PTSD follows and is a result of exposure to a traumatic event. However, the exposure by itself is not a sufficient precondition for the onset of PTSD, leading investigators to examine risk factors for the development of PTSD following such exposure.

The current study examined the association between levels of DSM 5 PTSD symptoms with pre- and peri-traumatic PTSD risk factors.

Specifically, the study focused on gender, peri-traumatic dissociation, and social support, levels of objective and subjective threat, and trait tendency for forgiveness as PTSD risk factors.

501 Israeli civilians were assessed during real-time exposure to missile and rocket fire at the eruption of the Gaza war. Assessments took place two weeks after the beginning of this military operation. The study utilized a revised self-assessment PTSD symptoms questionnaire adhering to DSM 5 diagnostic criteria, formulated and validated by the authors.

A structural equation model (SEM) design revealed that higher levels of forgiveness toward situations but not for self or for others were associated with fewer PTSD symptoms, while peri-traumatic dissociation and high levels of objective and subjective threat were positively associated with PTSD symptoms. Additionally, females were at higher risk for PTSD symptoms than males.

The findings of the study are of significance in applying the revised version of the PTSD DSM 5 diagnostic criteria in a unique real-time combat situation, thereby directing preventive attention to those vulnerable to the development of elevated levels of PTSD symptoms in the short and long run.