Effects on Children of Persistent Exposure to Political Violence: Follow-up

描述（由申请人提供）：本申请是一项持续的纵向研究的继续建议，该研究旨在研究暴露于冲突和暴力对巴勒斯坦和以色列青年的心理健康和行为的影响。三组青年（最初年龄为8岁、11岁和14岁）每隔一年进行三次评估。对截至2010年6月收集的数据进行的分析表明，遭受族裔政治暴力和战争暴力与随后的创伤后应激反应症状和对同伴的攻击有关。目前建议的目标是继续分析在2010年6月之前收集的三波数据，并收集另一波数据，更加侧重于年龄较大的群体，因为他们现在已经成年（2013年，20岁），以研究累积接触暴力对临床综合征、药物使用、反社会和攻击行为的影响，以及对政治暴力的支持此外，我们还将检查与年龄相关的潜在保护因素，这些因素我们以前没有对这个老年队列进行评估（例如，公民参与、就业、建设性活动、政治活动和创伤后成长）。我们之所以关注老年群体，是因为我们认识到，在成年早期，新的机会和经历对适应提出了挑战，而年龄上突出的保护因素可能会减轻持续遭受暴力的影响。然而，对于所有年龄组，我们建议扩展我们对心理健康结果的评估，并扩展我们对情绪反应在应对种族政治暴力中的作用的检查 通过收集生物标记（例如，皮质醇）和评估皮肤电导以响应观看描绘人际暴力的视频。这将使我们能够测试有关调解认知和情感过程的关键理论命题，这些过程可能会解释暴力暴露的长期影响，并区分那些表现出更多外部化问题的高度暴露青年和那些表现出更多内部化问题的青年。 公共卫生相关性：本申请是一项持续的纵向研究的继续建议，该研究旨在研究暴露于种族政治冲突和暴力对巴勒斯坦和以色列青年（从8岁、11岁和14岁开始的三个队列）的心理健康和行为的影响，这些青年已经以一年的间隔进行了三次评估。我们将重新采访所有三个队列中的年轻人，但特别关注年龄最大的队列（2013年20岁），以检查种族政治暴力累积暴露对临床综合征，物质使用，反社会和攻击性行为以及参与政治暴力的风险的影响 对于这些即将成年的年轻人，并检查因素（例如，公民参与，就业，建设性活动，政治活动，创伤后成长），可能会保护他们免受这些结果;并为所有年龄组，测试社会认知和情感因素（例如，放松管制的压力反应系统），这可能是暴露对心理健康和攻击性的长期影响的原因。这一新阶段的结果将为我们现有的数据增加重要价值，提供与长期暴露于暴力影响的具有治疗意义的生物行为和社会认知机制相关的临床诊断信息，从而为针对儿童应对暴力暴露负面影响的有针对性的干预措施的设计增加新的有价值的见解。

DESCRIPTION (provided by applicant): The present application is a continuation proposal for an ongoing longitudinal study of the effects of exposure to conflict and violence on the mental health and behavior of Palestinian and Israeli youth. Three cohorts of youth (originally ages 8, 11, and 14) have been assessed three times at one-year intervals. Analyses of the data collected through June 2010 have shown that exposure to ethnic-political and war violence is related to subsequent post-traumatic stress symptoms and aggression directed at peers. The goals of the current proposal are to continue analyses with the three waves of data collected by June 2010 and to collect one more wave of data with a more intense focus on the older cohort as they now reach adulthood (age 20 in 2013) in order to examine effects of cumulative exposure to violence on clinical syndromes, substance use, antisocial and aggressive behavior, and endorsement of politically-motivated violence. Additionally, we will examine age-relevant potential protective factors that we did not previously assess for this older cohort (e.g., civic engagement, employment, constructive activities, political activism, and post traumatic growth). Our focus on the older cohort is motivated by the recognition that early adulthood is a period in which new opportunities and experiences present challenges to adjustment and when age-salient protective factors may moderate the impact of persistent exposure to violence. However, for all age cohorts, we propose to extend our assessment of mental health outcomes and extend our examination of the role of emotional reactivity in response to ethnic-political violence exposure by collecting bio-markers (e.g., cortisol) and assessing skin conductance in response to viewing a video depicting interpersonal violence. This will allow us to test key theoretical propositions concerning mediating cognitive and emotional processes that might account for the long-term effects of violence exposure and distinguish between those highly exposed youth who display more externalizing problems and those who display more internalizing problems. PUBLIC HEALTH RELEVANCE: The present application is a continuation proposal for an ongoing longitudinal study of the effects of exposure to ethnic-political conflict and violence on the mental health and behavior of Palestinian and Israeli youth (three cohorts starting at ages 8, 11, and 14) who have been assessed three times at one-year intervals. We will re-interview youth in all three cohorts, but with a particular focus on the oldest cohort (age 20 in 2013), to examine the effects of cumulative exposure to ethnic-political violence on clinical syndromes, substance use, antisocial and aggressive behavior, and risk for participation in political violence for these youth who are on the verge of adulthood and to examine factors (e.g., civic engagement, employment, constructive activities, political activism, post traumatic growth) that might protect them against these outcomes; and for all age cohorts, to test social-cognitive and emotional factors (e.g., deregulated stress response systems) that might account for the long-term effects of exposure on mental health and aggression. The results of this new phase will add significant value to our existing data by presenting clinical diagnostic information linked to therapeutically- meaningful bio-behavioral and social-cognitive mechanisms impacted by long-term exposure to violence, thus adding new and valuable insights to the design of targeted interventions for children coping with the negative effects of violence exposure.