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Higher level of psychological stress. The IES-R provides three sub-scores, the mean avoidance, intrusion and hyperarousal scores, a total mean IES-R score (divided by the total number of items) and a total IES-R score (without division by the total number of items). A total IES-R score equal to or more than 33 signifies the likely presence of acute stress reaction syndrome [15,16]. All statistical