Can psychosocial intervention improve peer and sibling relations among war‐affected children? Impact and mediating analyses in a randomized controlled trial

Social resources are considered important protectors in traumatic conditions, but few studies have analyzed their role in psychosocial interventions among war‐affected children. We examined (1) whether a psychosocial intervention (teaching recovery techniques, TRT) is effective in improving peer and sibling relations, and (2) whether these potentially improved relations mediate the intervention's impacts on children's mental health. Participants were 428 Palestinian children [10–13 (mean = 11.29, standard deviation SD = .68)‐year‐old girls (49.4 percent) and boys (50.6 percent)], who were cluster‐randomized into the TRT and wait‐list control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well‐being at baseline (T1

Trajectories of posttraumatic stress symptoms (PTSS) after major war among Palestinian children: Trauma, family-and child-related predictors

Objective Research shows great individual variation in changes in posttraumatic stress symptoms (PTSSs) after major traumas of terrorist attacks, military combat, and natural disasters. Earlier studies have identified specific mental health trajectories both in children and adults. This study aimed, first, to identify potential PTSS-related trajectories by using latent class growth analyses among children in a three-wave assessment after the 2008/2009 War on Gaza, Palestine. Second, it analyzed how family- and child related factors (e.g., attachment relations, posttraumatic cognitions (PTCs), guilt, and emotion regulation) associate with the trajectory class membership. Methods The sample consisted of 240 Palestinian children (49.4% girls and 50.6% boys) of 10–13 years of age (M=11.29, SD=0.68), who completed PTSS (CRIES) assessments at 3 (T1), 5 (T2), and 11 (T3) months after the war. Children reported their

Effectiveness of psychosocial intervention enhancing resilience among war-affected children and the moderating role of family factors

The study examines, first, the effectiveness of a psychosocial intervention based on Teaching Recovery Techniques (TRT) to increase resiliency among Palestinian children, exposed to a major trauma of war. Second, it analyses the role of family factors (maternal attachment and family atmosphere) as moderating the intervention impacts on resilience. School classes in Gaza were randomized into intervention (N = 242) and control (N = 240) groups. The percentage of girls (49.4%) and boys (50.6%) were equal, and the child age was 10–13 years in both groups. Children reported positive indicators of their mental health (prosocial behaviour and psychosocial well-being) at baseline (T1), post-intervention (T2) and at a six-month follow-up (T3). At T1 they accounted their exposure to war trauma. Mothers reported about their willingness to serve as an attachment figure, and the child reported about the family

The influence of role awareness, empathy induction and trait empathy on dictator game giving

We ask how state empathy, trait empathy, and role awareness influence dictator game giving in a monetarily incentivized experiment. We manipulated two factors: role awareness (role certainty vs. role uncertainty) and state empathy induction (no empathy induction vs. empathy induction). Under role uncertainty, participants did not know their role as a dictator or a recipient when making their choices. State empathy was induced by asking the dictators to consider what the recipient would feel when learning about the decision. Each participant was randomly assigned into one of the four conditions, and in each condition, participants were randomly assigned into dictator and receiver roles. The role assignment took place before or after decisions were made, depending on the condition. We also studied the direct influence of trait empathy on dictator game giving as well as its interaction with the experimental manipulations. Trait empathy was measured by the Interpersonal Reactivity Index (IRI) and the Questionnaire of Cognitive and Affective Empathy (QCAE) before the experiment. Of our experimental manipulations, role awareness had an effect on dictator game giving; participants donated more under role uncertainty than under role certainty. Instead, we did not observe an effect of state empathy induction. Of trait empathy subscales, only affective empathy was positively associated with dictator game giving. Finally, role awareness did not influence all participants similarly but had a larger impact on those with low scores on trait empathic concern or trait affective empathy. Our results indicate that specific measures to induce altruistic sharing can be effective but their effect may vary depending on certain personal characteristics. </p

Effects of fear on donations to climate change mitigation

Despite 70 years of research, there is no consensus about the effects of threat messages on behavior, partly because of publication bias. The lack of consensus concerns situations such as climate change where people tend to believe that they cannot easily make a major difference. Using a 2 × 2, (threat, neutral) × (efficacy, no efficacy) between-subjects design, we tested four hypotheses: the effect of threat stimuli on (1) mitigation of climate change and (2) experienced fear depends on efficacy information, (3) threat stimuli increase monetary donations to mitigation regardless of efficacy information, and (4) the effect of the threat stimuli depends on political identity. The threat stimuli were climate change related pictures and a prompt to write either about one’s knowledge of or about the threat of climate change. The efficacy stimuli were an efficacy related picture and written information about the efficacy of a climate change mitigating organization. We collected a representative online sample of 1517 U.S. citizens. The manipulations affected experienced fear and self-efficacy, but there was no statistically significant main effect of threat on donations nor a statistically significant interaction between threat and efficacy or between threat and political identity. It is concluded that threat appeals do not increase climate change mitigation behavior by more than a very small amount compared to making people think about the subject.publishedVersionPeer reviewe

Lasten ajatukset sodan jälkeen: Traumaan liittyvät kognitiot ja vanhempien sotatraumat ennustavat sotaa kokeneiden lasten mielenterveysongelmia

Tutkimuksessa analysoitiin sodan kokeneiden gazalaisten lasten mielenterveyteen vaikuttavia tekijöitä. Otos koostui 482 10–13-vuotiaasta koululaisesta, joista puolet arvottiin mielenterveysongelmia ehkäisemään pyrkivään interventioon. Interventio perustui Teaching Recovery Techniques (TRT) –käsikirjaan ja se järjestettiin koululuokissa. Kaikki lapset vastasivat kyselyihin kolmena ajankohtana: kolme, viisi, ja yksitoista kuukautta sodan jälkeen vuonna 2009. Lasten vanhemmat vastasivat kyselyyn 11 kuukautta sodan jälkeen. Kognitiiviset teoriat traumaperäisestä stressihäiriöstä (engl. posttraumatic stress disorder, PTSD) ovat painottaneet trauman jälkeisten kielteisten ajatusten tai kognitioiden (engl. posttraumatic cognitions, PTCs) keskeistä roolia kroonisten traumaperäisten mielenterveysongelmien kehittymisesssä. Teorioiden mukaan kielteiset arviot itsestä, oireista, ja maailmasta johtavat epätarkoituksenmukaisten selviytymiskeinojen käyttämiseen ja uhan tunteisiin, jotka pitävät yllä traumaperäisiä stressioireita. Tässä työssä estimoitiin trauman jälkeisten kognitioiden ja traumaperäisten stressioireiden suhteellista ennustevoimaa toisiinsa ristiviivemallissa ja testattiin välittävätkö trauman jälkeiset kognitiot varhaisten traumaperäisten stressioirieden kehitystä kroonisiksi traumaperäisiksi stressioireiksi (Artikkeli I). Tulokset tukivat käsitystä trauman jälkeisten kognitioiden merkittävyydestä. Trauman jälkeiset kognitiot ennustivat myöhempiä traumaperäisiä stressioireita. Trauman jälkeiset kognitiot eivät välittäneet varhaisten traumaperäisten stressioireiden kehitystä kroonisiksi, koska traumaperäiset stressioireet eivät ennustaneet traumaperäisiä kognitioita. Tuloksen syy oli mahdollisesti se, että traumaperäiset stressioireet olivat vaikuttaneet kognitioihin jo ennen ensimmäistä mittausajankohtaa kolme kuukautta sodan jälkeen. Traumaperäisilla stressioireille on monia riskitekijöitä trauman jälkeisten kognitioiden lisäksi. Työssä testattiin hypoteesia, että traumaperäisten stressioireiden riskitekijät ovat myös trauman jälkeisten kognitioiden riskitekijöitä ja että trauman jälkeiset kognitiot välittävät näiden riskitekijöiden vaikutuksia traumaperäisiin stressioireisiin (Artikkeli II). Tulosten mukaan riskitekijät, jotka liittyvät lasten suhteisiin ikätovereihinsa (yksinäisyys tai epäsuosio), sisaruksiinsa (konflikti) ja vanhempiinsa (psykologinen kaltoinkohtelu), ennustivat trauman jälkeisiä kognitioita ja—kognitioiden kautta—traumaperäisiä stressioireita. Vanhempien psykologisen kaltoinkohtelun on arveltu olevan evolutionaarisesti adaptationaalista sotaisassa ympäristössä. Hypoteesien mukaisia tuloksia saatiin isien osalta (Artikkeli III). Vastoin odotuksia, äitien sotiin liittyvät kokemukset kuolemanvaarasta olivat yhteydessä vähäisempään lasten raportoimaan psykologisen kaltoinkohtelun kokemiseen. Kognitiivis-behavioraalisen ryhmäintervention tehokkuutta tutkittiin satunnaistetussa ja kontrolloidussa kokeessa (Artikkeli IV). Interventiolla saattoi olla hetkellinen vaikutus vähäistä traumanaikaista dissosiaatiota raportoivien tyttöjen traumaperäisiin stressioireisiin. Interventiolla ei ollut vaikutusta kognitioihin eikä interventiolla ollut yhtään tilastollisesti merkitsevää vaikutusta mielenterveysongelmiin, jos useiden testien tekemisestä johtuva kohonnut todennäköisyys vääriin merkitseviin tuloksiin otettiin huomioon. Tulokset ja tutkimuskirjallisuus viittaavat siihen, että soden kokeneiden lasten negatiivisilla arvioilla on merkittävä rooli pitkäaikaisten mielenterveysongelmien kehittymisessä. Kognitioden kautta riskitekijät muuttuvat traumaperäisiksi stressioireiksi ja interventiot vähentävät oireita.This study analyzed potential mechanisms behind war-affected children’s mental health problems in Gaza, Palestine. The sample was 482 10–13 –year-old school children, half of whom were randomly selected to a mental health intervention based on Teaching Recovery Techniques (TRT) given in school classes. The children and their parents answered to questionnaires at three time points: three, five, and eleven months after a war in 2009. Cognitive theories of posttraumatic stress disorder have emphasized the pivotal role of negative thoughts or cognitions (posttraumatic cognitions, PTCs) in the development of chronic trauma-related mental health problems. Negative appraisals of oneself, symptoms, and the world are thought to lead to maladaptive coping strategies and feelings of threat which perpetuate posttraumatic stress symptoms and make them chronic. In the thesis, the role of PTCs in the development of chronic symptoms of posttraumatic stress (PTS symptoms; i.e. symptoms which are part of the diagnosis of posttraumatic stress disorder, PTSD) was analyzed by estimating the relative predictive power of PTCs and PTS symptoms on each other over time and by testing whether PTCs are the mediating mechanism through which early PTS symptoms develop into chronic PTS symptoms (Article I). The results confirmed the importance of negative cognitions which predict posttraumatic stress symptoms. Furthermore, PTCs was not a mechanism through which stress symptoms at three months develop into chronic ones because PTS symptoms did not predict PTCs. This result might have been observed because the stress symptoms had already influenced negative cognitions by three months after the war. In addition to PTCs, PTS symptoms among children have many risk factors. The hypothesis tested was that the risk factors of PTS symptoms would also be the risk factors of PTCs and the PTCs would mediate their effects on PTS symptoms (Article II). The results confirmed that risk factors related to children’s relationships with their peers (loneliness or unpopularity), siblings (conflict), and parents (psychological maltreatment) did predict PTCs and, via PTCs, PTS symptoms. Parental psychological maltreatment in turn has been hypothesized to be an evolutionarily adaptational response to parents’ own experiences of war. This was confirmed only among fathers (Article III). Contrary to expectations, mothers’ war-related life-threat was negatively associated with children’s reports of psychological maltreatment by their parents. The effectiveness of a cognitive-behavioral group intervention was studied (Article IV). The intervention might have had a temporary effect on PTS symptoms among girls with a low level of peritraumatic dissociation. However, additional analyses did not find an effect of the intervention on cognitions, and there were no significant effects of the intervention on PTS symptoms, either, if the probability of finding false significant results because of multiple tests was taken into account. The results and literature in general point to the importance of cognitive appraisals in the development of chronic mental health problems among war-affected children and others affected by traumatic stress. Cognitive appraisals appear to be a point where risk factors turn into posttraumatic stress symptoms and where interventions reduce the symptoms

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