War-torn childhoods

Dubow studies ethnic, political violence’s effect on kids

This is important not only for the children's individual sake but because of the serious implications for society as the next generation is damaged by post-traumatic stress or in turn becomes more aggressive and dangerous.

Dubow, who specializes in clinical child psychology, and his colleagues in the U.S., Israel and Palestine are conducting one of the few longitudinal studies of the effects of persistent political and ethnic violence on Israeli and Arab children. First funded in 2006 by the National Institutes of Health, the study has now been renewed and the team is preparing to collect its fourth wave of data.

Dubow is an affiliate of the Institute for Social Research at the University of Michigan, where he works with team members Drs. Rowell Huesmann (past director of the Research Center for Group Dynamics at the institute and lead scientist on the NIH grant); Simha Landau, emeritus professor of the Hebrew University of Jerusalem; Khalil Shikaki of the Palestinian Center for Policy and Survey Research, Paul Boxer of Rutgers University and Michigan, and Jeremy Ginges of the New School for Social Research. 

Dubow and his teammates are working with three groups: Israeli Jewish children, Israeli Arab children, and Palestinian children, in the West Bank and Gaza. They began surveying the children and their families in 2007, when the children were 8, 11 and 14 years old, and repeated their at-home interviews at one-year intervals. The next wave will re-interview them at 14, 17 and 20.

The children and their parents are asked such questions as how often they witness violence, either on TV or firsthand, how much time they spend in security shelters, and whether they have had a friend or relative killed or injured by violence.

It is the first known study to "present direct comparisons through the same measurement batteries among the three predominant ethnic groups involved in the Middle East conflict; these comparisons highlight the importance of assessing the experiences of all parties to large-scale ethnopolitical conflict," according to an article the group recently published in Child Development.

Preliminary results have been reported in other professional journals including Clinical Child and Family Psychology Review and the Journal of Clinical Child and Adolescent Psychology.

"We know that there's a contagion of violence," Dubow said. "When there is ethnic and political violence in a country, there also tend to be increases in family, school and community violence. The higher-level violence seems to legitimize it in more intimate contexts. We've seen higher levels of domestic violence among post-war survivors in Sierra Leone, for example."

However, even given all that, the team has found a surprising number of children - by far the majority, in fact - who do not exhibit aggression despite being exposed to ethnic and political violence. What is happening to prevent them from internalizing what they see around them?

So far, the research seems to show that factors such as experiencing "positive" parenting that utilizes nonviolent discipline, having parents who are not depressed or mentally ill, and having a high level of self-esteem can protect a child from suffering from post-traumatic stress symptoms.

What is not clear in every case is which comes first; for instance, do children have higher self-esteem because they are not traumatized by the violence or is there some innate quality of resilience at work?

The study has sought to unravel relevant threads including how what children see and learn through their social environment affects the development of their sense of self and identity and thus their behavior and interaction with the world and the respective impact of violence in more external versus more intimate contexts.

"In this next wave of interviews, we'll be looking at biological factors for the first time and doing clinical diagnoses," Dubow said. The children's response to viewing violence will be measured by the levels of cortisol, a stress hormone, and sweat they produce in reaction to a violent video clip.

"We'll be looking at whether they are desensitized or highly sensitized through exposure to violence," Dubow said.

The negative effect of so much violence does seem to be cumulative. "Will those who were exposed to more violence in the first two years be more aggressive in the last year of the study?" Dubow asked. "And will these youth become physiologically desensitized to the violence?" The group has already found that the more contexts in which children experience violence - domestic, school, community - the more aggressive they may become or the more likely to experience post-traumatic stress.

Of the roughly 1,500 children surveyed, the Palestinian children were exposed to the most violence, followed by Israeli Jews and last by Israeli Arabs. The team speculates that the lower levels among the latter group may be explained by the fact that the violence they witnessed was not directed at them but at their Jewish counterparts. The group has also found that the Palestinian youth report the highest levels of exposure to ethnic-political violence, and also the highest levels of post-traumatic stress symptoms.

As governments around the world, including the United States, become concerned about a future in which a generation of children has grown up with violence, they have looked to psychologists for help.

The problem is not confined to other countries outside the U.S. "The events of Sept. 11, 2001, made it clear that the U.S. is not immune to extreme ethnic-political violence," the team wrote in Child Development.

In addition, "Many residents of the United States are also refugees or immigrants victimized by ethnic-political violence." In 2003 alone, the U.S. accepted a quarter-million refugees, they pointed out.

Dubow and his team responded to a 2004 call for research from the National Institutes of Health into the effects of violence on child development. Since their proposal was funded in 2006, they have traveled back and forth between the respective countries, translated the interviews into English, Arabic and Hebrew, and shared their findings. The National Center for Child and Human Development has organized events where all could present their findings.

"Research informs practice," Dubow noted. Since conflicts do not seem to be abating, the team is hopeful that its work will help guide mental health agencies in the Middle East and elsewhere to develop successful intervention programs.