Cross-Cultural Comparison of Community Violence Exposure & Post-Traumatic Stress Disorder In Adolescents In Israel

Background and Purpose: Youth community violence exposure (CVE) includes victimization, perpetration, witnessing, or possessing knowledge of others' victimization in community settings (Guterman & Cameron, 1998). Youth CVE has been shown to be a problem in many national contexts (e.g. Ward et al., 2001; Vermeiren et al., 2003) and is linked to negative internalizing and externalizing symptoms (e.g. depression and anxiety) and mental disorders (e.g. post-traumatic stress disorder, PTSD) (Buka et al., 2001). Recent research shows that rates of CVE and mental health sequelae differ by race/ethnicity (e.g. Chen, 2010), yet cross-national and cross-cultural comparisons of youth CVE and PTSD are lacking. This study examines the relationship between CVE and PTSD cross-culturally, while controlling for socio-demographic variables (e.g. age, gender, father education), in sample of Arab and Jewish adolescents in Israel.

Methods: In school surveys were completed by 1573 Arab (n = 751) and Jewish (n = 822) high school students in their first language (N=1835). Surveys included an adapted version of the My Exposure to Violence Scale (MyETV) measuring self-reported life-time exposure and exposure over the last year to community violence, and the UCLA PTSD Index assessing PTSD symptoms. To compare rates of CVE and PTSD scores cross-culturally, chi-square and one-way ANOVAs analyses were conducted. To explore the strengths of bivariate relationships between CVE, PTSD, and socio-demographic variables for Arab and Jewish adolescences, Pearson-r correlations were conducted. To assess ethnicity as a predictor of PTSD while controlling for socio-demographic factors and CVE, multiple ordinary least-squares regression equations were analyzed for 1) the total sample, 2) the Arab sub-sample, and the 3) Jewish sub-sample.

Results: High rates of CVE were reported: 93% of Jewish and 87% of Arab youth report witnessing CVE and 52% of Arab and 39% of Jewish youth report victimization through CVE. Multiple regression analyses reveal that race/ethnicity significantly predicts PTSD when controlling for socio-demographic variables and CVE. Victimization through CVE accounts for a greater amount of the explained variance in PTSD symptoms for Jewish adolescents (9%) than Arab adolescents (4%). When victimization is not included in the regression model, witnessing CVE is a significant predictor for Jewish, but not Arab adolescents (p<.01). Also, gender is a significant predictor of PTSD for Arab, but not Jewish adolescents (p<.05).

Conclusions and Implications: The high rates of CVE and PTSD endorsed by adolescents in Israel and variations observed cross-culturally suggest the need for developing and evaluating prevention strategies that target CVE and psychological sequelae for Jewish and Arab adolescents. The observed differences in rates of PTSD as related to witnessing and victimization through CVE between Arab and Jewish adolescents suggest that psychological responses may differ between to the two groups. Understanding cross-cultural differences in youth CVE and psychosocial responses provides an opportunity to expand on CVE traditional approaches (e.g. age-based or individual treatment) to prevention models that are driven by cultural-specific beliefs about CVE and tailored for communities, schools, and families.