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The relationship between multiple exposures to violence and war trauma, and mental health and behavioural problems among Palestinian children and adolescents

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Abstract

The current study aims to investigate the effect of cumulative exposure to violence on mental health amongst children and adolescents living in the Gaza Strip. The sample consists of 1029 children and adolescents aged 11–17 years. Of them, 533 (51.8%) were female and 496 (48.2%) were male. War-traumatic events were measured using the War-Traumatic Events Checklist (W-TECh). Violence was derived from the Multicultural Events Schedule for Adolescents (M.E.S.A.) containing three domains: violence at home, violence in the neighbourhood, and violence at school. Emotional and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ). Posttraumatic Stress Disorder was measured using the Post-Traumatic Stress Disorders Symptoms Scale (PTSDSS). Finally, depression symptoms were measured by the Depression scale. Around two thirds of the children (64.5%, N = 665) reported that they were exposed to violence at home, 48.2% (N = 497) to violence in the neighbourhood, 78.2% (N = 806) to violence at school. In addition, boys significantly showed more exposure to violence compared to girls. Moreover, the prevalence of PTSD according to DSM-5 is 53.5% (N = 549). The results also showed that cumulative effect of exposure to violence in more contexts (political war trauma, violence at home, neighbourhood and/or school) predicted higher levels of PTSD, social and emotional problems, depression, and overall mental health problems amongst children. Cumulative exposure to violence may increase the propensity of developing mental health problems such as PTSD, emotional and behavioural problems, and depression symptoms and thus interventions should be targeted to these populations.

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Acknowledgements

We thank Qatar University for providing continuous and full support and help to Basel El-Khodary. We also thank the Islamic University of Gaza for their support. This work was supported by the Qatar National Research Fund (QNRF) a member of Qatar Foundation Doha, Qatar, National Priority Research Programs (NPRP) under Grant (NPRP 7-154-3-034) funded to Professor Muthanna Samara. The authors would like to thank QNRF for their support. We thank the Palestinian children and adolescents for their participation in the study. In addition, we greatly appreciate the cooperation of parents, schools’ principals, and Ministry of Education in Palestine for their agreement to give us a permission to collect the data from the students. Besides, we thank schools’ counsellors and psychologists for their help in data collection.

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  1. Department of Psychology, Kingston University London, Penrhyn Road, Kingston upon Thames, KT1 2EE, UK

    Basel El-Khodary &  Muthanna Samara

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  1. Basel El-Khodary
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Correspondence to Basel El-Khodary.

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El-Khodary, B., Samara, M. 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 29, 719–731 (2020). https://doi.org/10.1007/s00787-019-01376-8

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