Posttraumatic stress disorder among preschoolers exposed to ongoing missile attacks in the Gaza war

The association between maternal and child posttraumatic stress symptoms among families living in southern Israel: The buffering role of maternal executive functions

Posttraumatic stress disorder is a prolonged stress and anxiety response that occurs after exposure to a traumatic event. Research shows that both parental and child posttraumatic stress symptoms (PTSS) are correlated but parental executive functions (EFs) could buffer this link. EFs refers to a group of high-level cognitive processes that enable self-regulation of thoughts and actions to achieve goal-directed behaviours and can be of importance for both positive parenting interactions and effective coping skills for PTSS. Our study aimed to (1) examine the link between maternal and child PTSS and the moderating role of varying degrees of exposure to severe security threats context, and (2) to identify the moderating role of maternal EFs in this interaction, among families living in southern Israel. Our sample included 131 mothers in their second pregnancy and their firstborn children. Mothers performed computerised tasks to assess their EFs and they reported on their own and their child's PTSS. Results revealed a positive correlation between maternal PTSS and child PTSS. However, the link between maternal and child PTSS was moderated by maternal working memory updating abilities and threat context severity. Among mothers with lower updating capacities, the association between maternal and child symptoms was stronger under higher threat contexts; conversely, among mothers with higher maternal updating abilities, threat context did not modulate the link between maternal and child PTSS, suggesting a stress-buffering effect. Our study contributes to the growing literature on the significant role of parental EFs in the context of parent-child interactions.

Bosnian Paternal War Orphans: Mental Health in Postwar Time

ABSTRACT

More research on the medium- and long-term effects of childhood exposure to war, including orphanhood, is needed. We compared 50 orphans 1 who lost their father during the war in Bosnia and Herzegovina (1992-1995) and 50 age- and sex-matched adolescents from two-parent families during 2011-2012 in terms of sociodemographic characteristics, behavioral/emotional problems, depression, resilience, maternal mental health, and perceived social support. The two groups differed on sociodemographic factors, that is, number of children, family composition, income, school grades, and refugeehood. Paternal war orphans did not differ in terms of adolescent mental health and resilience from their nonorphaned peers, controlling for sociodemographic variables. The mothers of orphans had comparably more posttraumatic psychopathology. As for perceived resources for social support, orphans identified those comparably more often among distant relatives and in the community, that is, religious officials and mental health professionals, and less often among siblings, paternal grandparents, paternal and maternal uncles/aunts, school friends and teachers. Our findings suggest that contextual factors may play an important role in orphans' postwar mental health.

Assessment of PTSD and posttraumatic symptomatology in very young children: A systematic review

CONTEXT

Very young children are said to be a vulnerable group for exposure to trauma, and for a psychopathological response (e.g., PTSD) after a risk-exposure. The specific assessment of young children is necessary to enable them to be enrolled in an appropriate care pathway.

OBJECTIVE

The objective was to identify the instruments available in the English language for the assessment of posttraumatic symptoms in very young children (from 0- to 5-year old).

DESIGN

This article reports on a systematic review, conducted using the search engines Google Scholar, Science Direct, PsycArticles, and PubMed.

RESULTS

Nine instruments are available to specifically assess traumatic symptomatology in very young children (0-7-year old), five instruments are available for the broader assessment of very young children (1-6-year old), six instruments are available for the assessment of traumatic symptoms in very young children and in older children (2-18-year old), one instrument did not correspond to any category. These 21 tools are adapted to different ages, built according to different objectives, and do not rely on the same diagnostic algorithm.

CONCLUSION

Future research should compare the instruments quantitatively to identify those most specific and sensitive to the assessment of trauma symptoms in young children.

Parenting among mothers exposed to ongoing military conflict in childhood: An exploratory study

Mothers living in areas exposed to ongoing military conflict are at higher risk for psychological difficulties, such as posttraumatic stress disorder, than those not living in such areas. The aim of this two-part exploratory study was twofold. The first aim was to examine differences between mothers who grew up under ongoing military conflict in childhood and mothers who did not grow up in affected areas in terms of their levels of differentiation of self and parental self-efficacy (PSE). The second aim was to identify and describe the parenting experiences of mothers who were exposed to military conflict in childhood. In Part 1 of the study, the sample included 120 mothers (half of whom reported on being exposed to ongoing military conflict in childhood). Findings showed that mothers exposed to ongoing military conflict in childhood reported lower levels of differentiation of self and PSE than their counterparts. In Part 2, 10 mothers who were exposed to ongoing military conflict as children were interviewed about their experience as parents and their PSE. Results indicated that the mothers felt their childhood experiences affected their parenting and PSE negatively, resulting in anxiety, difficulty dealing with stress and sometimes posttraumatic symptoms as well as parental patterns of overprotectiveness, separation anxiety and intergenerational transmission of anxiety. The results highlight the consequences of exposure to ongoing military conflict during childhood on levels of differentiation of self and parenting practices.

Continuous Traumatic Stress and the Life Cycle: Exposure to Repeated Political Violence in Israel

PURPOSE OF REVIEW

Millions of individuals and families live under continual exposure to threat such as protracted socio-political conflict or community violence facing current and future danger. The construct of continuous traumatic stress (CTS) was suggested as a supplement perspective for the understanding of the specific impact of living under both current and realistic future threat. Yet, the unique parameters, utility, and validity of the construct CTS are underexplored.

RECENT FINDINGS

Currently, CTS describes both the exposure and the unique clinical conglomerate of distress. In this paper, we first elaborate on the rationale for the construct of CTS. Then, we present evidence on the consequences of exposure to CTS in the Israeli context of continual ongoing and prolonged political violence. Research on CTS is presented across the life cycle with an emphasis on risk and protective factors from a developmental perspective. We conclude with implications for research, assessment, and interventions.

Quality or quantity of coping resources: Why not both? An integration of common stress theories

Threatening situations may cause distress (e.g., armed conflicts, natural disasters, etc.) and provoke Psychological Distress and Post-Traumatic Stress Symptoms. National resources may mitigate threats or damage in certain situations. This research suggests that in doing so, such resources deployed in concert with personal resources, may reduce levels of these symptoms. Two major stress theories are integrated in theoretical support of the role of national resources: The Conservation of Resource theory (Hobfoll, 1989) and the Cognitive Appraisal Theory (Lazarus and Folkman, 1984). Hobfoll's theory is extended beyond personal resources to encompass national resources. We offer the case of the Iron Dome as an example of a national resource. Iron Dome is an Israeli missile defense system successfully used during Operation Protective Edge in 2014 in response to rocket attacks from Gaza. A cross-sectional study was conducted during the operation in the form of an online survey in which 910 Israeli civilians were assessed using a Psychological Distress and the Impact of Event Scale. They reported on their personal resources and perception of the Iron Dome as a national security resource. Our findings revealed that resource quantity significantly predicted Psychological Distress and Post-Traumatic Stress Symptoms. In addition, it was found that the national security resource significantly contributed to decreased Psychological Distress and Post-Traumatic Stress Symptom predictions beyond all personal resources examined. Research contributions and practical implications are discussed.

PTSD in Children Below the Age of 6 Years

PURPOSE OF REVIEW

This review summarizes the latest evidence and developments in the validation of PTSD diagnostic criteria for children 6 years and under (PTSD<6Y), discusses the limitations of the current diagnostic criteria, and highlights areas for future research.

RECENT FINDINGS

Research has found that the DSM-5 PTSD<6Y, and a similar version in the DC:0-5, currently provides the most developmentally sensitive classification of PTSD for young children. In contrast, preliminary evidence suggests that the ICD-11 criteria might not appropriately capture PTSD in young children. The inclusion of PTSD<6Y, the first developmental subtype in the DSM-5, represents an important step towards having a diagnostic system that is developmentally sensitive and relevant across the life span. However, further validation work and research with regard to the definition of trauma and functional impairment as well as with the age-appropriate description of symptoms is needed, especially in the youngest age group (0-3 years).

Effects of War, Terrorism and Armed Conflict on Young Children: A Systematic Review

Millions of children have been maimed, displaced, orphaned and killed in modern warfare that targets civilian populations. Several reviews have documented the impact of political trauma on children's mental health but none has focused specifically on young children (ages 0-6). Since developmental factors influence the young child's perception and experience of traumatic events, this developmental period is characterized by a unique spectrum of responses to political trauma. This systematic review, comprising 35 studies that included a total of 4365 young children, examined the effects of exposure to war, conflict and terrorism on young children and the influence of parental factors on these effects. Results showed that effects include PTSD and post-traumatic stress symptoms, behavioral and emotional symptoms, sleep problems, disturbed play, and psychosomatic symptoms. Correlations emerged between parental and children's psychopathology and, additionally, family environment and parental functioning emerged as moderators of the exposure-outcome association for children.

Relational trauma in the context of intimate partner violence

The relational model of trauma (Scheeringa & Zeanah, 2001) proposes that infants' trauma symptoms may be influenced by their mothers' trauma symptoms and disruptions in caregiving behavior, although the mechanisms by which this occurs are less well understood. In this research, we examined the direct and indirect effects of a traumatic event (maternal intimate partner violence [IPV]), maternal trauma symptoms, and impaired (harsh and neglectful) parenting on infant trauma symptoms in a sample of mother-infant dyads (N=182) using structural equation modeling. Mothers completed questionnaires on IPV experienced during pregnancy and the child's first year of life, their past-month trauma symptoms, their child's past-month trauma symptoms, and their parenting behaviors. Results indicated that the effects of prenatal IPV on infant trauma symptoms were partially mediated by maternal trauma symptoms, and the relationship between maternal and infant trauma symptoms was fully mediated by neglectful parenting. Postnatal IPV did not affect maternal or infant trauma symptoms. Findings support the application of the relational model to IPV-exposed mother-infant dyads, with regard to IPV experienced during pregnancy, and help identify potential foci of intervention for professionals working with mothers and children.