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A 2 (threat, neutral) by 2 (efficacy, no efficacy) between subject experiment testing hypothesis about the effects of threat appeals of climate change mitigation donations.

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The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification.

We examined the effectiveness of a psychosocial intervention in reducing mental health symptoms among war-affected children, and the role of peritraumatic dissociation in moderating the intervention impact on posttraumatic stress symptoms (PTSS). School classes were randomized into intervention (n = 242) and waitlist control (n = 240) conditions in Gaza, Palestine. The intervention group participated in 16 extracurriculum sessions of teaching recovery techniques (TRT) and the controls received normal school-provided support. Participants were 10-to 13-year-old Palestinian girls (49.4%) and boys (50.6%). Data on PTSS, depressive symptoms, and psychological distress were collected at baseline (T1), postintervention (T2), and 6-month follow-up (T3). Peritraumatic dissociation was assessed only at baseline. Regression analyses that took regression to the mean and cluster sampling into account were applied. The results on intervention effectiveness were specific to gender and peritraumatic dissociation. At T2, the intervention significantly reduced the proportion of clinical PTSS among boys, and both the symptom level (R 2 = .24), and proportion of clinical PTSS among girls who had a low level of peritraumatic dissociation. The results have implications for risk-specific tailoring of psychosocial interventions in war conditions.

Effective emotion regulation (ER) is expected to protect mental health in traumatic stress. We first analysed the protective (moderator) function of different ER strategies and the associations between ER and mental health. Second, we tested gender differences in the protective function of ER and the associations between ER strategies and mental health. Participants were 482 Palestinian children (girls 49.4%; 10–13 years, M = 11.29, SD = .68) whose ER was assessed by the Emotion Regulation Questionnaire and mental health by post‐traumatic stress (Children's Impact Event Scale), depressive, and psychological distress (Strengths and Difficulties Questionnaire) symptoms, and by psychosocial well‐being (Mental Health Continuum‐Short Form). War trauma involved 42 events. Results showed, first, that none of the ER strategies could protect a child's mental health from negative impact of war trauma, but self …

Tutkimuksessa analysoitiin sodan kokeneiden gazalaisten lasten mielenterveyteen vaikuttavia tekijöitä. Otos koostui 482 10–13-vuotiaasta koululaisesta, joista puolet arvottiin mielenterveysongelmia ehkäisemään pyrkivään interventioon. Interventio perustui Teaching Recovery Techniques (TRT) –käsikirjaan ja se järjestettiin koululuokissa. Kaikki lapset vastasivat kyselyihin kolmena ajankohtana: kolme, viisi, ja yksitoista kuukautta sodan jälkeen vuonna 2009. Lasten vanhemmat vastasivat kyselyyn 11 kuukautta sodan jälkeen. Kognitiiviset teoriat traumaperäisestä stressihäiriöstä (engl. posttraumatic stress disorder, PTSD) ovat painottaneet trauman jälkeisten kielteisten ajatusten tai kognitioiden (engl. posttraumatic cognitions, PTCs) keskeistä roolia kroonisten traumaperäisten mielenterveysongelmien kehittymisesssä. Teorioiden mukaan kielteiset arviot itsestä, oireista, ja maailmasta johtavat epätarkoituksenmukaisten selviytymiskeinojen käyttämiseen ja uhan tunteisiin, jotka pitävät yllä traumaperäisiä stressioireita. Tässä työssä estimoitiin trauman jälkeisten kognitioiden ja traumaperäisten stressioireiden suhteellista ennustevoimaa toisiinsa ristiviivemallissa ja testattiin välittävätkö trauman jälkeiset kognitiot varhaisten traumaperäisten stressioirieden kehitystä kroonisiksi traumaperäisiksi stressioireiksi (Artikkeli I). Tulokset tukivat käsitystä trauman jälkeisten kognitioiden merkittävyydestä. Trauman jälkeiset kognitiot ennustivat myöhempiä traumaperäisiä stressioireita. Trauman jälkeiset kognitiot eivät välittäneet varhaisten traumaperäisten stressioireiden kehitystä kroonisiksi, koska traumaperäiset stressioireet eivät ennustaneet traumaperäisiä kognitioita. Tuloksen syy oli mahdollisesti se, että traumaperäiset stressioireet olivat vaikuttaneet kognitioihin jo ennen ensimmäistä mittausajankohtaa kolme kuukautta sodan jälkeen. Traumaperäisilla stressioireille on monia riskitekijöitä trauman jälkeisten kognitioiden lisäksi. Työssä testattiin hypoteesia, että traumaperäisten stressioireiden riskitekijät ovat myös trauman jälkeisten kognitioiden riskitekijöitä ja että trauman jälkeiset kognitiot välittävät näiden riskitekijöiden vaikutuksia traumaperäisiin stressioireisiin (Artikkeli II). Tulosten mukaan riskitekijät, jotka liittyvät lasten suhteisiin ikätovereihinsa (yksinäisyys tai epäsuosio), sisaruksiinsa (konflikti) ja vanhempiinsa (psykologinen kaltoinkohtelu), ennustivat trauman jälkeisiä kognitioita ja—kognitioiden kautta—traumaperäisiä stressioireita. Vanhempien psykologisen kaltoinkohtelun on arveltu olevan evolutionaarisesti adaptationaalista sotaisassa ympäristössä. Hypoteesien mukaisia tuloksia saatiin isien osalta (Artikkeli III). Vastoin odotuksia, äitien sotiin liittyvät kokemukset kuolemanvaarasta olivat yhteydessä vähäisempään lasten raportoimaan psykologisen kaltoinkohtelun kokemiseen. Kognitiivis-behavioraalisen ryhmäintervention tehokkuutta tutkittiin satunnaistetussa ja kontrolloidussa kokeessa (Artikkeli IV). Interventiolla saattoi olla hetkellinen vaikutus vähäistä traumanaikaista dissosiaatiota raportoivien tyttöjen traumaperäisiin stressioireisiin. Interventiolla ei ollut vaikutusta kognitioihin eikä interventiolla ollut yhtään tilastollisesti merkitsevää vaikutusta mielenterveysongelmiin, jos useiden testien tekemisestä johtuva kohonnut todennäköisyys vääriin merkitseviin tuloksiin otettiin huomioon. Tulokset ja tutkimuskirjallisuus viittaavat siihen, että soden kokeneiden lasten negatiivisilla arvioilla on merkittävä rooli pitkäaikaisten mielenterveysongelmien kehittymisessä. Kognitioden kautta riskitekijät muuttuvat traumaperäisiksi stressioireiksi ja interventiot vähentävät oireita. This study analyzed potential mechanisms behind war-affected children’s mental health problems in Gaza, Palestine. The sample was 482 10–13 –year-old school children, half of whom were randomly selected to a mental health intervention based on Teaching Recovery Techniques (TRT) given in school classes. The children and their parents answered to questionnaires at three time points: three, five, and eleven months after a war in 2009. Cognitive theories of posttraumatic stress disorder have emphasized the pivotal role of negative thoughts or cognitions (posttraumatic cognitions, PTCs) in the development of chronic trauma-related mental health problems. Negative appraisals of oneself, symptoms, and the world are thought to lead to maladaptive coping strategies and feelings of threat which perpetuate posttraumatic stress symptoms and make them chronic. In the thesis, the role of PTCs in the development of chronic symptoms of posttraumatic stress (PTS symptoms; i.e. symptoms which are part of the diagnosis of posttraumatic stress disorder, PTSD) was analyzed by estimating the relative predictive power of PTCs and PTS symptoms on each other over time and by testing whether PTCs are the mediating mechanism through which early PTS symptoms develop into chronic PTS symptoms (Article I). The results confirmed the importance of negative cognitions which predict posttraumatic stress symptoms. Furthermore, PTCs was not a mechanism through which stress symptoms at three months develop into chronic ones because PTS symptoms did not predict PTCs. This result might have been observed because the stress symptoms had already influenced negative cognitions by three months after the war. In addition to PTCs, PTS symptoms among children have many risk factors. The hypothesis tested was that the risk factors of PTS symptoms would also be the risk factors of PTCs and the PTCs would mediate their effects on PTS symptoms (Article II). The results confirmed that risk factors related to children’s relationships with their peers (loneliness or unpopularity), siblings (conflict), and parents (psychological maltreatment) did predict PTCs and, via PTCs, PTS symptoms. Parental psychological maltreatment in turn has been hypothesized to be an evolutionarily adaptational response to parents’ own experiences of war. This was confirmed only among fathers (Article III). Contrary to expectations, mothers’ war-related life-threat was negatively associated with children’s reports of psychological maltreatment by their parents. The effectiveness of a cognitive-behavioral group intervention was studied (Article IV). The intervention might have had a temporary effect on PTS symptoms among girls with a low level of peritraumatic dissociation. However, additional analyses did not find an effect of the intervention on cognitions, and there were no significant effects of the intervention on PTS symptoms, either, if the probability of finding false significant results because of multiple tests was taken into account. The results and literature in general point to the importance of cognitive appraisals in the development of chronic mental health problems among war-affected children and others affected by traumatic stress. Cognitive appraisals appear to be a point where risk factors turn into posttraumatic stress symptoms and where interventions reduce the symptoms.

We examined the effectiveness of a psychosocial intervention in reducing mental health symptoms among war‐affected children, and the role of peritraumatic dissociation in moderating the intervention impact on posttraumatic stress symptoms (PTSS). School classes were randomized into intervention (n = 242) and waitlist control (n = 240) conditions in Gaza, Palestine. The intervention group participated in 16 extracurriculum sessions of teaching recovery techniques (TRT) and the controls received normal school‐provided support. Participants were 10‐ to 13‐year‐old Palestinian girls (49.4%) and boys (50.6%). Data on PTSS, depressive symptoms, and psychological distress were collected at baseline (T1), postintervention (T2), and 6‐month follow‐up (T3). Peritraumatic dissociation was assessed only at baseline. Regression analyses that took regression to the mean and cluster sampling into account were …