Alessandro Pepe

Psychometric Properties of IES-R, Short Arabic Version in Contexts of Military Violence

Objective: Professional social workers and emergency workers operating in war contexts may develop posttraumatic stress disorder (PTSD) following exposure to traumatic events. Impact of trauma must be accurately assessed by researchers via robust models of measurement. In this article, measurement models for the 13-item Children’s Revised Impact of Event scale (CRIES-13), Arabic version were assessed in an adult population operating in a war context. Method: A sample (N = 218) of in-service adult Palestinian helpers was evaluated using confirmatory factor analysis. Results: Findings supported adoption of a bidimensional model comprising two normally distributed measures labeled intrusion and avoidance as a quantitative screening tool for PTSD in contexts of military violence. Conclusion: The solid psychometric properties of CRIES in an adult population suggest its use as a short version of the Impact of Event scale–Revised (IES), Arabic version (IES-R-13).

Conceptualizing the well-being of helpers living and working in war-like conditions: A mixed- method approach

The aim of this study was to add to current understanding of the constituents of well-being amongst Palestinian helpers working in war-like conditions. Using a purposive sampling design, 23 semi-structured in-depth interviews were conducted with health professionals in two Palestinian cities. Quantitative Textual Analysis was carried out, adopting content-pattern analysis via cluster methods. Two ‘macro’ dimensions emerged: specifically, a first dimension termed personal well-being and a second termed political well-being. Our investigation into the complex construct of quality of life illustrates that contextually based evidence does indeed help to identify bunched structures containing local cultural values defining well-being.

Positive and Negative Affect in Children Living in Refugee Camps Assessing the Psychometric Proprieties and Factorial Invariance of the PANAS-C in the Gaza Strip

In the present study, we assessed the psychometric proprieties of the Positive and Negative Affect Scale–Child Version (PANAS-C) in a large sample of Palestinian children (N = 1,376) of different age ranges living in refugee camps. In particular, we used standard confirmatory factor analysis to test competing factor structures for the PANAS-C, with a view to developing a stable version of the instrument, suitable for speedy administration in applied and research settings in the contexts of military violence. Four alternative models of the PANAS-C were evaluated: unidimensional; two-dimensional with independent PA and NA scales and covariance of item-level errors unallowed; two-dimensional with dependent PA and NA scales and covariance of item-level errors unallowed; and two-dimensional with dependent PA and NA scales and covariance of item-level errors. The results of the statistical analysis supported a 20-item measurement model comprising the PANAS-C20 Arabic version for children. The items in this best fitting model loaded on two different and negatively correlated factors. These findings encourage full adoption of the PANAS-C20 as a tool for assessing both PA and NA in Palestinian children living in contexts of warfare.

Sense of Coherence as a Determinant of Psychological Well-Being Across Professional Groups of Aid Workers Exposed to War Trauma

The present study aims to test whether sense of coherence (SOC) acts as a determinant of positive psychological functioning in aid workers directly exposed to warfare. Specifically, we performed multiple regression analyses to compare different groups of aid workers in terms of the effects of SOC and cumulative trauma on their psychological distress. Palestinian helpers, both professional and non-professional (N = 159) completed three self-reported measures: the General Health questionnaire, Sense of Coherence Scale, and Impact of Events Scale. The findings bear out the predictive power of SOC and posttraumatic stress disorder (PTSD) in relation to mental health across different professional groups. In particular, volunteers without a specific professional profile, psychiatrists, medical doctors, and less markedly counselors seemed to protect their mental health through a SOC. Clinical implications and recommendations for training and supervision are discussed.

Quality of Life and Determinants of Parents’ School Satisfaction in War Contexts

The present mixed-method exploratory study aims at exploring how families’ perceptions of education are influenced by the availability of resources promoting well-being and the ability to cope with political and military violence. A convenience sample of 120 households selected in the Gaza Strip was administered using two self-reported instruments: WHOQOL-BREF (WHO Quality of Life-BREF) adapted to the Palestinian context, and items adapted from the Teacher Involvement of Parents (TIP) Questionnaire. The quantitative results showed interactions between different domains of quality of life—namely, basic needs (B = .361, p < .01) and psychological distress (B = .307, p < .05)—while perceptions of education had a statistically significant effect on school satisfaction. Three main themes emerged from the qualitative survey: economic constraints, constraints on the school environment, and issues with the curriculum. The ongoing disruption of general economic, environmental, health, and living conditions affects the domain of education, contributing to further undermining opportunities for improvements in subjective well-being and familial quality of life.

The Semantics of Freedom in Agoraphobic Patients: An Empirical Study

This study aimed to empirically test the clinical theory, common to constructivist and constructionist psychotherapeutic approaches, that the semantics of freedom (i.e., bipolar constructs regarding the dimension of meaning “free/constrained”) are psychologically linked to agoraphobia. Repertory grid technique was used to elicit constructs from 30 agoraphobic patients and from a matched control group of patients suffering from other psychological disorders, and the two sets of constructs were compared in terms of their semantic content. Results confirm the hypothesis, suggesting that freedom semantics seem to be prevalent in agoraphobia in terms of both frequency and importance. These results and their limitations are discussed in relation to their clinical applications and in light of the methodological issues arising from the study.

Modelling life satisfaction and adjustment to trauma in children exposed to ongoing military violence: An exploratory study in Palestine

Exposure to war and ongoing political violence increases mental health risks among children, especially in terms of posttraumatic stress disorder (PTSD), and depressive or somatic symptoms. However, an exclusive focus on negative functioning can lead to underestimating the coping abilities and natural potential for adjusting to trauma of war-affected children at different developmental phases. Using structural equation modelling, we tested the extent to which data gathered in a predominantly nonclinical sample of Palestinian children (N=1276) living in refugee camps supported a conceptual model in which the relationship between subjective wellbeing and the effects of trauma is mainly top-down in direction. The cross-sectional design adopted showed that feelings of life satisfaction contributed to better affect balance in children (aged 6-11 years), which in turn, mitigated the impact of traumatic events. These findings point up the importance of dimensions of subjective well-being in children involved in traumatic events and may inspire intervention and treatment focused on the ability to activate positive emotions as a crucial resource for dealing with traumatic reactions.

Self-Other Positioning in Obesity: A Pilot Study Using Repertory Grid Technique

Self-other positioning was investigated in a group of obese youths in order to empirically test the clinical hy- pothesis - based on the constructionist theory of Family Semantic Polarities - that obese people are affected by a negative self-perception and low self-esteem. Repertory grid technique was used with 30 participants (15 obese-overweight and 15 control) to elicit and compare their personal constructs and assess, via ad hoc measurement indices, the positions they as- signed to the self and significant others in relation to these constructs. The results confirmed the research hypotheses, with obese subjects displaying a tendency to position both self and others at the negative pole of bipolar constructs and report- ing greater self-ideal discrepancy. These findings and their limitations are discussed in relation to their clinical applica- tions and in light of the methodological issues arising from the study.

Posttraumatic growth is related to subjective well-being of aid workers exposed to cumulative trauma in Palestine

The present study examined how stress reactions after traumatic events influence subjective well-being (SWB) via the indirect effect of posttraumatic growth (PTG) in two samples of Palestinian professional helpers from the Gaza Strip and West Bank (n = 201). Using the General Health Questionnaire (GHQ-12) as a dependent measure of well-being, and PTGI-10, PANAS-20, WHO-5 BREF, and IES-13 questionnaires as independent variables, structural equation modelling (SEM) was used to examine whether: (a) cumulative trauma was negatively and directly related to subjective well-being; (b) levels of trauma were positively and directly related to posttraumatic growth; and (c) PTG was positively and directly related to subjective well-being. The findings suggest that posttraumatic growth contributes to mitigating and buffering (on the order of approximately 10%) the effect of trauma on subjective well-being. PTG seems to be a resource that can help aid workers deal with the consequences of stressful life events. Clinical implications and directions for supervision and training are discussed.

False-Belief Understanding and Language Ability Mediate the Relationship between Emotion Comprehension and Prosocial Orientation in Preschoolers

Emotion comprehension (EC) is known to be a key correlate and predictor of prosociality from early childhood. In the present study, we examined this relationship within the broad theoretical construct of social understanding which includes a number of socio-emotional skills, as well as cognitive and linguistic abilities. Theory of mind, especially false-belief understanding, has been found to be positively correlated with both EC and prosocial orientation. Similarly, language ability is known to play a key role in children’s socio-emotional development. The combined contribution of false-belief understanding and language to explaining the relationship between EC and prosociality has yet to be investigated. Thus, in the current study, we conducted an in-depth exploration of how preschoolers’ false-belief understanding and language ability each contribute to modeling the relationship between children’s comprehension of emotion and their disposition to act prosocially toward others, after controlling for age and gender. Participants were 101 4- to 6-year-old children (54% boys), who were administered measures of language ability, false-belief understanding, EC and prosocial orientation. Multiple mediation analysis of the data suggested that false-belief understanding and language ability jointly and fully mediated the effect of preschoolers’ EC on their prosocial orientation. Analysis of covariates revealed that gender exerted no statistically significant effect, while age had a trivial positive effect. Theoretical and practical implications of the findings are discussed.