Cumulative Effects of Exposure to Violence on Posttraumatic Stress in Palestinian and Israeli Youth

Eric F. Dubow, Paul Boxer, L. Rowell Huesmann, Simha Landau, Shira Dvir, Khalil Shikaki, Jeremy Ginges

Research output: Contribution to journalArticlepeer-review


We examine cumulative and prospective effects of exposure to conflict and violence across four contexts (ethnic-political, community, family, school) on posttraumatic stress (PTS) symptoms in Palestinian and Israeli youth. Interviews were conducted with 600 Palestinian and 901 Israeli (Jewish and Arab) children (ages 8, 11, and 14) and their parents once a year for 3 consecutive years. Palestinian children, males, and older youth were generally at greatest risk for exposure to conflict/violence across contexts. Regression analysis found unique effects of exposure to ethnic-political (Palestinian sample), school (Palestinian and Israeli Jewish samples), and family conflict/violence (Israeli Arab sample) during the first 2 years on PTS symptoms in Year 3, controlling for prior PTS symptoms. Cumulative exposure to violence in more contexts during the first 2 years predicted higher subsequent PTS symptoms than did exposure to violence in fewer contexts, and this was true regardless of the youth's level of prior PTS symptoms. These results highlight the risk that ongoing exposure to violence across multiple contexts in the social ecology poses for the mental health of children in contexts of ethnic-political violence. Researchers and mental health professionals working with war-exposed youth in a given cultural context must assess both war- and non-war-related stressors affecting youth. Based on this assessment, interventions may not be limited to individual-based, war-trauma-focused approaches but also may include school-based, community-based, and family-level interventions.

Original languageEnglish
Pages (from-to)837-844
Number of pages8
JournalJournal of Clinical Child and Adolescent Psychology
Issue number6
StatePublished - Nov 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Developmental and Educational Psychology
  • Clinical Psychology


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