Media Exposure to Armed Conflict: Dispositional Optimism and Self-Mastery Moderate Distress and Post-Traumatic Symptoms among Adolescents

BACKGROUND

Rapid technological developments enable the immediate transmission of armed conflict events through a variety of media channels, inducing mass anxiety, fear, and helplessness. Youth are particularly vulnerable and face new challenges as a result of this exposure. The effects of media exposure to such events on psychological distress and post-traumatic symptoms were examined.

METHODS

A total of 161 participants aged 13-18 years completed a questionnaire battery that included measures of media exposure to armed conflict events, previous direct exposure to armed conflict events, psychological distress, post-traumatic symptoms, dispositional optimism, and self-mastery. A structural equation model (SEM) approach was employed for data analysis.

RESULTS

The extent of media exposure to armed conflict was directly associated with psychological distress and post-traumatic symptoms. Dispositional optimism moderated the association between media exposure and psychological distress, while self-mastery moderated the association between media exposure and post-traumatic symptoms. The effects of the Internet factor of media exposure, which included social media, were particularly disturbing as neither of the resilience factors moderated negative outcomes.

CONCLUSIONS

The findings suggest that clinical interventions to enhance dispositional optimism and self-mastery as well as other potential resilience factors can protect adolescents from the severe effects of media exposure to violent armed conflict events. Developmental and public health implications related to vulnerabilities and resilience during adolescence are discussed.

How can adolescent aggression be reduced? A multi-level meta-analysis

Aggressive behaviour among adolescents has significant social and economic costs. Numerous attempts have been made to intervene to reduce aggression in adolescents. However, little is known about what factors enhance or diminish intervention effectiveness. The present systematic review and meta-analysis, therefore, seeks to quantify the effectiveness of interventions to reduce aggressive behaviour in adolescents and to identify when and for whom such interventions work best. Sixteen databases were searched for randomised controlled trials that assessed interventions to reduce aggression among adolescents. After screening 9795 records, 95 studies were included. A multi-level meta-analysis found a significant overall small-to-medium effect size (d = 0.28; 95% CI [0.17, 0.39]). More effective interventions were of shorter duration, were conducted in the Middle East, were targeted at adolescents with higher levels of risk, and were facilitated by intervention professionals. Potentially active ingredients were classified using the Behaviour Change Technique Taxonomy. Behavioural practice and problem solving were components of more effective interventions targeted at the general population. Overall the findings indicate that psychosocial interventions are effective in reducing adolescent aggression. Future trials need to assess the effect of individual techniques and their combination to identify the key components that can reduce aggression in adolescents.

From Character Strengths to Children's Well-Being: Development and Validation of the Character Strengths Inventory for Elementary School Children

Although research on character strengths has flourished in recent years, the paucity of suitable quantitative instruments for the assessment of children’s character strengths limits the study of character development in childhood. The Character Strengths Inventory for Children (CSI-C) is a new self-report character inventory for children that was designed for easy administration directly to elementary school-aged children. The CSI-C provides an evaluation of 24 character strengths defined in Peterson and Seligman’s Values in Action Classification of Strengths. Data from two samples of 2,061 Israeli children aged 7–12 support the constructs of the instrument. Principal component analysis and confirmatory factor analysis of the 96 CSI-C items revealed preliminary evidence for a hierarchical structure with 24 lower factors nested within four higher-order latent factors: interpersonal, transcendence, intellectual, and temperance strengths. Children’s interpersonal and temperance strengths were negatively associated with mental health difficulties, and their temperance and transcendence strengths were positively associated with subjective well-being. The intellectual and temperance strengths were correlated with children’s school functioning and grit. The potential uses of the CSI-C in research and practice are discussed.

Children Affected by War and Armed Conflict: Parental Protective Factors and Resistance to Mental Health Symptoms

This study examined the role of parenting styles and parental warmth in moderating relations between exposure to political life events and mental health symptoms among 277 Israeli adolescents aged 12–14 and their parents, who had been exposed to protracted periods of war, missile bombardments, and terrorism. Adolescents completed the Political Life Events (PLE) scale, Brief Symptom Inventory and questionnaires regarding parenting style and parental warmth. The primary caregiver completed the Child Behavior Checklist for assessment of the child’s internalizing and externalizing symptoms. Results confirmed that severity of PLE exposure was positively correlated with psychological distress and with internalizing and externalizing symptoms. Maternal authoritativeness and warmth functioned as protective factors and had moderating effects on the relation between PLE exposure and mental health symptoms. In contrast, maternal authoritarianism exacerbated the relation between PLE exposure and children’s externalizing symptoms. Fathers’ parenting style and warmth had no significant relationship with children’s mental health outcomes. These findings have important clinical and practical implications for parental guidance and support during periods of war and armed conflict.

Through the Looking Glass: The Role of Ethnicity and Affiliation in Responses to Terrorism in the Media

This study examined whether attitudinal and emotional responses to broadcasts of images of terrorist events differ according to ethnic group (Jewish and Arab Israelis) and outgroup affiliation during an intense wave of terrorism that occurred in Israel during 2015. Participants were 118 Jewish and 110 Arab-Israelis adults randomly allocated to a terrorism or criminal violence television broadcast. State anxiety, state anger, stereotypes, and negative attitudes toward an adversary were examined prior and subsequent to the media exposure. Findings showed significant increases in anxiety, anger, stereotypes, and negative adversary perceptions in the terrorism exposure group compared to only anxiety increases in the criminal violence exposure. In the terrorism exposure group, Jewish participants showed greater increases in negative adversary perceptions of the Palestinians than Arab Israeli participants, but both groups showed similar significant increases in levels of anxiety and anger. Exposure to broadcasts of terrorism increased willingness to negotiate with the adversary among the Arab participants, but not among the Jewish participants. In the terrorism exposure group, both Jewish and Arab Israelis with high affiliation with the Palestinian cause showed less increases in stereotypes than those with low affiliation. Findings emphasize the role of ethnicity and outgroup affiliation in responses to media exposure to terrorism images.

Help seeking in school by Israeli Arab minority adolescents with emotional and behavioral problems: results from the Galilee Study

BACKGROUND

Many distressed minority adolescents with little access to professional mental health services use teachers and school counselors as their main consultation sources. This paper presents data from the Galilee study on factors that may increase the probability of adolescents' help-seeking in school and discusses the needed linkage between the school mental health services and those provided by other agencies, in the framework of the Mental Health Reform in Israel.

METHODS

This cross-sectional survey included 1639, 9th grade students living in 5 Arab localities in the Galilee in northern Israel, representative of the Muslim and Druze populations. The study was carried out in two stages: in the screening stage, the Strengths and Difficulties Questionnaire (SDQ) was completed in the classroom. During the follow-up stage 704 students were selected and interviewed at home regarding service use in school and wellbeing at home. Their mothers were interviewed as well providing information on sociodemographic traits of the family. Total response rate was 69.3 % during the screening stage and 84.4 % during the follow-up. Students were categorized according to their SDQ scores and all students in the higher 25th percentile (high risk) and a simple systematic sample without replacement of those in the lower 75 % (low risk) were included in the follow-up study.

RESULTS

Significantly more high risk than low risk students reported having felt the need to seek professional help (14.0 and 6.5 % respectively) and more high risk than low risk consulted a school source (27.1 and 15.2 %, respectively). Bivariate analyses show that among Muslim adolescents more high risk than low risk consulted a school source (30 vs. 16.2 % respectively) and among high risk students more Muslim than Druze sought help from a school source (30 vs. 18 %). Higher consultation rates were found among adolescents who felt uncomfortable at home, than among those who felt very comfortable. Binary logistic regression showed that for high risk adolescents, only religion remained significantly associated with help-seeking in school: Muslim students were 2 times more likely to seek help than Druze students. In the low-risk group, students who do not feel comfortable at home were 3.3 times more likely to seek help than those who feel comfortable at home. The main sources of consultation for both risk groups were the school counselor and the grade teacher.

CONCLUSIONS

A constellation of factors may be associated with help-seeking in school by minority Israeli Arab adolescents: they are students at higher risk for an emotional or behavioral disorder, they have more socio-economic hardship, they feel less comfortable at home and they are more likely to live in the larger Muslim cities. Adolescents with less family support and particularly those not classified as being at high risk, are more likely to seek help from school counselors and teachers. The school staff may need additional training to care for the mental health needs of students. There is a need to integrate the school mental health services with the other government agencies that provide services to children and adolescents.

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.

The Resilience Function of Character Strengths in the Face of War and Protracted Conflict

This study investigated the role of character strengths and virtues in moderating relations between conflict exposure and psychiatric symptoms among 1078 adolescents aged 13–15 living in southern Israel, who were exposed to lengthy periods of war, terrorism and political conflict. Adolescents were assessed for character strengths and virtues, political violence exposure using the Political Life Events (PLE) scale, and psychiatric symptoms using the Brief Symptom Inventory and the UCLA PTSD Index. Results confirmed that political violence exposure was positively correlated with psychiatric symptoms. Interpersonal, temperance and transcendence strengths were negatively associated with psychiatric symptoms. Moderating effects of the interpersonal strengths on the relation between political violence exposure and the psychiatric and PTSD indices were confirmed. The findings extend existing knowledge about the resilience function of character strengths in exposure to protracted conflict and have important practical implications for applying strength-building practices for adolescents who grow up in war-affected environments.

The effects of the Make a Wish intervention on psychiatric symptoms and health-related quality of life of children with cancer: a randomised controlled trial

OBJECTIVE

Children with life-threatening medical conditions frequently undergo invasive medical procedures that may elicit anxiety and distress. However, there are few empirically validated interventions that reduce mental health symptoms and increase the resilience of children during the acute stages of illness. This study aimed to evaluate the efficacy of the Make a Wish intervention for children with life-threatening cancer.

METHODS

The design was a wait-list-controlled trial with two parallel groups. Sixty-six children aged 5-12 with an initial diagnosis of life-threatening cancer were identified and randomly assigned to the Make a Wish intervention (n = 32) or a wait-list control group (n = 34). Children completed measures of psychiatric and health-related symptoms, positive and negative affect, hope, and optimism pre-intervention and post-intervention. After baseline data collection, children were interviewed and made an authentic wish that they wanted to come true. These wishes were made possible 5-6 months after baseline data collection, to fuel anticipation and excitement over the wish-fulfillment event. The post-intervention assessment point was 5 weeks after wish fulfillment (approximately 7 months after baseline data collection).

RESULTS

Children in the intervention group exhibited a significant reduction in general distress (d = 0.54), depression (d = 0.70), and anxiety symptoms (d = 0.41), improved health-related quality of life (d = 0.59), hope (d = 0.71), and positive affect (d = 0.80) compared to decrease in positive affect and no significant changes in the other measures in the control group.

CONCLUSIONS

These findings emphasize the role of hope and positive emotions in fostering the well-being of children who suffer from serious illnesses.

Trajectories of Adolescent Aggression and Family Cohesion: The Potential to Perpetuate or Ameliorate Political Conflict

Correlations between intergroup violence and youth aggression are often reported. Yet longitudinal research is needed to understand the developmental factors underlying this relation, including between-person differences in within-person change in aggression through the adolescent years. Multilevel modeling was used to explore developmental and contextual influences related to risk for youth aggression using 4 waves of a prospective, longitudinal study of adolescent/mother dyad reports (N = 820; 51% female; 10-20 years old) in Belfast, Northern Ireland, a setting of protracted political conflict. Experience with sectarian (i.e., intergroup) antisocial behavior predicted greater youth aggression; however, that effect declined with age, and youth were buffered by a cohesive family environment. The trajectory of aggression (i.e., intercepts and linear slopes) related to more youth engagement in sectarian antisocial behavior; however, being female and having a more cohesive family were associated with lower levels of youth participation in sectarian acts. The findings are discussed in terms of protective and risk factors for adolescent aggression, and more specifically, participation in sectarian antisocial behavior. The article concludes with clinical and intervention implications, which may decrease youth aggression and the perpetuation of intergroup violence in contexts of ongoing conflict.

Helping youth immediately following war exposure: a randomized controlled trial of a school-based intervention program

This study evaluates a school-based primary prevention intervention designed to promote adolescents' coping in the immediate aftermath of war exposure in Operation Cast Lead. Participants were 179 adolescents from two demographically similar schools in Ashkelon in south Israel. The intervention incorporated two previously proven resilience factors-mobilization of support and self-efficacy. In a repeated measures design, the study assessed pre- to post-test changes in intervention (n=94) and control (n=85) conditions among adolescents exposed to high or low political life events (PLE). Findings showed significant pre-test differences in self-efficacy and psychological symptoms between participants with low and high PLE. For both PLE groups, the intervention strengthened support mobilization and self-efficacy and reduced psychological distress and emotional symptoms. Findings reinforce the importance of offering appropriate evidence-based interventions for school staff to restore security and well-being to adolescents in a crisis context immediately following war. Despite the apparent return to a school routine after war, school staff should be aware of the risk to youth for development of psychological symptoms and disorders, and the need for preventative intervention.

Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care

BACKGROUND

Children and adolescents exposed to armed conflict are at high risk of developing mental health problems. To date, a range of psychosocial approaches and clinical/psychiatric interventions has been used to address mental health needs in these groups.

AIMS

To provide an overview of peer-reviewed psychosocial and mental health interventions designed to address mental health needs of conflict-affected children, and to highlight areas in which policy and research need strengthening.

METHODS

We used standard review methodology to identify interventions aimed at improving or treating mental health problems in conflict-affected youth. An ecological lens was used to organize studies according to the individual, family, peer/school, and community factors targeted by each intervention. Interventions were also evaluated for their orientation toward prevention, treatment, or maintenance, and for the strength of the scientific evidence of reported effects.

RESULTS

Of 2305 studies returned from online searches of the literature and 21 sources identified through bibliography mining, 58 qualified for full review, with 40 peer-reviewed studies included in the final narrative synthesis. Overall, the peer-reviewed literature focused largely on school-based interventions. Very few family and community-based interventions have been empirically evaluated. Only two studies assessed multilevel or stepped-care packages.

CONCLUSIONS

The evidence base on effective and efficacious interventions for conflict-affected youth requires strengthening. Postconflict development agendas must be retooled to target the vulnerabilities characterizing conflict-affected youth, and these approaches must be collaborative across bodies responsible for the care of youth and families.

Evaluation of a program to prevent political violence in the Basque conflict: effects on the capacity of empathy, anger management and the definition of peace

OBJECTIVE

To assess the effects of a program for the prevention of political violence on empathy, expression of feelings of anger, and the capacity to define peace-violence.

METHOD

This study used a quasi-experimental design with pretest-posttest repeated measures and a control group. The sample comprised 276 adolescents aged between 15 and 17 years (191 in the experimental group, 85 in the control group; 127 boys and 149 girls). A battery of three assessment instruments was administered before and after the intervention. The aim of the program was to increase sensitivity to the victims of political violence, promote respect for human rights, and prevent violence. The intervention consisted of 10 sessions over 3 months.

RESULTS

MANOVA analyses revealed that the program increased participants' capacity of empathy (perspective-taking), anger control in annoying situations, and capacity to define peace-violence.

CONCLUSIONS

This study has practical educational implications and provides an intervention tool that enhances the development of personality during adolescence and may have a preventive effect on violent behavior.

'My happiness is the refugee camp, my future Palestine': optimism, life satisfaction and perceived happiness in a group of Palestinian children

BACKGROUND

This study aimed to explore optimism, perceived happiness and life satisfaction in a group of Palestinian children living in urban districts, rural areas and a refugee camp in the West Bank, as well as in a city in Israel.

METHOD

Three self-report instruments were administered to a convenience sample of school-age children (n. 226; 8-12 years old): the Youth Life Orientation Test (YLOT), the Subjective Happiness Scale (SHS) and the Face Scale (FS). The scores were analyzed using anovas and correlation tests (Pearson's r). Gender and age differences were explored.

RESULTS

Optimism, life satisfaction and perceived happiness characterize the entire group of Palestinian children in general. Very little difference was found as a function of gender.

CONCLUSION

Palestinian children seem to enjoy a satisfactory quality of life with regard to optimism, satisfaction and perceived happiness. We hypothesize that these factors may reinforce resilience and positive adjustment to trauma in children. The implications for clinical psychology are discussed.

A social-cognitive-ecological framework for understanding the impact of exposure to persistent ethnic-political violence on children's psychosocial adjustment

In this article, we describe a theoretical framework for understanding how persistent and extreme exposure to ethnic-political conflict and violence interacts with cognitive, emotional, and self processes to influence children's psychosocial adjustment. Three recent strands of theorizing guide our approach. First, we focus on how observational and social learning processes combine to influence the development of social-cognitive structures and processes that affect behavior. Second, we focus on the role of developing self and identity processes in shaping the child's interactions with the world and the consequences of those interactions. Third, we build on the complex systems perspective on development and assume that human development can only be understood accurately by examining how the multiple contexts affecting children and the adults in their lives interact to moderate biosocial factors which predispose individuals to develop in certain directions. We review the recent empirical literature on children's exposure to ethnic-political violence and we apply the social-cognitive-ecological framework to the empirical findings in this literature. Finally, we propose future directions for research and clinical implications derived from this framework.

Children and political violence from a social ecological perspective: implications from research on children and families in Northern Ireland

The effects on children of political violence are matters of international concern, with many negative effects well-documented. At the same time, relations between war, terrorism, or other forms of political violence and child development do not occur in a vacuum. The impact can be understood as related to changes in the communities, families and other social contexts in which children live, and in the psychological processes engaged by these social ecologies. To advance this process-oriented perspective, a social ecological model for the effects of political violence on children is advanced. This approach is illustrated by findings and methods from an ongoing research project on political violence and children in Northern Ireland. Aims of this project include both greater insight into this particular context for political violence and the provision of a template for study of the impact of children's exposure to violence in other regions of the world. Accordingly, the applicability of this approach is considered for other social contexts, including (a) another area in the world with histories of political violence and (b) a context of community violence in the US.