Trauma, PTSD, Anxiety, and Resilience in Palestinian Children in the Gaza Strip

Abstract

Aims: The aim of the study was to investigate the effect of traumatic events due to eight days of military escalation on children PTSD, anxiety, resilience, relationship of between children mental health problems and resilience. Methods: This was descriptive analytic study. The study sample consisted of 502 randomly selected children from 16 districts of the Gaza Strip. Age ranged from 9 to 16 years. Children were assessed by a socio demographic questionnaire, Gaza Traumatic Events Checklist, Post traumatic stress disorder scale, Children’s Revised Manifest Anxiety Scale, and Resilience Scale for Adolescents.  Results: Children reported commonly traumatic events such as hearing the loud voice of Drones (98.8%), hearing shelling of the area by artillery (98.6%), hearing the sonic sounds of the jetfighters (98.4%), and watching mutilated bodies of Palestinians in TV (98.2%). Mean traumatic events reported by children was 7 events. Boys reported severe traumatic events than girls; traumatic events were reported in children living in a city than in village and camp.    This study showed that 35.9% of children showed full criteria of PTSD. Post traumatic stress disorder and re-experiencing symptoms were more in girls. Also, children coming from families with family income less than $300 and living in city. The children anxiety symptoms, 30.9% of children had anxiety disorder. No differences in anxiety disorder between boys and girls.  Anxiety was more in children living in camps and family monthly income less than $300. Palestinians children used different ways of coping with the stress and trauma, and common resilience items were 94.6% said they  were proud of their citizenship, 92.4% said they feel safe when they were with their caregivers, 91.4% said that their spiritual (religious) beliefs were a source of strength for them, and 91% said they were proud of their family  background. Total resilience in children, personal skills, peer component, and social skills, contextual components that facilitate a sense of belonging (Spiritual beliefs, culture, and educational items) were more in of girls. Total resilience and contextual components were more in children living in a camps and a village than in a city. However, there were statistically significant differences in individual factors (personal skills, peer component, and social skills) were more in children from family monthly income $301-750 than families with monthly income of 300$ and less. Also, traumatic events were correlated positively with anxiety and PSTD and negatively correlated with total resilience factor. Conclusion: This study showed that the last war on Gaza had negative impact on children mental health and resilience. Children were a particularly vulnerable target group. Trauma due to war increased children psychological symptoms, including post-traumatic stress disorder and anxiety. Such psychological problems were associated with traumatic experiences, and trauma decrease children resilience.