Impact of Trauma on Palestinian Children PTSD, Anxiety, Depression and Coping Strategies

Aim: The aim of the paper was to investigate the impact of trauma after one year of Gaza War on children PTSD, anxiety, depression, and coping strategies as mediator factors.

Methods: The study sample consisted of 449 children from the children who were exposed to the Israeli war on the Gaza Strip, 51.9% of the them were boys and 48.1% were girls. Children completed measures of experience of traumatic events (Gaza Traumatic Events Checklist-20 items, War on Gaza), PTSD, Birleson Depression Scale, and Child Revised Manifest Anxiety Scale. The data was collected on March 2010 from the entire Gaza Strip.

Results: After one year, still the Palestinian children reported many traumatic events, 90.4% of children reported watched mutilated bodies in TV, 44.6% exposed to deprivation from water, food, or electricity during the war, 33.5% left their homes with families and relatives, 29.8%  witnessed firing by tanks and heavy artillery at neighbors’ homes, 4.1% threaten with being killed, 4.1% threatened with death by being used as human shield by the army to arrest their neighbor.  Our results showed that each child experience 5.92. The study showed that 56.6% of children still reporting mild trauma (0-5 events), 32.9% reported moderate trauma (6-10), and 10.6% reported severe trauma level. There were no significant sex and age differences in exposure to trauma. Children with high traumatic experiences reported more self-criticism, also children with high exposure to trauma had less social support.

For post traumatic stress reactions, 43.4% of children reported that when something reminds them of what happened during the war, they get very upset, afraid or sad. 31.5% afraid that the bad thing will happen again. 30.4% feel jumpy or startle easily, like when I hear a loud noise or when, 30% try to stay away from people, places, or things that make me remember what happened.  Using DSM-TR criteria for PTSD, 24.9% of children had no symptoms, 30.2%   had at least one cluster of symptoms (intrusion or avoidance or hyperarousal), 32.5% had partial PTSD (Two cluster of symptoms), and 12.4% had full criteria of PTSD. No significant sex differences in PTSD. Children living in families with monthly income less than $300 had more PTSD, intrusion, avoidance and hyperarousal than the other groups. The study showed that children live in cities showed more PTSD symptoms than those in villages and camps. There was significant correlation between total traumatic events and PTSD. For fear symptoms, commonly children: always my parents tell me to be careful of all people (72%), I become tired quickly when I run from the house (60.4%), scream when I see and hear the plane in the air (56.2%). The results showed that total fears symptoms were 9.27 (SD =5.13).   

For anxiety symptoms, the most common symptoms were: Feel worried when things do not go as they want (79.1%), being anxious to what is happening in the future (67%), they are always anxious for bad things can happen to them (64.4%), hurt easily their feelings when they are anxious (54.8%), while the less items was they always feel that they are am alone when they are with people (22.1%).  Using cut-off point of RCMAS, 20.5% of children scored above cut-off point of anxiety. There were significant correlations between total anxiety and total traumatic events score. There were statistically significant differences in anxiety toward boys. Children with anxiety scored more in total coping strategies, more resignation, and social withdrawal as coping strategies than children without anxiety.

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