Mental Suffering in Protracted Political Conflict: Feeling Broken or Destroyed (original) (raw)
Related papers
Global Public Health, 2011
This paper presents a brief history of Palestinian mental health care, a discussion of the current status of mental health and health services in the occupied Palestinian territory, and a critique of the biomedical Western-led discourse as it relates to the mental health needs of Palestinians. Medicalising distress and providing psychological therapies for Palestinians offer little in the way of alleviating the underlying causes of ongoing collective trauma. This paper emphasises the importance of separating clinical responses to mental illness from the public health response to mass political violation and distress. Palestinian academic research reframes the mental health paradigm utilising an approach based on the broader framework of social justice, quality of life, human rights and human security. Recognising social suffering as a public mental health issue requires a shift in the emphasis from narrow medical indicators, injury and illness to the lack of human security and human rights violations experienced by ordinary Palestinians. Such a change in perspective requires a parallel change in mental health policies from short-term emergency humanitarian aid to the development of a sustainable system of public mental health services, in combination with advocacy for human rights and the restoration of political, historical and moral justice.
BMJ Global Health, 2024
The onslaught on Gaza is leading to catastrophic psychological consequences which will not be limited to the short term and to those directly affected, but will have long-term, intergenerational effects. This commentary argues that to understand trauma responses among Gazans, we need to go beyond individual illness and, instead, link the biomedical sphere with the political sphere through the concept of social suffering and, thereby, expose the socio-political conditions of life and the collective trauma-inducing nature of the Israeli military occupation and repression. Addressing these complex trauma responses requires approaches that bring together the political, social and personal-level components of mental health with a focus on three factors: safety and allyship; the right to agency and acknowledgement, accountability and reparations.
The limits of resilience: Distress following chronic political violence among Palestinians
2011
We examined posttraumatic stress disorder (PTSD) and depression symptom trajectories during ongoing exposure to political violence, seeking to identify psychologically resilient individuals and the factors that predict resilience. Face-to-face interviews were conducted with a random sample of 1196 Palestinian adult residents of the West Bank, Gaza, and East Jerusalem across three occasions, six months apart (September 2007–November 2008).
Psychiatry, 2010
Little is known about the impact of traumatic experiences and stressful life conditions on people in low-income countries who live in conditions of ongoing political violence. In order to determine the prevalence and predictors of post-traumatic stress disorder (PTSD) and major depression (MD) among Palestinians subjected to chronic political violence and upheaval, we used a stratified multi-stage cluster random sampling strategy to interview a representative sample of 1,200 Palestinian adults living in Gaza, the West Bank, and East Jerusalem. Prevalence of PTSD/MD for men living in the West Bank, Gaza, and East Jerusalem was 25.4%/29.9%, 11.6%IT7.6%, and 16.1%/16.1%, respectively. For women, the prevalence of PTSD/MD was 23.8%/29.0%, 23.9%/28.9%, and 19.7%/27.6%. Among men, PTSD was significantly positively associated with age group, two or more incidences of political violence (compared to none), greater intrapersonal resource loss, and loss of faith in government. MD was positively associated with experiencing exposure to one, or two or more, incidences of political violence (compared to none), and greater interpersonal and intrapersonal resource loss. Among women, PTSD was positively associated with greater interpersonal and intrapersonal resource loss, and MD was positively associated with death of a loved one, two or more socio-political Stressors (compared to none) previous to . the past year, one or more socio-political Stressors (compared to none) in the past year, and greater interpersonal and intrapersonal resource loss. Interpersonal and intrapersonal resource losses were consistently associated with PTSD and MD, suggesting potential targets for intervention and prevention efforts and thus provide important keys to treatment in areas of ongoing conflict.
The experience and prevalence of PTSD in Palestinian adults living in the Gaza Strip
2017
Objective: This study aims to explore the traumatic experiences and to estimate prevalence and predictor factors for PTSD, depression and general psychiatric morbidity amongst Palestinian adults living in the Gaza Strip. Method: A total of 500 Palestinian adults were recruited from four areas of the Gaza Strip using a snowball sampling. The same sample was used for both quantitative studies. Four scales were employed to identify predictors for trauma, PTSD, depression and general mental health. Participants were divided into three age groups: young adults (18 to 25 years), adults (26 to 49 years) and older adults (50 to 65 years). The third qualitative study was aimed at exploring the traumatic experiences of adults living in the Gaza Strip to expand upon the outcomes from the quantitative studies. Results: For Studies 1 and 2, the prevalence rate of PTSD symptoms was 90% and 36.7% met the criteria of DSM-IV for PTSD. Study 2 found depression was 38.4%, and general mental health com...
Can People Remain Engaged and Vigorous in the Face of Trauma? Palestinians in the West Bank and Gaza
2012
This is the first study of the relationship between being exposed to traumatic conditions and, yet, remaining engaged in life tasks and vigorous. A national random sample of adult residents (n= 1,196) of the Palestinian Authority were interviewed in person in a three-wave longitudinal study: (. Using path modeling, we found that those who reported greater trauma exposure at time 1 reported modestly reduced engagement at time 3, mediated by their greater psychosocial resource loss at time 1 and greater depressive symptoms at time 2. At the same time, trauma exposure had a modest direct positive effect on engagement at time 3, suggesting that trauma exposure may also activate engagement. Loss of psychosocial resources as assessed at time 2 was the best predictor of lower engagement at time 3. Greater engagement was also predicted by greater social support, being male, being more educated, being younger, and being more religious. PTS symptoms at time 2 did not independently predict engagement when controlled for all variables in the model. The relative independence of psychological distress and engagement was noted as a critical finding supporting a key tenet of positive psychology.
The psychological toll of the Intifada: symptoms of distress and coping in Israeli soldiers
The Israel Medical Association journal : IMAJ, 2008
Detrimental effects of military service among the civilian Palestinian population have been reported in soldiers. To examine the frequency and type of stressors encountered by soldiers in close contact with the CPP and its relationship with post-traumatic symptomatology. We also investigated coping methods and the preferred types of professional help. Using random digit dialing methodology we conducted a phone survey of veteran soldiers, men (n=167) and women (n=59) in close contact with the CPP; the comparison group comprised male veteran soldiers with no CPP exposure (n=74). We used focus groups to develop context-related measures to assess exposure to violent incidents, coping modes and preferred modes of professional assistance. We included measures of traumatic exposure, post-traumatic stress symptoms and post-traumatic stress disorder. Soldiers who served among the CPP had greater exposure to traumatic events and to civilian-related violent incidents (more than half as victims...
Psychological trauma : theory, research, practice and policy, 2012
A total of 1,196 Palestinian adults living in the West Bank, Gaza Strip, and East Jerusalem were interviewed beginning in September 2007 and again at 6-and 12-month intervals. Using structural equation modeling, we focused on the effects of exposure to political violence, psychosocial and economic resource loss, and social support on psychological distress and the association of each of these variables on subjective health. Our proposed mediation model was partially supported. Exposure to political violence, psychosocial resource loss, and social support were related to subjective health, fully mediated by their relationship with psychological distress. Female gender and being older were also directly related to poorer subjective health and partially mediated via psychological distress. Greater economic resource loss, lower income, and poorer education were directly related to poor subjective health. An alternative model exploring subjective health as a mediator of psychological distress revealed that subjective health partially mediated the relationship between resource loss and psychological distress. The associate between female gender, education, income, and age on psychological distress were fully mediated by subjective health. Social support and exposure to political violence were directly related to psychological distress. These results were discussed in terms of the importance of resource loss on both mental and physical health in regions of chronic political violence and potential intervention strategies.
The Israel journal of psychiatry and related sciences, 2005
The study assesses the effects of exposure to nationality-related and personal stressful events, threat appraisal and coping strategies on level of distress of Palestinian Israeli students. One hundred forty-eight Palestinian Israeli students filled out a battery of questionnaires that tapped their exposure to stressful life events, terrorism and political related violence, their primary and secondary appraisals, and coping strategies. Level of distress was evaluated by (1) acute stress disorder, and (2) psychiatric symptomatology. Results reveal relatively low exposure to terrorism-related traumatic events, yet considerable exposure (35.8%) to nationality-related stressful events during the last two years. Twenty-five percent of the students suffered from acute stress disorder, and their levels of psychiatric symptomatology exceeded norms for the general population. Primary appraisal processes and emotion-focused coping strategies made unique contribution to the respondents' le...