Exposure to political conflict and violence and posttraumatic stress in Middle East youth: protective factors.

We examine the role of family- and individual-level protective factors in the relation between exposure to ethnic-political conflict and violence and posttraumatic stress among Israeli and Palestinian youth. Specifically, we examine whether parental mental health (lack of depression), positive parenting, children's self-esteem, and academic achievement moderate the relation between exposure to ethnic-political conflict/violence and subsequent posttraumatic stress (PTS) symptoms. We collected three waves of data from 901 Israeli and 600 Palestinian youths (three age cohorts: 8, 11, and 14 years old; approximately half of each gender) and their parents at 1-year intervals. Greater cumulative exposure to ethnic-political conflict/violence across the first 2 waves of the study predicted higher subsequent PTS symptoms even when we controlled for the child's initial level of PTS symptoms. This relation was significantly moderated by a youth's self-esteem and by the positive parenting received by the youth. In particular, the longitudinal relation between exposure to violence and subsequent PTS symptoms was significant for low self-esteem youth and for youth receiving little positive parenting but was non-significant for children with high levels of these protective resources. Our findings show that youth most vulnerable to PTS symptoms as a result of exposure to ethnic-political violence are those with lower levels of self-esteem and who experience low levels of positive parenting. Interventions for war-exposed youth should test whether boosting self-esteem and positive parenting might reduce subsequent levels of PTS symptoms.