paper of the Global Collaboration on Traumatic Stress.European journal of psychotraumatology · 2026Article
- Interventions addressing mental health in conflict-affected settings: A literature review.Conflict and health · 2026Article
- Ukrainians under continuous traumatic stress: towards increasing the diagnostic condition's clinical utility.Frontiers in psychiatry · 2026Article
- The cost of ongoing war: escalation of continuous traumatic stress response over time and later functional, adjustment, and affective difficulties.Frontiers in psychiatry · 2026Article
- Posttraumatic stress symptoms and posttraumatic stress disorder in adolescents exposed to continuous traumatic stress in Sub-Saharan Africa: A systematic review and meta-analysis.Global mental health (Cambridge, England) · 2026Review
- Therapists on the front lines: constructing continuous traumatic stress as a dynamic axis of exposure.Frontiers in psychiatry · 2026Article
- Psychometric properties of the revised Ukrainian version of the Continuous Traumatic Stress Response scale (CTSR) in the context of the Russo-Ukrainian war.European journal of psychotraumatology · 2025Article
- Living under threat: adolescents' continuous traumatic stress reactions in relation to violence exposure.European journal of psychotraumatology · 2025Article
- Cumulative Violence and Post-Traumatic Stress: An Integrative Model of Coping and Resilience Among Women Exposed to Sexual and Conflict-Related Violence.European journal of investigation in health, psychology and education · 2025Article
- The Interplay of Personal and Collective Resilience and Mental Health During Prolonged Conflict: Insights From Young Adults in Israel.Stress and health : journal of the International Society for the Investigation of Stress · 2025Article
- Article
- Psychological function in the context of protracted stress during war: a multi-sample, multivariate longitudinal study.Frontiers in psychiatry · 2025Article
- Psychological wellbeing of Ukrainian civilians: a data report on the impact of traumatic events on mental health.Frontiers in psychology · 2025Article
- Post-traumatic Stress Disorder and Moral Injury Among Ukrainian Civilians During the Ongoing War.Journal of community health · 2023Article
- Habituation of Fear-Israeli-Jewish Population during Protracted Belligerence.International journal of environmental research and public health · 2022Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent diagnostic criteria for posttraumatic stress disorder (PTSD) do not include symptoms resulting from exposure to continuous or ongoing traumatic stress. Thus existing assessment tools do not fully capture stress symptoms associated with exposure to threats that extend over months or years. To address this void, we enumerated the symptoms associate with ongoing exposure to stress including those that are distinct from existing PTSD diagnostic criteria.
objectivesTo develop the Continuous Traumatic Stress Response Scale (CTSR) and assess its psychometric properties.
methodWe sampled 313 adults exposed and unexposed to ongoing security threat between December 2016 and February 2017. Respondents lived in communities bordering the Gaza Strip in southern Israel where they are exposed to frequent rocket attacks, requiring they locate and find shelter in 30 seconds or less. We assessed the concurrent validity of CTSR relative to the Posttraumatic Diagnostic Scale (PDS).
resultsOn the basis of exploratory factor analysis (EFA), we retained 11 of 25 items measuring three distinct factors: exhaustion/detachment, rage/betrayal, and fear/helplessness. We found moderate concurrence between the scales; that is, the CTSR appears to measure a construct related to, but distinct from PTSD. This conclusion is supported by confirmatory factor analysis (CFA) indicating that each factor significantly contributes to measurement of a higher-order, continuous traumatic stress latent construct.
conclusionsThese results support the psychometric properties of CTSR. Future research is required to confirm these findings in other countries and cultures and among individuals exposed to other forms of continuous traumatic stress.
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