The impact of conflict on children: The Palestinian experience

Violence permeates all parts of the West Bank and Gaza Strip. Since the onset of the Al-Aqsa Intifada on the September, 28, 2000, through October 31, 2003, more than 51,000 Palestinians have been injured and 2700 have been killed. Palestinian children suffer from various physical aliments due to their disadvantaged situation, including 10% who suffer from moderate to severe malnutrition. The children also suffer from significant mental health disorders, including 33% with acute levels of posttraumatic stress disorder, 49% with moderate levels and 15.6% low levels. In “hot” areas, 55% of the children have acute levels of posttraumatic stress disorder, 35% moderate levels, and 9% low levels. Key words: children, Palestinians, posttraumatic stress disorder, wa

Disaster and Mental Health: The Palestinian experience

Background: The Middle East conflict between the Palestinians and the Israelis is a deadly battle between two victims. The Israelis, survivors of a long history of persecution and discrimination, are still bearing the scars of victimization. They are trapped in their collective memories of brutal suffering, which culminated in the horrors of the Holocaust. In their attempt to escape their history and to create a better future, they were led by the Zionist movement to establish a Jewish home and a Jewish nation. Their choice was the Biblical land of Palestine and their victims were to become the Palestinians. The modern Palestinian tragedy goes back to the late part of the 19th centaury when the Zionist movement was created in the wake of nationalism which spread in Europe. Zionism’s declared goal was to fulfill the dream of establishing a Jewish homeland in Palestine. The British colonial government which was mandated over Palestine responded favorably by issuing the Balfour declaration in 1917

Personality and trauma: Adult attachment and posttraumatic distress among former political prisoners

Attachment patterns are especially salient in facing danger and threats to one's life. Earlier research has suggested that secure persons are protected and insecure persons vulnerable in conditions of traumatic stress. We argued that the general view may not apply to the complex person-trauma interaction that is characteristic to torture and ill-treatment. Rather, as Crittenden maintains, each attachment pattern involves a unique strategy that is the most adaptive solution, depending on the nature of the trauma. We hypothesized that the general view of the secure attachment pattern being protective, and the insecure patterns being unprotective, would apply when political prisoners are exposed to physical torture and ill-treatment. Whereas, when exposed to psychological torture involving interpersonal cruelty, securely attached persons would be more vulnerable than insecure. The hypotheses were examined among

Adult attachment and emotional responses to traumatic memories among Palestinian former political prisoners

The association between attachment styles and emotional responses to traumatic memories was examined among 153 Palestinian former political prisoners. Self-report tools revealing adult attachment and intensity and valence of emotional responses were applied. As hypothesized, a high intensity of cognitive appraisal and a low intensity of affective responses characterized the emotional profile of insecure-dismissing men. By contrast, the emotional profile of insecure-preoccupied men was characterized by low cognitive and high affective responses, and intensive behavioral urge to act. Secure men in turn had a moderate and balanced emotional profile involving both cognitive and affective responses. In accordance with the activation hypothesis, when exposed to a high level of torture and ill-treatment, the insecure-preoccupied men showed especially intensive affective and behavioral responses. Contrary to

Prevalence and determinants of PTSD among Palestinian children exposed to military violence

Abstract. The prevalence and determinants of PTSD were assessed among 121 Palestinian children (6–16 years; 45% girls and 55% boys) living in the area of bombardment. The mothers (21–55 years) and the children themselves reported their exposure to military violence (being personally the target of violence or witnessing it towards others) and symptoms of posttraumatic stress disorders (PTSD: intrusion, avoidance and hypervigilance). The results showed that 54% of the children suffered from severe, 33.5 % from moderate and 11 % from mild and doubtful levels of PTSD. Girls were more vulnerable; 58% of them suffered from severe PTSD, and none scored on the mild or doubtful levels of PTSD. The child’s gender and age, mother’s education and PTSD symptoms were significant, and the exposure to traumatic experiences marginally significant determinants of children’s PTSD

Adult attachment, posttraumatic growth and negative emotions among former political prisoners

Although traumatic events are generally associated with negative psychosocial consequences, trauma survivors also report positive changes in themselves, human relationships and spirituality. Our aims are, first to study associations between exposure to torture and ill-treatment and posttraumatic growth and negative emotions, and second, to examine the role of adult attachment in moderating the association between exposure and positive growth. The participants were 275 Palestinian men imprisoned in a political context. They completed the Posttraumatic Growth Inventory (PTGI), adult attachment questionnaire (AAQ) and reported exposure to traumatic events. The results show that a high level of torture and ill-treatment was associated with a low level of posttraumatic growth and a high level of negative emotions. However, adult attachment style moderated that association, among men with secure attachment

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

Predictors of psychological distress and positive resources among Palestinian adolescents: Trauma, child, and mothering characteristics

Objective The aim was to examine how traumatic and stressful events, responses to violence, child characteristics, and mothering quality, as measured in middle childhood predict psychological distress and positive resources in adolescence. Method The participants were 65 Palestinian adolescents (17 ± .85 years; 52% girls), who had been studied during the First Intifada (T1), during the Palestinian Authority rule (T2) and before the Second Al Aqsa Intifada (T3) in Gaza. Psychological distress was indicated by PTSD, and depressive symptoms and positive resources by resilient attitudes and satisfaction with quality of life, all measured at T3. The predictors that were measured at T1 were exposure to military violence, active coping with violence and children's intelligence, cognitive capacity, and neuroticism. Mothering quality and stressful life-events were measured at T2, the former reported by both the mother and

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