Table 1. Nine primary research studies focused on Palestinian adolescents.
| Study | Setting | Sample characteristics | Methods | Significant results | Non-significant results |
|---|---|---|---|---|---|
| Al-Krenawi, J. Graham, 2012 | Gaza and the West Bank | 971 adolescents 42% boys and 57% girls 521 adolescents from the West Bank and 450 from the Gaza strip Ages 14-18 |
Cross-sectional Self-reported Participants were from randomly selected schools from refugee camps, villages and major cities in both Gaza and the West Bank, through the ministries of education Outcome: PTSD symptom severity |
Risk Factors: GLOBAL: N/A MACRO: Greater political violence exposure MEZZO: N/A MICRO: INDIVIDUAL: female sex Protective factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: Higher family economic status INDIVIDUAL: N/A |
GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: Parents' education INDIVIDUAL: Nationality and religion |
| Dubow et al., 2010 | West Bank (64% of the sample) and Gaza Strip 36% of the sample) | 600 adolescents 200 8 year olds (101 girls and 99 boys), 200 11 year olds (100 girls and 100 boys) and 200 14 year olds (100 girls and 100 boys) |
Longitudinal Representative sample Diagnostic interview and self-reported Outcome: PTSD symptom severity |
Risk Factors: GLOBAL: N/A MACRO: Living in Gaza compared to West Bank; greater political conflict/violence MEZZO: Greater exposure of school conflict/violence MICRO: family conflict/violence INDIVIDUAL: N/A Protective factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: N/A INDIVIDUAL: male sex, older age |
GLOBAL: N/A MACRO: N/A MEZZO: community conflict/violence MICRO: parent education and income INDIVIDUAL: no significant interactions between sex or age and ecological level of exposure, or political violence and ecological level of exposure |
| Elbadour et al. 2007 | The Rafah and Kan-Younis Refugee camps in the southern region of the Gaza Strip | 229 adolescents Of the 229 adolescents, 52.8% were boys Ages 15-19 |
Cross-sectional Diagnostic interview and self-reported Randomized sampling using a 2 –stage procedure Outcome: PTSD diagnosis |
Risk Factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: N/A INDIVIDUAL: Low levels of seeking guidance and support coping, higher depression and anxiety Protective factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: N/A INDIVIDUAL: Positive reappraisal coping |
GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: N/A INDIVIDUAL: coping styles of logical analysis, problem solving, cognitive avoidance, acceptance or resignation, and emotional discharge |
| Khamis, 2005 | East Jerusalem and various governorates in the West Bank | 1000 adolescents 52.3% were boys and 47.7% were girls Ages 12-16 |
Cross-sectional Diagnostic interview Stratified random sample in governmental, private and UNRWA schools Questionnaires were administered in an interview format Outcome: PTSD diagnosis |
Risk Factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: Family ambiance (child's experience of anxiety in the home environment) INDIVIDUAL: male sex, refugee status, and child employment Protective factors: None were reported |
GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: family economic pressures; harsh discipline INDIVIDUAL: age, child psychological maltreatment |
| Khamis, 2008 | Gaza Strip and the West Bank from cities (41.3%), villages (17.3% and refugee camps (41.3%). | 179 adolescent boys Ages 12- 18 |
Cross-sectional Diagnostic interview and self-reported Questionnaires were administered in an interview format with adolescents at home Outcome: PTSD diagnosis |
Risk Factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: N/A INDIVIDUAL: Fatalism and negative coping Protective factors: None were reported |
GLOBAL: N/A MACRO: geographical location MEZZO: N/A MICRO: family economic pressures, parents' education, family income; parental support INDIVIDUAL: age, time since trauma, participating in Intifada, positive coping |
| Khamis, 2012 | Gaza Strip and south Lebanon | 600 adolescents Age 12-16 |
Cross-sectional Diagnostic interview Interview format conducted in the public school system in highly war exposed areas Outcome: PTSD diagnosis |
Risk Factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: family member injured, home demolished, family economic pressure INDIVIDUAL: depression and anxiety symptoms Protective factors: None were reported |
GLOBAL: MACRO: N/A MEZZO: N/A MICRO: family member killed INDIVIDUAL: religiosity, ideology |
| Punamaki et al., 2001 | Gaza | 86 adolescents 44 girls and 42 boys Ages 14 |
Longitudinal Diagnostic interview and self-reported Design excluded baseline measures of study outcome Outcome: PTSD symptom severity |
Risk Factors: GLOBAL: N/A MACRO: higher exposure to traumatic events MEZZO: N/A MICRO: higher maternal love and caring INDIVIDUAL: N/A Protective factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: higher paternal love and caring INDIVIDUAL: child reporting they would actively respond to violent threat (e.g., confront soldiers) |
GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: maternal and paternal rejection and hostility INDIVIDUAL: intelligence, creativity, age, sex, stressful life events |
| Qouta et al., 2007 | Gaza | 65 adolescents 52% girls Ages 17 |
Longitudinal prospective study Diagnostic interview Military trauma exposed adolescents from a community-based random sample of 1,082, which was representative of schools in refugee camps, and urban and resettled areas Outcome: PTSD symptom severity |
Risk Factors: GLOBAL: N/A MACRO: N/A MEZZO: High exposure to military trauma MICRO: N/A INDIVIDUAL: Cognitive capacity and neuroticism Protective factors: None were reported |
GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: mother's discipline style INDIVIDUAL: sex, intelligence; active coping |
| Thabet et al., 2009 | Gaza Strip | Participants were 412 children from the Gaza Strip Ages 12- 16 |
Cross-sectional Diagnostic interview and self-reported Random sample Gaza traumatic events checklist (GTEC), the SCID (DSM-V) and the Perceived Parenting Support Scale (PPSS) Outcome: PTSD diagnosis |
Risk Factors: GLOBAL: N/A MACRO: The number of exposures to traumatic events MEZZO: receiving social assistance MICRO: Fathers lower education INDIVIDUAL: N/A Protective factors: GLOBAL: N/A MACRO: N/A MEZZO: N/A MICRO: Perceived parenting support INDIVIDUAL: N/A |
GLOBAL: N/A MACRO: N/A MEZZO: geographic region MICRO: number of rooms in house; number of siblings; family income, mother's education, parental education INDIVIDUAL: age, sex |