Schöler Nina, Gal Gilad, Wissow Lawrence S, Seita Akihiro
United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza Field Office, Gaza.
Academic College of Tel Aviv-Yaffo, Yaffo, Israel.
JAACAP Open. 2024 Aug 22;3(3):609-617. doi: 10.1016/j.jaacop.2024.06.003. eCollection 2025 Sep.
Children in the Gaza Strip have lived their entire lives with chronic economic and political insecurity punctuated by periodic escalations of overt combat. Clinicians need to learn how children raised in these conditions respond to escalations of threat. This study investigated the prevalence of stress and trauma-related symptoms and functional impairment among young Palestinian children following the May 2021 escalation in Gaza.
Survey (conducted in 2021) of first-year elementary school students aged 5 to 7 years from all 5 Gaza Strip governorates (n = 11,646). Symptoms were measured in joint parent-child interviews using an adapted version of the Acute Stress Checklist for Children (ASC-Kids) administered after the May 2021 escalation. Children were classified as having no exposure to the May 2021 escalation, personal exposure (witnessed or experienced injury or property damage), subjective experience of fear (recalled feelings of fear at the time), and combined personal and subjective exposure.
Personal and/or subjective exposure was reported by 75.9% of children. ASC-Kids scores increased as a function of exposure: none<personal<subjective<combined. However, the relationship between exposure and ASC-Kids scores was stronger in some governorates than others and was attenuated among children from higher-income families. Functional impairment was found in 38.1% of the children, and the rate increased with the level of exposure. ASC-Kids scores were not related to the time of assessment.
Exposure to the May 2021 escalation was related to elevated stress and trauma-related symptoms and higher rates of functional impairment. Feelings of distress at the time of the escalation were stronger predictors of later problems than were reports of exposure to injury or destruction alone. The study findings suggest ways of identifying children who could be candidates for preventive interventions following escalations of violence.
加沙地带的儿童一生都生活在长期的经济和政治不安全之中，其间还不时穿插着公开冲突的周期性升级。临床医生需要了解在这些条件下成长的儿童如何应对威胁升级。本研究调查了2021年5月加沙冲突升级后，巴勒斯坦幼儿中与压力和创伤相关症状及功能损害的患病率。
对加沙地带所有5个省的5至7岁一年级小学生进行调查（于2021年开展），共11,646名。在2021年5月冲突升级后，通过使用改编版的儿童急性应激检查表（ASC-Kids），在亲子联合访谈中测量症状。儿童被分为未经历2021年5月冲突升级、个人暴露（目睹或经历伤害或财产损失）、恐惧的主观体验（回忆当时的恐惧感受）以及个人和主观暴露均有的情况。
75.9%的儿童报告有个人和/或主观暴露。ASC-Kids得分随暴露程度增加：无暴露<个人暴露<主观暴露<个人和主观暴露均有。然而，暴露与ASC-Kids得分之间的关系在一些省份比其他省份更强，并且在高收入家庭的儿童中减弱。38.1%的儿童存在功能损害，且该比率随暴露程度增加而上升。ASC-Kids得分与评估时间无关。
经历2021年5月冲突升级与压力和创伤相关症状增加以及功能损害发生率升高有关。冲突升级时的痛苦感受比仅报告暴露于伤害或破坏更能预测后期问题。研究结果提示了识别暴力升级后可能适合接受预防性干预儿童的方法。
