Mental Suffering in Protracted Political Conflict: Feeling Broken or Destroyed
- PMID: 27232335
- PMCID: PMC4883798
- DOI: 10.1371/journal.pone.0156216
Mental Suffering in Protracted Political Conflict: Feeling Broken or Destroyed
Abstract
Purpose: This mixed-methods exploratory study identified and then developed and validated a quantitative measure of a new construct of mental suffering in the occupied Palestinian territory: feeling broken or destroyed.
Methods: Group interviews were conducted in 2011 with 68 Palestinians, most aged 30-40, in the West Bank, East Jerusalem, and the Gaza Strip to discern local definitions of functioning. Interview participants articulated of a type of suffering not captured in existing mental health instruments used in regions of political conflict. In contrast to the specific difficulties measured by depression and PTSD (sleep, appetite, energy, flashbacks, avoidance, etc.), participants elaborated a more existential form of mental suffering: feeling that one's spirit, morale and/or future was broken or destroyed, and emotional and psychological exhaustion. Participants articulated these feelings when describing the rigors of the political and economic contexts in which they live. We wrote survey items to capture these sentiments and administered these items-along with standard survey measures of mental health-to a representative sample of 1,778 32-43 year olds in the occupied Palestinian territory. The same survey questions also were administered to a representative subsample (n = 508) six months earlier, providing repeated measures of the construct.
Results: Across samples and time, the feeling broken or destroyed scale: 1) comprised a separate factor in exploratory factor analyses, 2) had high inter-item consistency, 3) was reported by both genders and in all regions, 4) showed discriminate validity via moderate correlations with measures of feelings of depression and trauma-related stress, and 5) was more commonly experienced than either feelings of depression or trauma-related stress.
Conclusions: Feeling broken or destroyed can be reliably measured and distinguished from conventional measures of mental health. Such locally grounded and contextualized measures should be identified and included in assessments of the full impact of protracted political conflict on functioning.
Conflict of interest statement
Similar articles
-
Human insecurity, chronic economic constraints and health in the occupied Palestinian territory.Glob Public Health. 2014;9(5):495-515. doi: 10.1080/17441692.2014.903427. Epub 2014 Apr 25. Glob Public Health. 2014. PMID: 24766078
-
Long-term exposure to political violence: The particular injury of persistent humiliation.Soc Sci Med. 2016 May;156:154-66. doi: 10.1016/j.socscimed.2016.03.011. Epub 2016 Mar 11. Soc Sci Med. 2016. PMID: 27039017
-
Exposure to prolonged socio-political conflict and the risk of PTSD and depression among Palestinians.Psychiatry. 2010 Fall;73(3):219-31. doi: 10.1521/psyc.2010.73.3.219. Psychiatry. 2010. PMID: 20843212
-
Psychological Aspects of the Israeli-Palestinian Conflict: A Systematic Review.Trauma Violence Abuse. 2017 Jul;18(3):322-338. doi: 10.1177/1524838015613774. Epub 2015 Oct 27. Trauma Violence Abuse. 2017. PMID: 26511933
-
Prevalence of post-traumatic stress disorder among Palestinian children and adolescents exposed to political violence: A systematic review and meta-analysis.PLoS One. 2021 Aug 26;16(8):e0256426. doi: 10.1371/journal.pone.0256426. eCollection 2021. PLoS One. 2021. PMID: 34437595 Free PMC article.
Cited by
-
Refugees' Agency: On Resistance, Resilience, and Resources.Int J Environ Res Public Health. 2022 Jan 12;19(2):806. doi: 10.3390/ijerph19020806. Int J Environ Res Public Health. 2022. PMID: 35055628 Free PMC article.
-
'Madness' after the war in Bosnia and Herzegovina - challenging dominant understandings of distress.Health (London). 2024 Mar;28(2):216-234. doi: 10.1177/13634593221139717. Epub 2022 Dec 7. Health (London). 2024. PMID: 36476072 Free PMC article.
-
War-related quality of life is associated with depressive symptoms and hopelessness among Palestinians: sense of belonging and resilience as mediating variables.Glob Ment Health (Camb). 2022 Oct 17;9:483-490. doi: 10.1017/gmh.2022.52. eCollection 2022. Glob Ment Health (Camb). 2022. PMID: 36618748 Free PMC article.
-
The association between posttraumatic stress symptoms and suicidal ideations among Palestinians: The mediating role of spirituality, social support and mindfulness.Glob Ment Health (Camb). 2023 Aug 7;10:e48. doi: 10.1017/gmh.2023.41. eCollection 2023. Glob Ment Health (Camb). 2023. PMID: 37854392 Free PMC article.
-
'We are all children of war': a qualitative inquiry into parenting following adolescents' recent traumatic exposure in a multiple crisis setting in Beirut, Lebanon.Eur J Psychotraumatol. 2024;15(1):2382650. doi: 10.1080/20008066.2024.2382650. Epub 2024 Aug 8. Eur J Psychotraumatol. 2024. PMID: 39113651 Free PMC article.
References
-
- Harbom L, Wallensteen P. Armed conflicts, 1946–2009. J Peace Res. 2010; 47: 501–509. 10.1177/0022343310376887 - DOI
-
- Cloke K. Mediating Evil, War, and Terrorism: The Politics of Conflict In: Burgess G, Burgess H, editors. Beyond Intractability. Boulder, CO: Conflict Information Consortium, University of Colorado, Boulder; 2005. Available: http://www.beyondintractability.org/essay/mediating-evil. Accessed 8 September 2015.
-
- Barber BK, Schluterman JM. An overview of the empirical literature on adolescents and political violence In Barber BK, editor. Adolescents and war: How youth deal with political violence. New York, NY: Oxford University Press; 2009. pp. 35–61.
-
- Barber BK. Research on youth and political conflict: Where is the politics? Where are the youth? Child Dev Perspect. 2014; 8: 125–130. 10.1111/cdep.12074 - DOI
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical