Positive emotions and life satisfaction in Palestinian children growing up amid political and military violence: a pilot study

Abstract

Background Exposure to war has mostly negative psychological effects on children, according to the results of several studies undertaken in the occupied Palestinian territory (oPt). Political and military violence has been sustained in the oPt since the intifada (uprising) of 2000; according to the results of a study in the West Bank, the frequency of mild post-traumatic stress disorder was 73% (41% medium and severe) of 174 people. Additionally, direct and indirect exposure to trauma is associated with disruption of sleep and concentration, somatic symptom disorders, impulsive behaviours, and depression. Data for the resilience of Palestinian children or how they cope positively with trauma have been reported in few studies; in a study in the Gaza Strip, 21% of 640 children were judged resilient. We therefore assessed wellbeing in Palestinian children exposed to war in the oPt. Methods In this pilot study, wellbeing was assessed in 74 Palestinian children (aged 7–15 years, 43 boys and 31 girls) living in a refugee camp in Tulkarm, West Bank, with questionnaires administered during a summer camp run by a non-governmental organisation in 2010. Children were selected after meetings with their families and in accord with the recommendations of local institutions that had been in charge of the children during the school year. The children answered an open question What makes you feel good? and completed three self-report assessments. Positive and negative affect schedule-children (PANAS-C) was used to assess the intensity of positive and negative emotions; multidimensional students' life satisfaction scale for schoolchildren's contentedness with five domains (self, family, friends, school, and environment); and faces scale for self-perceived happiness. The qualitative data were analysed for thematic content, and self-report measures were analysed quantitatively (correlation and linear regression). The research was undertaken in accord with the ethics committee guidelines of the University of Milano-Bicocca, Milan, Italy. Parents provided verbal informed consent; the children could participate or withdraw from the study of their own volition and decline to answer any of the questions. Findings The children had healthy measurements for wellbeing in terms of positive emotions and life satisfaction, with 64 (86%) of 74 obtaining almost maximum scores for happiness. Personal factors (Spearman's rank correlation coefficient; p=0) and social factors—family (p=0·014) and friends (p=0·006)—were positively correlated with life satisfaction. The linear regression analyses showed that positive emotions significantly contributed to the contentedness of the children (p=0·015). No significant differences were noted in wellbeing as a function of sex. However, girls had greater ability than did boys in benefiting from both social relationships and personal resources. Girls had significantly greater satisfaction with both their friends and their lives overall, particularly with respect to family, educational, religious, and social dimensions. Significant differences were noted with respect to age in the PANAS-C scores for overall negative affect (Student's t test for two independent samples; p=0·1) and for the anxiety or fear subscale (p=0·024 or p=0·094, respectively). Specifically, older children (aged 11–15 years) obtained higher scores on both the negative emotion and anxiety or fear scales. Younger children (aged 7–10 years) had slightly but significantly higher scores for self-perceived happiness than did older children (p=0·043). Interpretation Our results, although exploratory, provide valuable guidance for clinical work, particularly with respect to the importance of social networks and the effects that they have on positive emotions in Palestinian children and adolescents. Clinical interventions should be targeted at strengthening aspects of positive functioning, rather than at correcting behaviours or cognitive and emotional states that are unequivocally thought to be maladaptive. Funding FSE-Dote Ricercatore, a programme of the Lombardy Region, Milan, Italy.