Main Article Content
Post-Traumatic-Stress Disorder (PTSD), Depression, Israeli-Palestinian
Purpose: The purpose of this study is to investigate the prevalence of posttraumatic distress disorder (PTSD) and depression among children in Gaza, Palestine.
Methodology: This study assessed the psychological effects of the Israeli-Palestinian conflict on children in the Gaza Strip. 286 children aged 9-14 years old, who were exposed to a wide range of war events, were selected from the Gaza Strip to participate in this study. All participants conducted the following scales: the child PTSD Reaction Index(CPTSD-RI), Beck Depression Inventory (BDI), and the Arabic version for PTSD and depression assessment.
Finding: The results show that the mean number of participants witnessing home destroyed and people killed was (88%) and home invasion (76%). Approximately 70% of the participants reported that they witnessed war violence against at least one of their family members. Further, 44 % of the children have a least one death in their family due to the Israeli invasion. Using t-tests, we found that significantly more females have both PTSD and depression than males. Approximately 32.8% of the participants met the criteria for severe depression, and 42.6 % met the criteria for PTSD.
Implications: Our results suggest that it is imperative to provide intervention programs to treat PTSD and depression symptoms among children in Gaza. These programs should take into account the cultural and religious background of the participants.
Originality: This investigation of the Israeli-Palestinian conflict has led to an increase in PTSD and depression symptoms among children in the Gaza Strip.
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Pub.Amnesty (2010). https://doi.org/10.1176/appi.books.9780890425596
3. Al-Ammar, F. (2018).Post-traumatic stress disorder among Yemeni children as a consequence of the ongoing war. Retrieved fromhttps://carpo-bonn.org/wp-content/uploads/2018/03/10_carpo_brief_final.pdf
4. Amog. (2012). Daily news. Gaza Community Mental Health program, 14 (80).
5. Berman, H. (2001). Children and war: Current understanding and future directions. Public Health Nursing, 18 (4), 243-252. https://doi.org/10.1046/j.1525-1446.2001.00243.x
6. Derluyn, I., Broekaert, E. Schuyten, G., &Temmerman, E. (2004). Post-traumatic stress in former Ugandan child soldiers. Lancet, 363, 861-863. https://doi.org/10.1016/S0140-6736(04)15734-6
7. De Jong J, Komproe I., Van Ommeren M., Masri M., Araya M., Khaled N., et al. (2001). Life time events and posttraumatic stress disorder in four postconflict settings. J Am Acad Child Adol Psychiatry, 286, 555-562. https://doi.org/10.1001/jama.286.5.555
8. Diab, S. Y., Isosavi, S., Qouta, S. R., Kuittinen, S., &Punamaki, R. L. (2018). The protective role of maternal post-traumatic growth and cognitive trauma processing in Palestinian mothers and infants: a longitudinal study. Lancet, 391 Suppl 2, S39. https://doi.org/10.1016/S0140-6736(18)30405-7
9. Bielawski, T., Misiak, B., Moustafa, A. A., Frydecka, D. (2019). Epigenetic mechanisms, trauma and psychopathology: targeting chromatin remodeling complexes. Reviews in the Neurosciences. https://doi.org/10.1515/revneuro-2018-0055
10. Elbedour S., Onwuegbuzie A. J., Ghannam, J., Whitcome, J. A., & Abu Hein, F.(2007). Post-traumatic stress disorder, depression, and anxiety among Gaza Strip adolescents in the wake of the second Uprising (Intifada). Child Abuse & Neglect, 31(7),719-729. https://doi.org/10.1016/j.chiabu.2005.09.006
11. El-khodary, B., Samara, M. (2018). The effect of exposure to war-traumatic events, stressful life events, and other variables on mental health of Palestinian children and adolescents in the 2012 Gaza War. Lancet, 391, S6. https://doi.org/10.1016/S0140-6736(18)30331-3
12. El-khodary, B., Samara, M. (2019). The relationship between multiple exposures to violence and war trauma, and mental health and behavioural problems among Palestinian children and adolescents. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-019-01376-8
13. Evelio J. F. (1999). Psychological effects of the civil war on children from rural communities of El Salvador, Unpublished doctoral dissertation, Columbia University.
14. Gharib, M.A., Gharib, R. A., Abohamza, E., Moustafa, A. A. (under review). The Syrian War and PTSD. International Journal of Psychology.
15. Gharib, M., Golembiewski, J., Moustafa, A. A. (2017). Mental Health and Urban Design - Zoning in on PTSD. Current Psychology. https://doi.org/10.1007/s12144-017-9746-x
16. Kandemir, H., Karataş, H., Çeri, V., Solmaz, F., Kandemir, S. B., Solmaz, A. (2018). Prevalence of war-related adverse events, depression and anxiety among Syrian refugee children settled in Turkey. Eur Child Adolesc Psychiatry. 27(11):1513-1517. https://doi.org/10.1007/s00787-018-1178-0
17. Keshini, S. C. (2002). Post-traumatic stress disorder in Sri lankan children exposed to war: The roles of culture, the nature of the stressor, temperament, coping strategies, and perceived social support. Unpublished doctoral dissertation, Clark University.
18. IRIN (2012). OPT: Psychological trauma, nightmares stalk Gaza children. Retrieved from http://www.irinnews.org/Report/87954/OPT-Psychological-trauma-nightmares-stalk-Gaza-children
19. Malik, S. (2011, June 20). UNHCR report says refugee numbers at 15-year high. The Guardian, Retrieved from http://www.guardian.co.uk/world/2011/jun/20/unhcr-report-refugee-numbers-15-year-high
20. Misiak, B., Krefft, M., Bielawski, T., Moustafa, A. A., Sąsiadek, M. M., Frydecka, D. (2017). Toward a unified theory of childhood trauma and psychosis: a comprehensive review of epidemiological, clinical, neuropsychological and biological findings. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2017.02.015
21. Misiak, B., Moustafa, A. A.,Kiejna, A., Frydecka, D. (2016). Childhood traumatic events and types of auditory verbal hallucinations in first-episode schizophrenia patients. Comprehensive Psychiatry. https://doi.org/10.1016/j.comppsych.2015.12.003
22. Morgos, D., Worden J. W., & Gupta, L. (2007). Psychological effects of war experiences among displaced children in southern Darfur. OMEGA, 56(3), 229-253. https://doi.org/10.2190/OM.56.3.b
23. Moustafa, A.A. (2013). Increased hippocampal volume and gene expression following cognitive behavioral therapy in PTSD. Frontiers in Human Neuroscience, 7:747. https://doi.org/10.3389/fnhum.2013.00747
24. Myers, C.E., Moustafa, A. A., Sheynin, J., VanMeenen, K. M., Gilbertson, M. W., Orr,S. P., Beck, K. B., Pang, K. C. H., Servatius, R. J. (2013). Learning to obtain reward, but not avoid punishment, is affected by presence of PTSD symptoms in male veterans: Empirical data and computational model. Plos One, 8(8):e72508. https://doi.org/10.1371/journal.pone.0072508
25. Okasha, A. (2007). Mental health and violence: WPA Cairo declaration—international perspective for intervention. International Review of Psychiatry, 19 (3), 193-200. https://doi.org/10.1080/09540260701349449
26. Punamäki, R. L., Qouta, S. R., Peltonen, K.(2018). Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parents.Eur J Psychotraumatol. 2018 Mar 20;8(Suppl 7):1439649. doi: 10.1080/20008198.2018.1439649. eCollection 2017. https://doi.org/10.1080/20008198.2018.1439649
27. Pynoos, R.S., Ferderick, C. &nader, K. (1987). Life threat and posttraumatic stress in school age children. Archives of general Psychiatry, 44, 1057-1063. https://doi.org/10.1001/archpsyc.1987.01800240031005
28. Rizkalla, N., & Segal, S. P. (2019). Trauma during humanitarian work: the effects on intimacy, wellbeing and PTSD-symptoms. Eur J Psychotraumatol, 10(1), 1679065. https://doi.org/10.1080/20008198.2019.1679065
29. Radell, M. L.,Myers, C. E., Sheynin, J., Moustafa, A. A. (2017). Computational models of post-traumatic stress disorder (PTSD). In A. Moustafa (Ed.)Computational models of Brain and Behavior. Wiley-Blackwell. https://doi.org/10.1002/9781119159193.ch4
30. Salman, E., Anthony, O., Jess, G., Janine, W., & Fadel Abu, H. (2007). Post-traumatic stress disorder, depression, and anxiety among Gaza Strip adolescents in the wake of the second uprising (Intifada). Child Abuse & Neglect, 31(7), 719-729. https://doi.org/10.1016/j.chiabu.2005.09.006
31. Sadock, B. J., & Sadock, V.A. (2007). Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 10th Ed: Lippincott Williams & Wilkins.
32. Schwartz, E., &Shrira, A. (2019). Social Connectedness Moderates the Relationship Between Warfare Exposure, PTSD Symptoms, and Health Among Older Adults. Psychiatry, 82(2), 158-172. https://doi.org/10.1080/00332747.2018.1534521
33. Shrira, A., Palgi, Y., Hoffman, Y., Avidor, S., Bodner, E., Ben-Ezra, M., & Bensimon, M. (2018). Subjective Age as a Moderator in the Reciprocal Effects Between Posttraumatic Stress Disorder Symptoms and Self-Rated Physical Functioning. Front Psychol, 9, 1746. https://doi.org/10.3389/fpsyg.2018.01746
34. Steinberg, A. M., Brymer, M. J., Decker, K. B., &Pynoos, R. S. (2004). The University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index. Current Psychiatry Reports, 6(2), 96-100. https://doi.org/10.1007/s11920-004-0048-2
35. Thabet A., Abu Tawahina, El Sarraj E., Henely D., Pelleick H., &Vostanis P. (2011). Post-traumatic stress disorder and attention deficit hyperactivity disorder in Palestinian children affected by the war on Gaza. International Psychiatry, 8 (4), (84 – 86). https://doi.org/10.1192/S1749367600002721
36. ThabetA.&Vostanis P. (2011). Impact of political violence and trauma in Gaza onchildren’s mental health and types of interventions: Areview of research evidence in a historical context. International Journal of Peace and Development Studies, 2(8), pp. 214-218, Retrieved from http://www.academicjournals.org/IJPDS
37. Thabet, A.Z., Abu Tawahina, A., El Sarraj, E., &Vostanis, P. (2008). Exposure to war trauma and PTSD among parents and children in the Gaza strip. European Child & Adolescent Psychiatry, 17 (4), 191-199. https://doi.org/10.1007/s00787-007-0653-9
38. Thabet, A.Z., Abed, Y., &Vostanis, P. (2004). Combridity of PTSD and depression among refuges children during war conflict. Journal of Child Psychology and Psychiatry, 45, 533-542. https://doi.org/10.1111/j.1469-7610.2004.00243.x
39. Thabet, A.Z., Abed, Y., &Vostanis, P. (2004). Post-traumatic stress reaction in children of war, Journal of Child Psychology and Psychiatry, 40, 385-391. https://doi.org/10.1111/1469-7610.00456
40. Thabet A.A., Vostanis P. (1999). Post-traumatic stress reactions in children of war. J. Child Psychol. Psychiatry, 40, 385-391. https://doi.org/10.1111/1469-7610.00456
41. West, J. (1985). An Arabic Validation of a Depression Inventory. International Journal of Social Psychiatry. https://doi.org/10.1177/002076408503100406
42. Yehuda, R., Hoge, C. W., McFarlane, A. C., Vermetten, E., Lanius, R. A., Nievergelt, C. M., ... & Hyman, S. E. (2015). Post-traumatic stress disorder. Nature Reviews Disease Primers, 1, 15057. https://doi.org/10.1038/nrdp.2015.57
43. Zakrison TL., Shahen A., Mortaja S., Hamel P.A. (2004). The prevalence of psychological morbidity in West Bank Palestinian children. Can. J. Psychiatr., 49: 60–63. https://doi.org/10.1177/070674370404900110