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Clinical Child Psychology and Psychiatry
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Mother-Child Expression of Psychological Distress in War Trauma

Samir Qouta

Gaza Community Mental Health Programme, Gaza City, Palestine

Raija-Leena Punamäki

University of Tampere, Helsinki, Finland, raija-leena.punamaki{at}uta.fi

Eyad El Sarraj

Gaza Community Mental Health Programme, Gaza City, Palestine

The aims of this study were, first, to examine how exposure to war trauma, maternal neuroticism and psychological distress are associated with child psychological distress, and, second, whether good maternal mental health and low neuroticism can moderate the negative impact of war trauma on child mental health. Third, we examined whether mother-child dyads’ psychological distress was dependent on who was the main war trauma victim in the family: the mother, the child or both. Fourth, we tested whether mother-child dyads express similar or different symptoms. The sample consists of 121 Palestinian children (aged 6-16 years; 45% girls and 55% boys), and their mothers (aged 21-55 years) living under conditions of military violence and war in Gaza. Child psychological distress was measured using the CPTS-RI (child-reported) and Rutter Parent Questionnaire (mother-reported), and mothers’ mental health was measured using the SCL-90-R. The results failed to show any moderating effect of good maternal mental health or low neuroticism in protecting child mental health from negative impact of war trauma. The main effects showed that the child’s young age, war trauma and poor maternal mental health were associated with children’s internalizing symptoms, and male gender, maternal neuroticism and poor mental health with children’s externalizing symptoms. There were gender differences in psychological distress depending on whether the mother, the child or both were the main war trauma victim in the family: girls showed particularly high psychological distress when their mothers were exposed to war trauma (family systems model), whereas boys showed high levels of distress when both they themselves and their mothers were exposed to war trauma (accumulative impact model). Similarities were confirmed in dyadic symptom expression: significant associations were found between mothers’ depressive and children’s internalizing symptoms, and between mothers’ hostile and children’s externalizing symptoms.

Key Words: mental health • mother-child dyads • Palestinians • war trauma

Clinical Child Psychology and Psychiatry, Vol. 10, No. 2, 135-156 (2005)
DOI: 10.1177/1359104505051208


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