Children and adolescents facing a continuous security threat: Aggressive behavior and post-traumatic stress symptoms

Unintentional childhood mortality during emergencies in Israel: a comparative study

BACKGROUND

Armed conflicts are likely to have implications for the welfare and safety of children, potentially leading to increased rates of unintentional childhood injuries.

METHODS

We examine data from Israel concerning the relationship between emergencies and childhood mortality due to unintentional injuries using the media-based database of Beterem Safe Kids Israel to analyse seven events: 2008 Gaza War, 2014 Gaza War, first COVID-19 Lockdown, second COVID-19 Lockdown (September 2020), third COVID-19 Lockdown (December 2020), 2021 Israel-Palestine crisis and 2023 Israel-Gaza War. These events are categorised into Emergency Periods (EPs) and Emergency Routine Periods (periods during which an emergency extends and normalises into a stable routine; ERPs). For each EP we selected a comparable Routine Period (RP).

RESULTS

Unintentional childhood mortality rates are lower during EPs, compared with RPs. Conversely, there is an increase in unintentional mortality rates during ERPs. EPs and ERPs occurring during armed conflicts exhibit higher unintentional mortality rates compared with health-related EPs and ERPs. Furthermore, military-related ERPs show higher unintentional mortality rates compared with the corresponding RPs. Unintentional mortality rates are notably higher among Arab children compared with Jewish children, particularly during ERPs. Unintentional childhood mortality also differs as a function of socioeconomic ranking, with widening gaps between municipalities of low socioeconomic ranking and municipalities of medium to high socioeconomic ranking, during EPs and ERPs.

CONCLUSIONS

We hypothesise that parents' emotional availability declines during EPs and ERPs associated with military conflicts, coinciding with socioeconomic aspects, impacting families' well-being and children's safety.

Pandemic Exposure, Post-traumatic Stress Disorder, Conflict Behaviors, and Online Aggressive Behaviors Among College Students During the COVID-19 Pandemic: Examining the Moderating Role of Gender

The COVID-19 pandemic impacts people's mental health and behaviors, but the influence mechanism between pandemic exposure, conflict behaviors, and online aggressive behaviors during the COVID-19 outbreak remains unclear. This study will address this gap. Data were collected from 1,153 college students in an online survey that included an pandemic experiences scale, a post-traumatic stress disorder (PTSD) scale, a conflict behaviors scale, and an online aggressive behaviors scale. Structural equation modeling and multi-group comparisons were used to analyze the data. Pandemic exposure positively predicted conflict and online aggressive behaviors through hyperarousal symptoms, and negatively predicted these behaviors through intrusive symptoms. The mediating roles of avoidance and negative alterations in cognition and mood symptoms in the relations between pandemic exposure and conflict behaviors and online aggressive behaviors were non-significant. Among male students, pandemic exposure directly predicted conflict and online aggressive behaviors, but for female students, pandemic exposure indirectly influenced these behaviors through intrusive and hyperarousal symptoms. The intrusive and hyperarousal symptoms play mediating roles in the relations between pandemic exposure and conflict behaviors and online aggressive behaviors. Gender plays a moderating role in the above mediating mechanism.

Understanding Chronic Aggression and Its Treatment in Children and Adolescents

PURPOSE OF REVIEW

Youth aggression is common and has a significant burden on individuals, families, and society. However, its treatment is often a challenge for clinicians. Thus, this review will examine the current understanding of youth aggression, conceptualize aggression as a symptom rather than its own disorder, and provide an overview of treatment strategies.

RECENT FINDINGS

Youth aggression is associated with complex genetic, neurobiological, and environmental risks. Prevention strategies are of the utmost importance for at-risk families and youth. Psychosocial interventions are the first line treatment. But if not fully effective, then pharmacologic interventions-including psychostimulants, alpha-2 agonists, atomoxetine, and risperidone-have shown benefits. Other medications, such as SSRIs, can be useful in certain scenarios. It is important to conceptualize youth aggression as being a trans-diagnostic symptom in psychopathology. Determining the underlying cause of aggression will help to guide treatment.

Generalized Violence as a Threat to Health and Well-Being: A Qualitative Study of Youth Living in Urban Settings in Central America's "Northern Triangle"

El Salvador, Guatemala, and Honduras rank among the top 10 countries experiencing violence in the world, despite not being at war. Although there is abundant literature on generalized violence in this “northern triangle” of Central America as a driver of out-migration to the United States, very little is known about the perspectives and experiences of youth who do not migrate. This study aimed to elicit the emic perspectives of youth residing in the region on how the day-to-day generalized violence produces a pervasive threat to the overall health and human security of youth as well as the key protective factors and resiliencies at work. We conducted two separate waves of qualitative research in 2015 and 2018 over a 6-month period, which included 60 in-depth interviews and six focus groups among Salvadoran, Guatemalan and Honduran youth living in urban areas. Qualitative thematic analysis revealed two meta-themes: (1) ‘Lack of health,’ defined as not experiencing peace within the family, the community, and the country’ and (2) ‘Resilience.’ Thematic clusters that reflect the first meta-theme are: (1) violence as a common occurrence; (2) living in fear and insecurity; (3) victimization; and (4) lack of state protection and services. Thematic clusters for the second meta-theme are: (1) a positive future outlook and a commitment to education; (2) transnational and local family network support; and (3) engagement in community-based youth groups. To interpret the findings, we adopt the Latin American Social Medicine and Collective Health (LASM-CH) approach that prioritizes perspectives from the region. Generalized violence is conceptualized as a systemic phenomenon that is generated and reproduced through the complex interactions of structural inequities and unequal power relations. The findings of this study provide new insights into the implementation of a different approach to address the generalized violence, insights that may guide multi-sectoral health policies and interventions both in the region and transnationally.

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.

Behavioral Responses in Youth Exposed to Natural Disasters and Political Conflict

PURPOSE OF REVIEW

The aim of this review was to focus solely on youths' behavioral responses to natural disasters and political conflicts in order to fully understand their impact and scope.

RECENT FINDINGS

Recent studies in the field of trauma have shown that theoretical conceptions have moved away from a narrow focus on the individual and towards wider ecological perspectives and from a narrow focus on negative responses to trauma exposure towards positive prosocial responses. Although there is a distinction between youths' behavioral responses towards natural disasters vs. towards political conflicts, in both of these adverse situations, behavioral responses exist alongside emotional responses. Adolescents exposed to either type of adverse scenario are often able to turn their negative experiences into positive ones, take greater responsibility for themselves and others, contribute to recovery processes, and engage in prosocial behaviors. These responses must be investigated in the context of the trauma field's recent understandings regarding psychological, biological, environmental, and cultural factors.