Relational trauma in times of political violence: Continuous versus past traumatic stress

Children's exposure to political violence has been found to be associated with posttraumatic symptoms and emotional and behavioral problems. However, little distinction has been made between the impact of exposure to continuous political violence and exposure to past political violence. This study in Israel compared a sample of preschool children and mothers (N = 85) with ongoing and recurring exposure to missile and rocket attacks ("Continuous sample") to a sample (N = 177) from a recent time-limited war ("Past sample"). Mothers completed self-report questionnaires, including exposure to both political violence and other traumatic events, the Posttraumatic Diagnostic Scale (PDS), and a Depression Scale (CES-D). Mothers also reported on the child's exposure to political violence and other traumatic events, posttraumatic symptoms, and the Child Behavior Checklist (CBCL). The results indicate the severe consequences of living in the face of ongoing traumatic stress. Children and mothers from the continuous exposure sample had more posttraumatic distress and their children had higher behavior problem scores compared with those in the past exposure sample, supporting the allostatic load hypothesis that cumulative stress exacts a heavier toll. Because the mother- child relationship is challenged in situations of exposure to violence, we compared relational trauma (measured by co-occurrence of posttraumatic distress in both mother and child) and found, as hypothesized, that relational trauma was more prevalent in the Continuous sample than in the Past sample.