1. School of Psychology What are the Possible Reasons for Different Re- actions to Chronic Trauma in Gaza Strip? By Dr. Mohamed Altawil,PhD & Dr. Pieter W Nel, PhD Presenter on behalf: Mr. Ahmad Awad GCMHP's 5 th International Conference 27 th -29 th October, 2008 Mohamed Altawil m.altawil@herts.ac.ukm.altawil@herts.ac.uk

2. The Types of Chronic Traumatic Events in Palestine

3. Introduction What is Chronic Trauma? Sudden & unaccepted events + Duration (>6 months) + Frequency of Traumatic events (>3 times) = PTSD Trauma in Gaza : high risk of suffering from PTSD (e.g., Thabet & Vostanis,2004; Kanninen et al., 2003) Current Research at University of Hertfordshire, UK(Altawil,2008): This larger study (Altawil, 2008) about the effects of chronic traumatic experiences on Palestinian children in the Gaza Strip. *Participants: 1,137 Palestinian children Age : = 10 - 18 years * Exposure to Trauma : All children in the Gaza are likely to have been exposed to at least 3 types of trauma. * Exposure to chronic traumatic experiences increases symptoms of PTSD

4. Results of the Quantitative Study (Cont…) PTSD symptoms: 41% of Palestinian children in this study suffered from Symptoms of PTSD. The population in Gaza strip is 1.4 million Palestinians and 53.3% (742,200)are children (PCBS, 2006). This study showed that 41% (305,195) of Palestinian children suffered from symptoms PTSD. Personality Traits: Symptoms of PTSD decrease when positive personality aspects increase. Psycho-social support : Symptoms also decrease whenever the level of psycho-social support increases. In particular: (a) family support; (b) level of spiritual-religious support; (c) national pride; (d) and school support.

5. The Qualitative Study Aim : to explore, in depth, some of the moderating factors relating to Palestinian children in the Gaza Strip who have been exposed to chronic traumatic experiences, particularly the children who are doing well or show low levels of PTSD. Participants: The sample consisted of six children interviewed by using a semi- structured interview. They were aged between 13-18 years. These children had all been exposed to at least 15 traumatic events which for some of them should have been severe, yet they showed low level symptoms of PTSD. They had all been living in clashing areas in the Gaza Strip. Method : The measurements were made using a semi- structured interview. The participants were interviewed in Arabic and the interview schedule was also translated into English.

6. Results What are the Possible Reasons for Different Re-actions to Chronic Trauma?

7. Results The results revealed that the moderating factors and levels of influence which protected children from developing PTSD are: 1- Positive personality traits (the patriotic sense, ambition and hope, religion and faith, courage and boldness, social person, determination and will). 2- Ideological commitment (e.g., culture of challenge, a strong belief in obligatory resistance to the occupation and the patience to do so) 3- Network of psychosocial support (e.g., family, friend, relatives, neighbours, teachers and community support). 4-Entertainment (e.g., sport and hobbies, sense of freedom gained from healthy activity, or following recreational programs like drama). 5- Adaptation or acclimatization (e.g., not thinking constantly about traumas or difficulties, usually facing up to traumas and difficulties and a collective sharing of grief and anxiety). Diligence at school and activities like painting or talking which give opportunities for emotional debriefing will also help a child adapt.

8. Conclusion Quantitative Study: Most children in Gaza do not receive any treatment for their symptoms If this traumatised society does not receive help and support in the near future, then the community will become too weak to recover. What interventions should be offered to these children and by whom?!!! Qualitative Study: Although some children in Gaza who have been exposed to traumatic experiences seem to be doing reasonably well at present, there is a significant risk that they will continue to be exposed to further traumatic experiences. If these and other less fortunate children in Gaza do not get adequate help (both preventative and reactive), we might face the prospect of a lost generation of Palestinian children.