Terrorism/War: Summary and Recommendations of break out group.

 Gaps in Research 

Definitions: Terrorism: • Unlawful use of threat or force against an individual/government for political or other end with the intent/purpose of imposing ones will (DOD). • Illegitimate use of force to achieve political, social or religious objectives, when innocent people are targeted (FBI). ƒ Played out before a larger audience ƒ Non-war atmosphere, unexpected, occurs in a safe place ƒ Asymmetrical warfare, recurrent attacks ƒ Groups who don’t have other means to get their message across ƒ Usually many more civilians involved War: • Planned and executed usually by governments against other governments or countries in self defense or revenge • Usually have a beginning and an end • Civilians affected secondarily (collateral damage, not primary target) 

QUESTIONS: • Is there a difference in the psychological consequences in a war situation versus a terrorist attack? • Is there a difference in emotional consequences if attack occurs when children are in a safe place War & Terrorism Peace interrupted by war, or war interrupted by peace (e.g., Middle East) 

QUESTIONS: • Chronic vs Acute: are the consequences different? • What is the role of anticipatory preparedness? Does it help or harm? • What are the effects of “chronic preparedness,” whether violent acts happen or not?

 Prevalence and Nature of Emotional Consequences

 QUESTIONS: • What does the prevalence of harmful consequences depend on? • What are the risk and protective factors? • Should we develop a “Risk Model” or “Vulnerability Scale? • What does the phenotype look like? • What are the various variables that affect the phenotype ƒ Culture ƒ Religious belief systems ƒ Developmental stages of the child ƒ Societal status of the victims

Secondary Effects of Terrorism 

Teenagers not going to mall

Ripple effect 

Cyber-terrorism.

Effect on the economy Parents losing their jobs

QUESTION: Need to think about it as a public health crisis and respond accordingly? 

In What Domains Do We Need To Examine The Effects?

 Neurons to neighborhoods 

When does adaptation to a stress become maladaptive? Allostatic load? 

• Physiological • Neurobiological • Psychosomatic (immune system, diseases etc.) • Psychological • Impairment of functioning in the absence of a Diagnostic and Statistical Manual (DSM) diagnosis ƒ Changes in behavior ƒ Family interactions and structure ƒ Societal interactions ƒ Effects on learning ƒ Neonatal and peri-natal impact on the child 

Developmental Approach to Understanding?

 Need to take a developmental approach - neuro-cognitive changes at different ages and the relationship on the development of neuro-psychiatric symptoms Are their gender differences? Effects of bereavement - early parent death and the effects depending on age (e.g., Stolz has shown that bonding of the father with a child born while the father is away at war is different than the bonding he has with his other children) 

Cultural Differences

“It is meant to be” 

“It is Karma” 

“God wanted it this way” 

 QUESTION: When does this type of coping become unhelpful and maladpative? Does it work in the short run? 

Longitudinal Course of the Evolution of Psychiatric Morbidity and Co-Morbidity? 

Is depression always preceded by anxiety? 

 If intervention is done in a timely fashion, can one postpone or even prevent the development of depression? Is depression related to the maternal response to trauma? 

Other Factors to Consider 

Refugee or not?

 Leaves the situation or not?

 Split families?

 Immigration?

Public Health Model 

Large majority need reassurance Interventions get more specific and intense as one moves up to the tip How does one identify those at greatest risk when an entire population is affected? 

Interventions - What Works? 

Available models of interventions following disasters generally don’t focus on children.

What are the effects of activities aimed at disaster preparedness in children? • Psychological/behavioral • Learning • Phsysiological/neurobiological 

Understanding coping and adaptation skills and strategies 

How does one define resilience and how do we promote it? What should the content of intervention modules be? Do we want to think about the modules that have already been developed to help youngsters after a natural disaster?

Do Modular Interventions in School Work?

 Immediate response that can take place in the schools Should schools be closed? Prepositioned supplies or resources for the first 24 to 48 hrs. in school (Level of preparedness). The National Education Association (NEA) has developed intervention models for the immediate response

 SHOULD RESEARCH INITIATIVES BE DEVELOPED THAT FORCE COLLABORATION BETWEEN THE SCHOOLS, MENTAL HEALTH & OTHER FIRST RESPONDERS? 

Value of a Demonstration Project?

 What Works? 

Family interventions? Extended family involvement? Parenting techniques? Single interventions strategies vs. ongoing? School interventions?  

Traumatic Reminders? 

Do we need to have anniversaries? What helps? What hurts even more? Should there be memorials?

 Challenges Faced by Researchers 

Need empathy but neutrality at the same time Expectations of the “subject” International research during war or an act of terrorism presents other ethical dilemmas 

Helping the Helpers 

Effect on children of helpers Effect of “helpers” on their own children. Are they at more risk? Evidence of increased levels of substance abuse, domestic violence and suicide

 Intergenerational Violence

 How do we study it and are there prevention strategies? 

Preventive Preparedness

 Gives people a sense of control vs. worrying them without giving them a way to prepare and react What effect does this have on society, parents, and children? 

Quarantine? 

What are the effects of quarantine on children and their families in a situation of bioterrorism? What are the psychological risks and benefits of such an approach? 


Workshop on Children Exposed to Violence,

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