Giacaman Rita, Shannon Harry S, Saab Hana, Arya Neil, Boyce Will
Institute of Community and Public Health, Birzeit University, Ramallah, West Bank, Occupied Palestinian Territory.
Eur J Public Health. 2007 Aug;17(4):361-8. doi: 10.1093/eurpub/ckl260. Epub 2006 Nov 30.
We conducted a survey of Palestinian adolescents in school. We hypothesized that collective and individual exposures to violence would both negatively affect adolescents' mental health. We also anticipated that the negative effect of collective exposures on mental health would be less than that of individual exposures. Our analysis was designed to test these hypotheses.
A representative sample of 3415 students of 10th and 11th grades from the Ramallah District of the West Bank participated in the survey. The primary independent variables were scales of individual and collective exposures to trauma/violence (ETV) by the Israeli military and settlers. Factor analysis revealed several sub-scales. Outcome measures were constructed and included: a binary measure of depressive-like states, and emotional, depressive-like state, and somatic scales. Several variables were identified as possible covariates: gender, age, school-type, residence, employment status of father, and identity documents held.
Logistic and multiple regression analyses revealed a strong relationship between ETV and adolescents' mental health, with both individual and collective exposures having independent effects. There was a higher prevalence of depressive-like symptoms among girls compared with boys, and in adolescents living in Palestinian refugee camps compared with those living in cities, towns and villages.
The findings confirmed our hypothesis that both individual and collective ETV independently affect the mental health of adolescents. Contrary to expectations, individual exposures did not consistently have a greater negative effect on health outcomes than collective exposures, although the sub-scale of direct personal exposures to violence consistently showed the strongest effect among sub-scales. The results emphasize the importance of going beyond individual experiences and including the health outcomes of collective violation when analyzing violent and traumatic contexts.
我们对在校的巴勒斯坦青少年进行了一项调查。我们假设集体暴力暴露和个人暴力暴露都会对青少年的心理健康产生负面影响。我们还预计集体暴力暴露对心理健康的负面影响将小于个人暴力暴露。我们的分析旨在检验这些假设。
来自约旦河西岸拉马拉地区的3415名十年级和十一年级学生的代表性样本参与了此次调查。主要自变量是以色列军队和定居者造成的个人和集体创伤/暴力暴露（ETV）量表。因子分析揭示了几个子量表。构建了结果指标，包括：抑郁样状态的二元指标、情绪、抑郁样状态和躯体量表。确定了几个可能的协变量：性别、年龄、学校类型、居住情况、父亲的就业状况以及所持有的身份证件。
逻辑回归和多元回归分析表明ETV与青少年心理健康之间存在密切关系，个人和集体暴露都有独立影响。与男孩相比，女孩中抑郁样症状的患病率更高；与生活在城市、城镇和村庄的青少年相比，生活在巴勒斯坦难民营中的青少年患病率更高。
研究结果证实了我们的假设，即个人和集体ETV都会独立影响青少年的心理健康。与预期相反，个人暴露对健康结果的负面影响并不总是比集体暴露更大，尽管直接个人暴力暴露子量表在各子量表中始终显示出最强的影响。结果强调了在分析暴力和创伤情境时，超越个人经历并纳入集体暴力侵害的健康结果的重要性。
