Final Report Summary - CHILDREN AND WAR (Children in the crossfire: The cumulative effect of political violence, parent-child relations, on the development of aggression)
Project context and objectives
The Israeli-Palestinian conflict has been ongoing for more than three generations (Qouta, Punamaki and El Sarraj, 2008). Unfortunately, it is a prime example of populated areas becoming battlefields, exposing children to destruction, pain and death (Joshi and O'Donnell, 2003). This conflict has caused countless civilian casualties on both sides, due to military raids, terror attacks, suicide bombings and rocket attacks. The psychological impact of this chronic state of war has affected the day-to-day lives of the Israeli and Palestinian populations, including children and their families. While growing attention has been given to the psychological well-being of child victims of war and terrorism in the past decade, it has focused primarily on the impact of such environments on the development of trauma-related symptoms (e.g. Finzi-Dottan, Dekel, Lavi and Su'ali, 2006; Pat-Horenczyk et al., 2009; Rosner, Powell and Buttollo, 2003) with only some attention being recently paid to the link between exposure to political violence and the development of aggression among children (e.g. Dubow et al., 2010; Kerestes, 2006).
Importantly, children's exposure to political violence (EPV) occurs in the context of other developmental risks that children face, particularly family relations (e.g. Garbarino and Kostenly, 1996). Based on the attachment theory (Ainsworth, Blehar, Waters and Wall, 1978; Bowlby, 1969/1982), which offers an intriguing formulation of protection and risk relevant to understanding the contribution of parent-child relations to children's symptoms of aggression (Guttmann-Steinmetz and Crowell, 2006), as well as research demonstrating the buffering effects of positive family relations on the link between EPV and the later development of symptoms (Garbarino and Kostelny, 1996; Finzi-Dottan et al., 2006), the goal of the present research project was to deepen our understanding on the cumulative effects of EPV, family relations and the child's own vulnerabilities and strengths on the development of behaviour problems among children. To this end, the current project includes several studies.
Work performed
The first published study of this project (Guttmann-Steinmetz, Shoshani, Farhan, Aliman and Hirschberger, 2012) examined Palestinian and Israeli children's behavioural problems and aggression within the context of their family, their culture and the violence to which they are exposed as a result of the ongoing Palestinian-Israeli conflict. Within this study, our first goal was to examine the link among the mothers' exposure to political violence, attachment style and symptoms. As predicted, a significant interaction was found between mothers' EPV (high/low) and mothers' attachment style on these psychological symptoms. Specifically, our data suggested that when exposed to high levels of political violence, non-secure mothers suffer from significantly higher levels of depression, anxiety and stress symptoms compared to secure mothers, a gap that was significantly reduced under conditions of low exposure to political violence. In addition, when looking at the entire sample of women, significantly higher levels of depression, anxiety and stress symptoms were found among non-secure mothers than secure mothers. Conversely, our data showed no link between EPV and these symptoms. Taken together, our data is in line with previous research, demonstrating a buffering role for secure attachment styles in situations of war-related traumatic experiences in adults (Mikulincer, Florian and Weller 1993; Mikulincer et al., 1999; Solomon et al., 1998), which suggests women's EPV may be attenuated by a sense of healthy family relationships.
Surprisingly, the same buffering effect of attachment has not been found for children. Specifically, children's symptoms were not related to their reports of attachment security nor were they related to their level of EPV. In our study, children's symptoms, particularly those of aggression, were linked to maternal levels of depressive symptoms and severity of stress. Specifically, this association is in line with the literature, which suggests maternal depression is a risk factor for childhood psychopathology, increasing the risk for both internalising and externalising problems (Goodman, 2007; Goodmand and Gotlib, 1999).
Main results
Exploring children's symptoms across the two nations, we found that Palestinian mothers reported that their children exhibited higher levels of externalising and internalising problems than the Israeli mothers. This finding follows on from the above mothers' data, which showed that the Palestinian mothers reported greater levels of psychological distress than their Israeli counterparts. Combined with the lack of association between children's symptoms and exposure to political violence, this finding lends support to previous research, implying that family factors may constitute a greater risk for the development of behavioural problems than the mere exposure to political violence (e.g. Barber, 1999; Garbarino and Kostelny, 1996).
The data from this study also includes video-taped observations of mother-child interactions, which have recently been analysed. These observations are currently being coded for emotional availability (Biringen, Robinson and Emde, 2000) with mothers being rated for sensitivity, co-operation, intrusiveness and hostility, and the children rated for responsiveness to their mother and the involvement of the mother in their ongoing activity. Preliminary results suggest that this data will deepen our understanding of the ways in which EPV affects the mothers' behaviour, which in turn impacts the relationship with their child and the children's behavioural symptoms, as maternal EPV was found to be linked to her emotional availability.
In a related dataset, Israeli families, who were approached during the first half of 2012 to be included in the study, were re-approached one month after Operation Pillar of Defence (which took place during November 2012) to assess the impact of exposure to sirens and missile attacks on children's levels of symptoms, and to examine whether positive parent-child relations (data collected earlier) serve as a buffer.
Finally, data collected from approximately 300 children in a school in Ashkelon (13 km north of the border with the Gaza Strip) in September 2011 and then again in June 2012 is currently being analysed for links between EPV, the children's reported security of attachment to parents, their personal strengths and difficulties, and aggression. Taken together, this data will hopefully shed light on the cumulative effects of EPV, attachment and personal vulnerabilities and on the adolescents' well-being.
The importance of understanding child development in the context of armed conflict cannot be overstated. Today, more than ever before, the battlefields are in populated areas (Joshi and O'Donnell, 2003). This project highlights the importance of studying the effects of exposure to political violence on children's development using a developmental ecological approach. Specifically, the data collected in the various studies included within this project point to environmental factors, such as maternal distress, as being key to understanding the implications on children's development of living in an environment characterised by armed conflict. While much of the data is still being analysed, and has yet to be understood and interpreted, we are hopefully on the path to gaining a greater understanding of the larger picture, leading to the development of prevention and intervention programmes, which will focus not only on the child but include significant others in the environment, making a meaningful impact and promoting the children's well-being.
The Israeli-Palestinian conflict has been ongoing for more than three generations (Qouta, Punamaki and El Sarraj, 2008). Unfortunately, it is a prime example of populated areas becoming battlefields, exposing children to destruction, pain and death (Joshi and O'Donnell, 2003). This conflict has caused countless civilian casualties on both sides, due to military raids, terror attacks, suicide bombings and rocket attacks. The psychological impact of this chronic state of war has affected the day-to-day lives of the Israeli and Palestinian populations, including children and their families. While growing attention has been given to the psychological well-being of child victims of war and terrorism in the past decade, it has focused primarily on the impact of such environments on the development of trauma-related symptoms (e.g. Finzi-Dottan, Dekel, Lavi and Su'ali, 2006; Pat-Horenczyk et al., 2009; Rosner, Powell and Buttollo, 2003) with only some attention being recently paid to the link between exposure to political violence and the development of aggression among children (e.g. Dubow et al., 2010; Kerestes, 2006).
Importantly, children's exposure to political violence (EPV) occurs in the context of other developmental risks that children face, particularly family relations (e.g. Garbarino and Kostenly, 1996). Based on the attachment theory (Ainsworth, Blehar, Waters and Wall, 1978; Bowlby, 1969/1982), which offers an intriguing formulation of protection and risk relevant to understanding the contribution of parent-child relations to children's symptoms of aggression (Guttmann-Steinmetz and Crowell, 2006), as well as research demonstrating the buffering effects of positive family relations on the link between EPV and the later development of symptoms (Garbarino and Kostelny, 1996; Finzi-Dottan et al., 2006), the goal of the present research project was to deepen our understanding on the cumulative effects of EPV, family relations and the child's own vulnerabilities and strengths on the development of behaviour problems among children. To this end, the current project includes several studies.
Work performed
The first published study of this project (Guttmann-Steinmetz, Shoshani, Farhan, Aliman and Hirschberger, 2012) examined Palestinian and Israeli children's behavioural problems and aggression within the context of their family, their culture and the violence to which they are exposed as a result of the ongoing Palestinian-Israeli conflict. Within this study, our first goal was to examine the link among the mothers' exposure to political violence, attachment style and symptoms. As predicted, a significant interaction was found between mothers' EPV (high/low) and mothers' attachment style on these psychological symptoms. Specifically, our data suggested that when exposed to high levels of political violence, non-secure mothers suffer from significantly higher levels of depression, anxiety and stress symptoms compared to secure mothers, a gap that was significantly reduced under conditions of low exposure to political violence. In addition, when looking at the entire sample of women, significantly higher levels of depression, anxiety and stress symptoms were found among non-secure mothers than secure mothers. Conversely, our data showed no link between EPV and these symptoms. Taken together, our data is in line with previous research, demonstrating a buffering role for secure attachment styles in situations of war-related traumatic experiences in adults (Mikulincer, Florian and Weller 1993; Mikulincer et al., 1999; Solomon et al., 1998), which suggests women's EPV may be attenuated by a sense of healthy family relationships.
Surprisingly, the same buffering effect of attachment has not been found for children. Specifically, children's symptoms were not related to their reports of attachment security nor were they related to their level of EPV. In our study, children's symptoms, particularly those of aggression, were linked to maternal levels of depressive symptoms and severity of stress. Specifically, this association is in line with the literature, which suggests maternal depression is a risk factor for childhood psychopathology, increasing the risk for both internalising and externalising problems (Goodman, 2007; Goodmand and Gotlib, 1999).
Main results
Exploring children's symptoms across the two nations, we found that Palestinian mothers reported that their children exhibited higher levels of externalising and internalising problems than the Israeli mothers. This finding follows on from the above mothers' data, which showed that the Palestinian mothers reported greater levels of psychological distress than their Israeli counterparts. Combined with the lack of association between children's symptoms and exposure to political violence, this finding lends support to previous research, implying that family factors may constitute a greater risk for the development of behavioural problems than the mere exposure to political violence (e.g. Barber, 1999; Garbarino and Kostelny, 1996).
The data from this study also includes video-taped observations of mother-child interactions, which have recently been analysed. These observations are currently being coded for emotional availability (Biringen, Robinson and Emde, 2000) with mothers being rated for sensitivity, co-operation, intrusiveness and hostility, and the children rated for responsiveness to their mother and the involvement of the mother in their ongoing activity. Preliminary results suggest that this data will deepen our understanding of the ways in which EPV affects the mothers' behaviour, which in turn impacts the relationship with their child and the children's behavioural symptoms, as maternal EPV was found to be linked to her emotional availability.
In a related dataset, Israeli families, who were approached during the first half of 2012 to be included in the study, were re-approached one month after Operation Pillar of Defence (which took place during November 2012) to assess the impact of exposure to sirens and missile attacks on children's levels of symptoms, and to examine whether positive parent-child relations (data collected earlier) serve as a buffer.
Finally, data collected from approximately 300 children in a school in Ashkelon (13 km north of the border with the Gaza Strip) in September 2011 and then again in June 2012 is currently being analysed for links between EPV, the children's reported security of attachment to parents, their personal strengths and difficulties, and aggression. Taken together, this data will hopefully shed light on the cumulative effects of EPV, attachment and personal vulnerabilities and on the adolescents' well-being.
The importance of understanding child development in the context of armed conflict cannot be overstated. Today, more than ever before, the battlefields are in populated areas (Joshi and O'Donnell, 2003). This project highlights the importance of studying the effects of exposure to political violence on children's development using a developmental ecological approach. Specifically, the data collected in the various studies included within this project point to environmental factors, such as maternal distress, as being key to understanding the implications on children's development of living in an environment characterised by armed conflict. While much of the data is still being analysed, and has yet to be understood and interpreted, we are hopefully on the path to gaining a greater understanding of the larger picture, leading to the development of prevention and intervention programmes, which will focus not only on the child but include significant others in the environment, making a meaningful impact and promoting the children's well-being.