TITLE:
Comorbidity of post traumatic stress disorder, attention deficit with hyperactivity, conduct, and oppositional defiant disorder in Palestinian children affected by war on Gaza
AUTHORS:
Abdelaziz M. Thabet, Ahmad Abu Tawahina, Eyad El Sarraj, David Henely, Henrick Pelleick, Panos Vostanis
KEYWORDS:
War on Gaza; Comorbidity; Post Traumatic Stress Disorder; Attention Deficit with Hyperactivity; Conduct; Oppositional Defiant Disorder
JOURNAL NAME:
Health,
Vol.5 No.6,
June
11,
2013
ABSTRACT: Aim: The aim of this study was to
investigate the impact of war on children and comorbidity of post traumatic
stress disorder, attention deficit with hyperactivity, conduct, and
oppositional defiant disorder in Palestinian children. Methods: The study was conducted in the entire Gaza Strip 6 months
after the end of the war on Gaza that lasted for 23 days. The study sample included
410 children aged 6 to 17 years. Children completed measures of experience of
traumatic events (Gaza Traumatic Checklist-War on Gaza), post traumatic stress
disorder index, attention deficit with hyperactivity scale for parents and
self, conduct disorder scale, and oppositional defiant disorder. Results: Palestinians children investigated 6
months after the war on Gaza still reported traumatic experiences: 94.6% heard
the sonic sounds of the jet fighters, 91.7% heard shelling of the area by
artillery, 92% watched mutilated bodies on television, 80% were deprived from
water or electricity during the war, 50.7% said they left home for safer place.
Using Diagnostic Manual of Mental Disorders-IV (DSM-IV) criteria for post
traumatic stress disorder, 25.1% of children reported no psychological reactions,
25.9% of children reported one criteria, 39.3% of children reported partial
post traumatic stress disorder and 9.8% of children reported full criteria for
post traumatic stress disorder. According to the parents’
report, the results showed 31.3% of children met the
criteria for inattentive type, 36.3% of children were impulsive and 29% met
criteria for combined type. According to the children’s report, the results
showed 28.8% of children met the criteria for inattentive type, 37.3%
of children were impulsive and 28.3% met criteria for combined type. Using
DSM-IV diagnostic criteria of conduct disorder and oppositional defiant
disorder, the study showed that 38.1% of parents reported conduct disorder in
their children and 46.3% reported oppositional defiant disorder. While 39.3% of
children themselves reported conduct disorder and 44% of them reported
oppositional defiant disorder. The study showed that 5.1% of children had comorbidity of post traumatic stress disorder
and attention deficit disorder, 4.4% had comorbidity of post traumatic stress
disorder and impulsivity-hyperactivity disorder, and 4.4% had comorbidity of
post traumatic stress disorder and attention deficit with hyperactivity combined type. Also, 4.6% of children had comorbidity of conduct and
post traumatic stress disorder and 6.1% had comorbidity of oppositional defiant
disorder and post traumatic stress disorder. Conclusions: This study revealed that children living in areas of
conflict and war are the main group at risk of developing post traumatic
stress disorder and other behavioral problems including attention deficit
with hyperactivity, conduct, and oppositional defiant disorder, and the internationallaws
must protect the civilians during the conflict, establishing safe havens
for children and their families to decrease the effect of war on children.