Faculty of Public Health, Al-Quds University, Abu Dees, West Bank-Palestine.
Department of Psychology, Technische Universität Dresden, Dresden, Germany.
Psychophysiology. 2020 Jan;57(1):e13271. doi: 10.1111/psyp.13271. Epub 2018 Aug 13.
Violent conflicts are severe traumatic stressors with detrimental effects on physical and mental health, with children and adolescents being particularly at risk. For the hypothalamic-pituitary-adrenal (HPA) axis, characteristic patterns of dysregulation in trauma-exposed individuals have been shown. This study set out to investigate self-reported mental well-being in Palestinian adolescents growing up during the Israeli-Palestinian conflict. Hair cortisol concentrations (HCC) as a psychoendocrine marker for long-term HPA axis aberrations along with the potential protective factor sense of coherence (SoC; i.e., the global mindset to interpret the world and emerging stressors as comprehensible, manageable, and meaningful) were examined. Between 2014 and 2016, posttraumatic stress disorder (PTSD), depression, anxiety, HCC, and SoC were examined in 233 adolescents aged 11 to 16 from the West Bank. More than half of the participants reported trauma exposure, with 40% fulfilling the criteria of a preliminary PTSD diagnosis and a high prevalence of anxiety and depression. HCC was significantly elevated in the PTSD subgroup compared to the subgroup not exposed to any traumatic events (p = 0.046), with trauma-exposed individuals in between. HCC was further associated with typical sequelae of traumatic stress. Notably, SoC was inversely related to self-reported psychopathology, as well as to HCC in the trauma group. The results illustrate the situation of adolescents exposed to chronic traumatic stress and extend the literature on aberrant HPA axis functioning under such conditions. They also point out a central role of SoC, which may imply new strategies to aid individuals exposed to ongoing conflicts.
暴力冲突是严重的创伤性应激源，对身心健康有不利影响，儿童和青少年尤其处于危险之中。对于下丘脑-垂体-肾上腺（HPA）轴，已经显示出创伤暴露个体中存在特征性的失调模式。本研究旨在调查在以色列-巴勒斯坦冲突中成长的巴勒斯坦青少年的自我报告心理健康状况。作为长期 HPA 轴异常的心理内分泌标志物的头发皮质醇浓度（HCC）以及潜在的保护因素应对感（SoC；即，将世界和新出现的压力源解释为可理解、可管理和有意义的全局心态）进行了检查。2014 年至 2016 年，在西岸检查了 233 名年龄在 11 至 16 岁的青少年的创伤后应激障碍（PTSD）、抑郁、焦虑、HCC 和 SoC。超过一半的参与者报告了创伤暴露，其中 40%符合初步 PTSD 诊断标准，焦虑和抑郁的患病率很高。与未暴露于任何创伤性事件的亚组相比（p=0.046），PTSD 亚组的 HCC 显着升高，而暴露于创伤的个体则介于两者之间。HCC 进一步与创伤性应激的典型后遗症相关。值得注意的是，SoC 与自我报告的精神病理学以及创伤组中的 HCC 呈负相关。研究结果说明了暴露于慢性创伤性应激的青少年的状况，并扩展了有关在这种情况下 HPA 轴功能异常的文献。它们还指出了 SoC 的核心作用，这可能意味着为暴露于持续冲突的个体提供新的策略。
