Impact of chronic war trauma exposure on PTSD diagnosis from 2006 -2021: a longitudinal study in Palestine

Background
Trauma and Post-Traumatic Stress Disorders (PTSD) are a common result of the occurrence of natural and man-made disasters, the refugees are one of these traumas in which some resulted from political conficts. Today, Palestinians are the largest refugee population in the world after the Nakba in 1948. This study aims to discover the impact of chronic war traumas on PTSD diagnosis and symptoms from 2006 to 2021. The current study is a follow-up of 607 adolescents and adults, aged between 10–30 years of which are also those children who participated in the 2006 study. This research used an adapted PTSD scale (PTSD-SRII, 33 items) from a validated original questionnaire developed by Altawil in 2008 to measure PTSD based on symptoms reported in DSM-IV and ICD-10.

Results
The main fndings show at least 97.2% of participants had experienced at least 6 traumatic experiences up to the year 2006 and 100% of the participants were exposed to traumas in 2021. This study found four categories of responses to chronic war trauma: (a) Acute group (n = 321, 52.9%) shows high PTSD symptoms in 2006 and in 2021; (b) Remitters group (n = 54, 8.9%) shows high PTSD symptoms in 2006 but did not show signifcant PTSD symptoms in 2021; (c) Delayed group (n = 204, 33.6%) shows no PTSD symptoms in 2006 but showed signifcant PTSD symp‑ toms in 2021; (d) Resilient group (n = 28, 4.6%) had no PTSD symptoms in 2006 and did not show PTSD symptoms in 2021.

Conclusions
The authors conclude that Palestinian children, youth, adults and their families in the Gaza Strip are continually at a huge risk of developing PTSD and other psychological problems. This means that Palestinians will suffer for a long time from PTSD, which should be called Chronic Traumatic Stress Disorder (CTSD) rather than PTSD. This PTSD or CTSD cannot be changed unless the root of the problem is solved by ending the 74 years of living under occupation.