Mental health of Palestinians
The findings in the below studies need to be considered
with caution due to weaknesses in study design, such as
the use of self-developed and unverified questionnaires
and measurement tools that are in need of further validation.
For example, Espie et al. [36] undertook a study to
describe the occurrence and treatment of psychiatric disorders
in the Palestinian populations of the Nablus district
in the West Bank. From 2005 to 2008, 1369 patients
were clinically assessed using a semi-structured interview
based on DSM-IV-TR criteria. Among 1254 patients,
15.3 % reported depression, 17.3 % anxiety disorder
(other than PTSD or acute stress disorder), and 23.2 %
post-traumatic stress disorder [PTSD]. Among children
≤15 years old, factors significantly associated with PTSD
included being witness to physical abuse or murder,
receiving threats, and property destruction or loss.
Dimitry [37] systematically reviewed the literature on
the mental health of children and adolescents living in
areas of armed conflict in the Middle East which include
Palestine. PubMed was searched and papers were identified
using specific inclusion criteria. The main findings
were that children and adolescents living in these conflict
zones are exposed to high levels of traumatic experiences.
Numbers of conflict-related traumatic experiences correlate
positively with prevalence of mental, behavioural
and emotional problems. Prevalence of post-traumatic
stress disorder in Palestinian children and adolescents is
estimated to be 23–70 %. These findings bring to light the
pressing need to provide children and adolescents living
in conflict areas with help.
Giacaman et al. [38] conducted a survey of Palestinian
adolescents in school in order to investigate collective
and individual exposures to violence and its negative
effect on adolescents’ mental health. A representative
sample of 3415 students of 10th and 11th grades from the
Ramallah District of the West Bank participated in the
survey. The primary independent variables were scales
of individual and collective exposures to trauma/violence
(ETV) by the Israeli military and settlers. Outcome measures
were constructed and included a binary measure of
depressive-like states, and somatic scales. The level of
exposure to trauma/violence was very high. For example,
80 % had seen shootings, 28 % had seen a stranger killed,
11 % had seen a friend or neighbour killed, and 54 % of
boys had experienced body searches. In addition, 10.4 %
of the participants had a depressive like state, 14.1 %
emotional difficulties and 10.3 % somatic disorders. The
findings confirmed that both collective and individual
ETV independently affected the mental health of participants.
The results of this study emphasize the importance
of the concept of collectively in analysing violent