Media Exposure to Armed Conflict: Dispositional Optimism and Self-Mastery Moderate Distress and Post-Traumatic Symptoms among Adolescents.

BACKGROUND: Rapid technological developments enable the immediate transmission of armed conflict events through a variety of media channels, inducing mass anxiety, fear, and helplessness. Youth are particularly vulnerable and face new challenges as a result of this exposure. The effects of media exposure to such events on psychological distress and post-traumatic symptoms were examined. METHODS: A total of 161 participants aged 13-18 years completed a questionnaire battery that included measures of media exposure to armed conflict events, previous direct exposure to armed conflict events, psychological distress, post-traumatic symptoms, dispositional optimism, and self-mastery. A structural equation model (SEM) approach was employed for data analysis. RESULTS: The extent of media exposure to armed conflict was directly associated with psychological distress and post-traumatic symptoms. Dispositional optimism moderated the association between media exposure and psychological distress, while self-mastery moderated the association between media exposure and post-traumatic symptoms. The effects of the Internet factor of media exposure, which included social media, were particularly disturbing as neither of the resilience factors moderated negative outcomes. CONCLUSIONS: The findings suggest that clinical interventions to enhance dispositional optimism and self-mastery as well as other potential resilience factors can protect adolescents from the severe effects of media exposure to violent armed conflict events. Developmental and public health implications related to vulnerabilities and resilience during adolescence are discussed.

Previous trauma exposure and self-mastery as moderators of psychiatric effects of home isolation during the Covid-19 pandemic: a field study.

BACKGROUND: Limiting contagion during the Covid-19 pandemic has necessitated employment of drastic measures ranging from complete lockdown to home isolation and quarantines. This study examined the psychiatric effects of home isolation, the effects of interacting previous traumatic events and the moderating effect of self-mastery as a resilience factor that could mitigate negative effects. METHODS: Six hundred forty-five adults aged 18-67 completed an online survey during the first wave lockdown during the Covid-19 outbreak in Israel. Participants completed a demographic questionnaire including measures of strictness of adherence to home isolation, a traumatic life events measure, the Mastery Scale, and the Brief Symptom Inventory. Data was analyzed using Structural Equation Model. RESULTS: Findings showed positive relations between strictness of home isolation adherence and psychiatric symptoms, and between previous trauma exposure and psychiatric symptoms. A negative relation between self-mastery and psychiatric symptoms emerged. During home isolation, effects of previous trauma exposure on psychiatric symptoms was moderated by self-mastery. Individuals with high self-mastery showed less psychiatric symptoms than those with low self-mastery, at both high and low levels of previous trauma exposure. CONCLUSIONS: Home isolation adherence is associated with significant psychological distress and symptomatology and, thus, should be of great concern for public mental health service providers. The present study offers a new slant on appropriate clinical interventions during this period with a focus on strengthening resilience factors that can moderate mental health decline. Therapy and interventions based on promoting self-mastery could exert a significant effect on lowering psychiatric symptoms during stressful periods of home isolation. TRIAL REGISTRATION: Not relevant.

Children's Reactions to War, Armed Conflict and Displacement: Resilience in a Social Climate of Support.

PURPOSE OF REVIEW: The aim of this review was to unravel recent evidence for children's reactions to war and armed conflict focusing on resilience factors mitigating adverse psychological and psychiatric consequences. RECENT FINDINGS: Three categories of mitigating resilience factors emerged from the literature - personal, family, and community factors. In addition, a unifying model of moderating resilience factors emerged, proposing a higher-tier environmental dimension conceptualized here as social climate of support. Wars and armed conflict affect children both by direct exposure to threats, and by disruption of the social fabric supporting development. The notion of producing a climate of social support can direct policy toward service provision and resilience-based programs that both build individual capacities and encompass development of the resources of families, schools, community, and societal structures supportive of children's adjustment and wellbeing. Future research should shift toward systems thinking within a socio-ecological nesting of individual, familial, community, and societal systems.

Sleep, screen time and behaviour problems in preschool children: an actigraphy study.

Inadequate sleep and excessive exposure to media screens have both been linked to poorer mental health in youth. However, the ways in which these interact to predict behaviour problems have yet to be examined using objective sleep measurement. The lack of objective evidence for these relationships in young children has recently been defined by the World Health Organization (2019) as a gap in the field. We thus aimed to test the interacting effects of screen exposure and objectively measured sleep on behaviour problems in the preschool age. A total of 145 children aged 3-to-6-years participated in this cross-sectional study. Sleep was assessed objectively using actigraphy for 1-week, and subjectively using parent-reported daily sleep diaries. Parents reported the child's daily duration of screen exposure, and completed the Strengths and Difficulties Questionnaire. Results showed that actigraphic sleep duration, timing and efficiency were associated with screen exposure. The link between screen time and behaviour problems was moderated by sleep duration, as it was significant only for children with sleep duration of 9.88 h or less per night. Sleep duration also moderated the relation between screen time and externalizing-but not internalizing-problems. Hence, the combination of increased screen exposure and decreased sleep duration may be particularly adverse for child mental health. While these key relationships should be further examined in longitudinal and experimental investigations, our findings shed light on their complexity, underscoring the importance of the moderating role of sleep.

Case studies of adults with central auditory processing disorder: Shifting the spotlight!

Vast literature exists detailing the identification and management of central auditory processing disorder in children: however, less information is available regarding central auditory processing disorder in the adult population. This study aimed to document the diagnostic and management procedure for adults presenting at a multidisciplinary clinic due to concerns regarding their listening and central auditory processing skills. This retrospective study was a case file audit of two adults (a male, aged 37 years and a female, aged 44 years) who presented at a multidisciplinary (audiology and speech pathology) clinic for a hearing and central auditory processing evaluation. Both participants completed a case history questionnaire and were then interviewed with results being documented in their file. Participants were evaluated by a dually qualified audiologist-speech pathologist on a battery of peripheral hearing tests (including pure-tone threshold audiometry, immittance measures and speech tests), central auditory processing assessments (including monaural low redundancy, dichotic listening and temporal processing tests) and evaluation of short-term auditory memory skills. Participants were self-referred, never having been assessed previously for central auditory processing disorder, yet had perceived heightened difficulty with processing information; having conversations (particularly in noisy work or social environments) and remembering information, resulting in a range of psychosocial responses. Following diagnosis of central auditory processing disorder, participants undertook an individualized short-term aural rehabilitation program as dictated by their needs and preferences. Post-program participants perceived better ability to listen and process information even in adverse listening conditions. They reported that their newly learned skills improved their work abilities and social participation leading to positive outcomes. Medical and other allied health professionals should consider the possibility of presentation of central auditory processing disorder in adulthood and make appropriate referrals for central auditory processing testing to facilitate diagnosis and appropriate intervention. Aural rehabilitation should be considered for adults newly diagnosed with central auditory processing disorder.

Positive Education for Young Children: Effects of a Positive Psychology Intervention for Preschool Children on Subjective Well Being and Learning Behaviors.

Despite the flourishing in recent years in applications of positive psychology in the field of education, there is a paucity of research investigating positive psychology interventions for preschool children. The present study examined the effects of a positive psychology-based intervention conducted in Israel on children's subjective well-being, mental health and learning behaviors. Twelve preschool classrooms of 3-6.5 year-olds were randomly assigned to a positive psychology intervention condition or a wait-list control condition. In the intervention condition, during one school year, 160 children experienced eight modules of basic concepts in positive psychology that were adapted to the developmental characteristics of young children and were compared to 155 children in demographically similar control classrooms. Children were administered a pre-test and post-test of subjective well-being measures. In addition, children's mental health and emotional well-being were measured by parental questionnaires. Preschool teachers completed questionnaires concerning children's learning behaviors. The findings showed significant increases in subjective well-being and positive learning behaviors among the intervention participants, with no significant changes in the control group. The results highlight the potential of positive psychology interventions for increasing subjective well-being and a positive approach to learning at young ages.

Children Affected by War and Armed Conflict: Parental Protective Factors and Resistance to Mental Health Symptoms.

This study examined the role of parenting styles and parental warmth in moderating relations between exposure to political life events and mental health symptoms among 277 Israeli adolescents aged 12-14 and their parents, who had been exposed to protracted periods of war, missile bombardments, and terrorism. Adolescents completed the Political Life Events (PLE) scale, Brief Symptom Inventory and questionnaires regarding parenting style and parental warmth. The primary caregiver completed the Child Behavior Checklist for assessment of the child's internalizing and externalizing symptoms. Results confirmed that severity of PLE exposure was positively correlated with psychological distress and with internalizing and externalizing symptoms. Maternal authoritativeness and warmth functioned as protective factors and had moderating effects on the relation between PLE exposure and mental health symptoms. In contrast, maternal authoritarianism exacerbated the relation between PLE exposure and children's externalizing symptoms. Fathers' parenting style and warmth had no significant relationship with children's mental health outcomes. These findings have important clinical and practical implications for parental guidance and support during periods of war and armed conflict.

Through the Looking Glass: The Role of Ethnicity and Affiliation in Responses to Terrorism in the Media.

This study examined whether attitudinal and emotional responses to broadcasts of images of terrorist events differ according to ethnic group (Jewish and Arab Israelis) and outgroup affiliation during an intense wave of terrorism that occurred in Israel during 2015. Participants were 118 Jewish and 110 Arab-Israelis adults randomly allocated to a terrorism or criminal violence television broadcast. State anxiety, state anger, stereotypes, and negative attitudes toward an adversary were examined prior and subsequent to the media exposure. Findings showed significant increases in anxiety, anger, stereotypes, and negative adversary perceptions in the terrorism exposure group compared to only anxiety increases in the criminal violence exposure. In the terrorism exposure group, Jewish participants showed greater increases in negative adversary perceptions of the Palestinians than Arab Israeli participants, but both groups showed similar significant increases in levels of anxiety and anger. Exposure to broadcasts of terrorism increased willingness to negotiate with the adversary among the Arab participants, but not among the Jewish participants. In the terrorism exposure group, both Jewish and Arab Israelis with high affiliation with the Palestinian cause showed less increases in stereotypes than those with low affiliation. Findings emphasize the role of ethnicity and outgroup affiliation in responses to media exposure to terrorism images.

Youth Exposed to Terrorism: the Moderating Role of Ideology.

The present review examines the moderating role of ideology on the effects of war, armed conflict, and terrorism on youth. Ideology is an important factor given the central role played by religio-political ideology and nationalism in present-day conflicts. Ideologies or worldviews represent cognitive frameworks that imbue the traumatic situation with meaning and order. Analysis of the pool of studies identified three categories of ideologically based moderating factors, each representing an aspect of social construction of traumatic events, namely, religion, political ideology, and self-concept. The two closely related categories of religion and politico-religious beliefs showed both positive and negative effects on psychological and psychiatric outcomes among youth. The third category of different aspects of self-concept yielded consistently positive moderating effects. The mechanisms by which each category of ideology moderates effects of exposure to war, armed conflict, and terrorism are discussed, and research and clinical implications are presented.

Effects of War, Terrorism and Armed Conflict on Young Children: A Systematic Review.

Millions of children have been maimed, displaced, orphaned and killed in modern warfare that targets civilian populations. Several reviews have documented the impact of political trauma on children's mental health but none has focused specifically on young children (ages 0-6). Since developmental factors influence the young child's perception and experience of traumatic events, this developmental period is characterized by a unique spectrum of responses to political trauma. This systematic review, comprising 35 studies that included a total of 4365 young children, examined the effects of exposure to war, conflict and terrorism on young children and the influence of parental factors on these effects. Results showed that effects include PTSD and post-traumatic stress symptoms, behavioral and emotional symptoms, sleep problems, disturbed play, and psychosomatic symptoms. Correlations emerged between parental and children's psychopathology and, additionally, family environment and parental functioning emerged as moderators of the exposure-outcome association for children.

Enhancing Children's Resilience in Schools to Confront Trauma: The Impact on Teachers.

BACKGROUND: Children's exposure to stressful events requires effective interventions to strengthen adaptive development. Expanding the teachers' role to deliver resilience-focused interventions has been shown to enhance children's coping and to have a positive impact on the teachers themselves. METHOD: This study compared the self-efficacy and perceived performance of 48 teachers following the implementation of such an intervention with 52 control teachers. RESULTS: Trained teachers reported higher self-efficacy and perceived performance. Associations between years of experience, perceived performance and self-efficacy are discussed. CONCLUSIONS: This study provides further evidence on the positive impact of teacher-delivered interventions on teachers' performance and self-efficacy. Future studies should replicate this design with a larger sample to examine stages of professional experience, grades, before-after measures, association with students' coping and include male teachers.

Preschool Israeli Children Exposed to Rocket Attacks: Assessment, Risk, and Resilience.

Preschool children are among the most vulnerable populations to adversity. This study described the effects of 4 weeks of daily exposure to rocket attacks on children living on Israel's southern border. Participants enrolled in this study were 122 preschool children (50% boys) between the ages 3 and 6 years from 10 kindergartens. We assessed mothers' report of children's symptoms according to the DSM-IV and alternative criteria resembling the DSM-5 criteria for posttraumatic stress disorder (PTSD), general adaptation, traumatic exposure, and stressful life events 3 months after the war. The prevalence of PTSD was lower when the diagnosis was derived from the DSM-IV (4%) than from the DSM-5 criteria (14%). Mothers of children with 4 or more stressful life events reported more functional impairment in social, occupational, and other important areas of functioning compared to children with 0 or 1 stressful life event. Children with more severe exposure showed more severe symptoms and mothers had more concerns about the child's functioning (η(p)(2) = .09-.25). Stressful life events and exposure to traumatic experiences accounted for 32% of the variance in PTSD and 19% of the variance in the adaptation scale. Results were explored in terms of risk and resilience factors.

The Resilience Function of Character Strengths in the Face of War and Protracted Conflict.

This study investigated the role of character strengths and virtues in moderating relations between conflict exposure and psychiatric symptoms among 1078 adolescents aged 13-15 living in southern Israel, who were exposed to lengthy periods of war, terrorism and political conflict. Adolescents were assessed for character strengths and virtues, political violence exposure using the Political Life Events (PLE) scale, and psychiatric symptoms using the Brief Symptom Inventory and the UCLA PTSD Index. Results confirmed that political violence exposure was positively correlated with psychiatric symptoms. Interpersonal, temperance and transcendence strengths were negatively associated with psychiatric symptoms. Moderating effects of the interpersonal strengths on the relation between political violence exposure and the psychiatric and PTSD indices were confirmed. The findings extend existing knowledge about the resilience function of character strengths in exposure to protracted conflict and have important practical implications for applying strength-building practices for adolescents who grow up in war-affected environments.

Psychiatric effects of protracted conflict and political life events exposure among adolescents in Israel: 1998-2011.

This cross-sectional study investigated relations between conflict exposure and psychiatric symptoms among 8,727 Jewish Israeli adolescents aged 12-17 years from 1998-2011. This 14-year span included periods of terrorism, missile attacks, wars, relocations, military operations, and relative quiet, reflecting a dynamically changing, primarily violent climate. Annual samples from the same cities, geographical regions, and schools throughout the country were assessed for personal political life events (PLE) exposure and for psychiatric symptoms using the Brief Symptom Inventory (BSI; Derogatis & Spencer, ). Data were divided into 8 exposure periods: (a) pre-Intifada 1998-2000, (b) Intifada peak 2001-2003, (c) Intifada recession 2004, (d) evacuation 2005, (e) missiles and the 2006 Lebanon war, (f) peak missiles 2006-2007, (g) Operation Cast Lead 2008-2009, and (h) global terrorism 2010-2011. Results confirmed a relation between type of exposure period, PLE exposure, and psychiatric symptoms. In addition, PLE exposure was positively correlated with psychiatric symptoms (ß = .49). A moderating effect of gender on the relationship between PLE exposure and the psychiatric index was found, with elevated symptoms among females (ß = .30).

Helping youth immediately following war exposure: a randomized controlled trial of a school-based intervention program.

This study evaluates a school-based primary prevention intervention designed to promote adolescents' coping in the immediate aftermath of war exposure in Operation Cast Lead. Participants were 179 adolescents from two demographically similar schools in Ashkelon in south Israel. The intervention incorporated two previously proven resilience factors-mobilization of support and self-efficacy. In a repeated measures design, the study assessed pre- to post-test changes in intervention (n=94) and control (n=85) conditions among adolescents exposed to high or low political life events (PLE). Findings showed significant pre-test differences in self-efficacy and psychological symptoms between participants with low and high PLE. For both PLE groups, the intervention strengthened support mobilization and self-efficacy and reduced psychological distress and emotional symptoms. Findings reinforce the importance of offering appropriate evidence-based interventions for school staff to restore security and well-being to adolescents in a crisis context immediately following war. Despite the apparent return to a school routine after war, school staff should be aware of the risk to youth for development of psychological symptoms and disorders, and the need for preventative intervention.

Does self-complexity moderate the effects of exposure to political violence for adolescents?

This study examined the moderating role of self-complexity (SC) on well-being (WB) and psychopathology among Israeli adolescents exposed to the Second Lebanon War (2006). Adolescents (N=584, mean age 16.41) completed a SC measure, Political and Negative Life Events (NLE) scales, Brief Symptom Inventory and Satisfaction with Life Scale. The theoretical model analyzed the function of SC as a moderator of exposure effects to political life events (PLE), while controlling for general NLE. Results corroborated the model with SC moderating the effects of the war-related PLE. Adolescents with low SC are at risk for damaged WB and psychiatric consequences from political violence exposure. This opens a diagnostic avenue for identification of at-risk adolescents in this socio-political context toward whom clinical programs should be directed.

Post-traumatic reaction of Israeli Jewish and Arab children exposed to rocket attacks before and after teacher-delivered intervention.

BACKGROUND: Belonging to ethnic minorities is a risk factor for traumatized children. this study investigated the influence of exposure to rocket attacks during the 2006 Lebanon War on Jewish and two groups of arab Israeli students and the effect of implementing a teacher-delivered intervention focusing on resilience enhancement. METHOD: Children from both ethnic groups (N = 1,372) were assessed for stressful life events, symptoms and parental concern regarding adaptation before the 16- week program (t1) and after its completion (t2). RESULTS: arab children reported more severe symptoms at t1. the three groups showed a significant decrease to the same level at t2. Both ethnic groups differed in the level of parental concern and in the way stressful life events affected children's symptoms. CONCLUSIONS: the results suggest that school-based programs with teachers as clinical mediators could be a valuable, cost-effective cross-cultural model of intervention after mass trauma, moderating vulnerabilities of ethnic minorities.

Parental practices and political violence: the protective role of parental warmth and authority-control in Jewish and Arab Israeli children.

Parental warmth and parental authority-control patterns have been documented as practices with highest significance for children's well-being and development in a variety of life areas. Various forms of these practices have been shown to have a direct positive effect on children and also to protect children from adverse effects of numerous stressors. However, surprisingly, few studies have examined the role of these practices as possible protective factors for children exposed to intractable conflict and political violence. Participants in this study were Jewish (n = 88) and Arab (n = 105) Israeli families, with children aged 7-12.5 (M = 10.73, SD = 0.99). Children completed questionnaires assessing political violence exposure, behavioral, psychological, and social difficulties, and perceived paternal and maternal warmth. Mothers and fathers completed questionnaires assessing parental warmth, parental authority-control, and the child's difficulties. Results showed parental warmth to be a significant moderator of political violence, related to low levels of behavioral and social difficulties of children. Parental authority-control patterns were not protectors from adverse effects of political violence exposure. Maternal authoritarian authority-control showed an effect resembling a risk factor. Differential roles of parental warmth and authority-control, fathers' versus mothers' roles, and ethnic differences are discussed, and practical clinical implications are proposed.

Teacher-delivered resilience-focused intervention in schools with traumatized children following the second Lebanon War.

The 2006 Lebanon War exposed children in the north of Israel to daily rocket attacks. To cope with the massive psychological needs, a teacher-delivered protocol focusing on enhancing personal resilience was implemented. Children were assessed for risk factors, symptoms, and adaptation before the 16-week program (Time 1; n = 983) and after its completion (Time 2; n = 563). At a 3-month follow-up (Time 3; n = 754) children were assessed together with a waiting-list comparison group (n = 1,152). Participating children showed a significant symptom decrease at Time 2 and significantly fewer symptoms than the control group at Time 3. Six or more risk factors were associated with greater symptoms and parental concern about the child's adaptive functioning. Teachers are valuable cost-effective providers for clinically informed interventions after mass trauma and disaster.

Relations between social support and psychological and parental distress for lesbian, single heterosexual by choice, and two-parent heterosexual mothers.

Relations between family type and psychological and parental distress and the moderating role of social support were studied for 90 Israeli lesbian mothers, single heterosexual mothers by choice and 2-parent heterosexual mothers who completed measures of psychological distress, well-being, parental distress, and direct and indirect social support. Findings indicated differences on psychological and parental outcome between mothers from the two heterosexual groups. Social support was higher for lesbian than single heterosexual mothers and was correlated with psychological and parental indices. Unique because of the distinctive demographics of Israeli society (especially in relation to Western Europe and North America), this study highlights ways in which social and individual processes affect psychological outcomes among minority groups.