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

说明(申请人提供)：本申请是一项持续的纵向研究，目的是继续研究接触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。三组年轻人(最初的年龄分别为8岁、11岁和14岁)每隔一年接受三次评估。对截至2010年6月收集的数据的分析表明，接触族裔-政治和战争暴力与随后的创伤后应激症状和针对同龄人的攻击有关。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，并再收集一波数据，重点放在年龄较大的队列中，因为他们现在已经成年(2013年为20岁)，以审查累积接触暴力对临床症状、药物使用、反社会和攻击性行为以及对出于政治动机的暴力的认可的影响。此外，我们将审查与年龄相关的潜在保护因素，这些因素是我们以前没有对这一老年群体进行评估的(例如，公民参与、就业、建设性活动、政治激进主义和创伤后成长)。我们之所以把重点放在老年群体上，是因为我们认识到，成年初期是一个新的机会和经历给适应带来挑战的时期，而突出年龄的保护因素可能会减缓持续暴露在暴力中的影响。然而，对于所有年龄段的人群，我们建议延长我们对精神健康结果的评估，并延长我们对情绪反应在应对种族政治暴力中的作用的审查。 通过收集生物标记物(如皮质醇)和在观看描述人际暴力的视频时评估皮肤传导性来暴露。这将使我们能够测试有关调解认知和情绪过程的关键理论命题，这些过程可能解释暴力暴露的长期影响，并区分那些暴露在高风险之下的年轻人，他们表现出更多的外在问题和更多的内化问题。 公共卫生相关性：本申请是一项持续进行的纵向研究的延续建议，研究暴露在种族-政治冲突和暴力中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，但特别关注年龄最大的队列(2013年为20岁)，以检查累积暴露于种族政治暴力对临床症状、药物使用、反社会和攻击性行为以及参与政治暴力的风险的影响。 针对即将成年的这些青年，调查可能保护他们免受这些后果影响的因素(例如，公民参与、就业、建设性活动、政治激进主义、创伤后成长)；以及对于所有年龄段的队列，测试可能导致暴露对心理健康和攻击性产生长期影响的社会认知和情感因素(例如，放松管制的应激反应系统)。这一新阶段的成果将为我们现有的数据增加重大价值，因为它提供了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有关的临床诊断信息，从而为儿童应对暴力暴露的负面影响的有针对性的干预设计增加了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.