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

描述（由申请人提供）：本申请是一项持续纵向研究的延续提案，研究冲突和暴力对巴勒斯坦和以色列青年心理健康和行为的影响。三组青少年（最初年龄为 8 岁、11 岁和 14 岁）每隔一年接受三次评估。对 2010 年 6 月收集的数据的分析表明，接触种族政治和战争暴力与随后出现的创伤后应激症状和针对同龄人的攻击行为有关。当前提案的目标是继续对 2010 年 6 月之前收集的三波数据进行分析，并收集另一波数据，重点关注现已成年的老年群体（2013 年 20 岁），以检查累积的暴力暴露对临床综合症、药物滥用、反社会和攻击行为以及对政治动机暴力的认可的影响。此外，我们将检查我们之前没有针对这一老年群体评估的与年龄相关的潜在保护因素（例如，公民参与、就业、建设性活动、政治活动和创伤后成长）。我们对老年群体的关注是因为我们认识到，成年早期是一个新的机会和经历对调整提出挑战的时期，并且年龄显着的保护因素可能会减轻持续接触暴力的影响。然而，对于所有年龄段的人，我们建议扩大对心理健康结果的评估，并扩大对情绪反应在应对种族政治暴力中的作用的检查 通过收集生物标记物（例如皮质醇）并评估皮肤电导来响应观看描述人际暴力的视频来暴露。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，这些命题可能解释暴力暴露的长期影响，并区分那些表现出更多外在问题的高度暴露的青少年和那些表现出更多内在问题的青少年。 公共卫生相关性：本申请是一项持续纵向研究的延续提案，该研究涉及种族政治冲突和暴力对巴勒斯坦和以色列青少年（从 8 岁、11 岁和 14 岁开始的三组）心理健康和行为的影响，这些青少年每隔一年接受三次评估。我们将重新采访所有三个队列中的年轻人，但特别关注最年长的队列（2013 年 20 岁），以研究累积接触种族政治暴力对临床综合征、药物使用、反社会和攻击行为以及参与政治暴力风险的影响 针对这些即将成年的年轻人，并研究可能保护他们免受这些结果影响的因素（例如公民参与、就业、建设性活动、政治活动、创伤后成长）；对于所有年龄组，测试可能解释暴露对心理健康和攻击性的长期影响的社会认知和情感因素（例如放松管制的压力反应系统）。这一新阶段的结果将通过提供与长期接触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，为我们现有的数据增加重要价值，从而为儿童应对暴力接触负面影响的有针对性的干预措施的设计提供新的和有价值的见解。

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.