Tammie Ronen

ADOLESCENT STRESS RESPONSES TO A SINGLE ACUTE STRESS AND TO CONTINUOUS EXTERNAL STRESS: TERRORIST ATTACKS

The present study relates to adolescent response to a terrorist attack in Tel Aviv. We studied two groups of Israeli Jewish adolescents who evidenced similar proportions of both emotional and geographical proximity to the event: (a) local Tel Aviv youth, for whom the attack constituted a single, isolated, acute stress, and (b) youth from a border settlement, for whom this attack constituted one in a continuous series of exposures to terrorist incidents (shootings, air-raid attacks). A significant difference emerged between the two groups regarding their increase in fears from the past to the present. As expected, following the terrorist attack, the acute stress group reported a higher increase in fears than the continuous stress group. As for proximity to the event, adolescents who personally knew a victim or were physically close to the terrorist attack (whether they belonged to the acute or the continuous group) reported more fears and symptoms than those who did not know a victim personally or were physically distant. Proximity did not affect the continuous stress group, whereas it did affect the acute stress group. As expected, significant differences emerged between the groups in trait anxiety, symptoms, and increases in fear. Participants with higher trait anxiety reported a higher level of state anxiety, more symptoms, and a higher increase in fears. Contrary to expectations, analyses revealed no significant gender differences. The outcomes support previous research suggesting that prolonged exposure results in habituation.

Children's Reactions to a War Situation as a Function of Age and Sex

The goal of the study was to assess childrens reactions to the stress induced by the 1991 Gulf War as a function of gender and age. It was conducted during the third week of the 1991 Gulf War in Israel. The participants were 229 boys and 189 girls who attended the 2nd, 6th, and 10th grades. They were asked to report behavior problems (for before and during the war), anxiety level (before and during the war), and war-related symptomatic behavior. The findings indicate that the war had an adverse effect on the well being of children, in particular girls. Girls in comparison to boys reported higher levels of anxiety and more behavior problems for the war period as well as more war related symptoms. Gender differences were mostly found for the data relating to the war period and not for the pre-war period. Age moderated the effect of gender on war related symptoms and on anxiety. Whereas among the younger children (2nd grade) no gender effects were found, among the older ones (6th and 10th grades) the gender effects were apparent. In sum (a) the Gulf war had an adverse effect on the well being of children, in particular on the well being of girls. (b) The gender effects appeared only among the older children.

DIFFICULTIES IN ASSESSING TRAUMATIC REACTIONS IN CHILDREN

Childrenstraumatic responses are of major interest to social workers, who are involved in assuring childrenswell-being, protecting children from harmful environmental influences, and preventing future injury (Ronen, 1998a).The present article aims at highlighting some of the difficulties related to the assessment of childrensresponses to traumatic experiences. Difficulties in assessing reactions to trauma are emphasized in light of contradictory research trends relating to the possibility that children develop posttraumatic stress disorder (PTSD). Assessment difficulties are discussed in terms of family and developmental issues, type of trauma, and assessment procedure variables. Guidelines are presented for assessing the severity of childrens responses to traumatic events based on PTSD criteria, the context of normal childhood behavior problems, and developmental considerations.

The Latent Structure of Childhood Aggression: A Taxometric Analysis of Self-Reported and Teacher-Rated Aggression in Israeli Schoolchildren

The purpose of this study was to determine whether the latent structure of childhood aggression, like the latent structure of adult antisocial behavior, is dimensional. One thousand and five Israeli schoolchildren completed a translation of the Buss-Perry Aggression Questionnaire (AQ; Buss & Perry, 1992) and were rated by their homeroom teachers on the Eyberg Child Behavior Inventory (ECBI; Robinson, Eyberg, & Ross, 1980). The AQ Physical Aggression and Verbal Aggression scales were combined to form the 1st indicator, the AQ Anger and Hostility scales were combined to form the 2nd indicator, the 10-item ECBI Oppositional Defiant Behavior Toward Adults scale composed the 3rd indicator, and the 8-item ECBI Conduct Problem Behavior scale composed the 4th indicator. Subjecting these indicators to taxometric analysis revealed consistent support for dimensional latent structure in the full sample as well as in 5 of the 6 subsamples. Childhood aggression, it would seem, differs quantitatively along a dimension (degree of aggression) rather than bifurcating into qualitatively distinct categories (aggressive vs. nonaggressive).

Helping Children to Help Themselves: A Case Study of Enuresis and Nail Biting

Objective: The Self-Control Dual Intervention Model, which is based on cognitive self-control principles, is presented. Method: In the first stage, the client is taught self-control skills and how to apply them to the referred problem, and in the second stage, the client is encouraged to independently apply these skills to another problem with minimal guidance from the therapist. The authors describe how SCDIM is used with a 10-year-old boy whose referred problem was enuresis and the other problem was nail biting. Results: While being treated for enuresis, the child was taught by the therapist self-control skills, which he later applied to resolving his nail-biting problem with minimal help from the therapist. Conclusion: The case study demonstrates how self-control training can promote children’s independent functioning via the ability to apply learned skills to other, future problematic areas.

Emotional Well-Being and Self-Control Skills of Children and Adolescents: The Israeli Perspective

Emotional well-being (EWB) is defined in terms of feeling good and energetic (i.e., positive affect and happiness). EWB is of cardinal importance for social and academic development and is not viewed as the obverse of mental illness and negative feelings. We trace and explain the reduction of EWB from early childhood to adulthood as a function of changing socialization practices and of life goals (i.e., from hedonic present to future hedonic goals). The role of self-control skills and social factors in enhancing children’s and adolescents’ EWB is explicated. We describe the dynamic triad that links self-control, EWB, and social relationship. Each of these processes is assumed to be reciprocally influenced and shaped by each other. In our studies with adolescents, we have found that the more they have self-control skills, the higher is their EWB, and both factors develop in the context of social relationship. The strength of the relationship among these factors is in part a function of sociocultural factors.

Self-Control and Enuresis

This paper presents the link between self-control and childhood enuresis, assuming that enuresis is maintained by deficiencies in self-control skills, whether caused by physiological, behavioral, or cognitive components. Acquisition of self-control skills is proposed as helping in eliminating enuresis. Seventy-seven enuretic children (aged 7 to 14) were randomly assigned to three treatment modes (bell and pad, token economy, and cognitive therapy) and to one control group. The self-control skills of children and their parents and the frequency of enuresis were measured before and after treatment. Results showed a negative correlation between self-control and enuresis on the one hand and between the acquisition of self-control skills and recovery from enuresis on the other hand. The results also highlighted the need for a follow-up period to determine the different longer-term effects of treatments.

Children's perceptions of their behavior problems during the gulf war

The purpose of the study was to investigate the impact of the Gulf War on the number and frequency of behavior problems among Israeli children as related to the childrens age and sex. During the Gulf War, 316 second- and sixth-grade children were interviewed and asked to complete self-report scales about their behavior during the war and before the war. Results showed an increase in the number of behavior problems during the war as compared with their number before the war. Age had a significant influence, with younger children reporting more problems. Sex did not influence the number and frequency of the behavior problems. The main predictor of childrens behavior problems during the war was the number and freqeuncy of such problems before the war. The paper supports a hypothesis of constant rather than proportional rise in the number of behavior problems during war, but also highlights the methodological difficulties in such research.

Collaboration on Critical Questions in Child Psychotherapy: A Model Linking Referral, Assessment, Intervention, and Evaluation

This article proposes that social workers can conduct effective child intervention through the application of a developmental cognitive and social approach that highlights common ground between all mental health professionals, regardless of theoretical orientation. By presenting a model of the psychotherapeutic process, the author calls attention to shared interdisciplinary modes of inquiry into individual child development. This model is intended to assist clinical social workers in identifying these basic shared assumptions in order to improve the outcomes of the therapeutic process during the referral, assessment, intervention, and evaluation stages.

Students' Evidence-Based Practice Intervention for Children with Oppositional Defiant Disorder.

Objective: This project integrates clinical intervention as an integral part of social work studies for third-year students. Students applied a new manual-based intervention aiming to develop self-control skills among children exhibiting oppositional defiant disorder. Throughout, students were involved in assessment, intervention, and evaluation. Method: Students participated in evidence-based intervention activities of a university-based clinical research center. The project for social work students combined theoretical study, training, research, and intervention under one umbrella, with the aims of helping students assimilate classroom learning with the realities of practice and of mobilizing field instructors’motivation. Conclusions: The 12-session intervention was found effective in reducing childrens disruptive behavior. Analysis of feedback fromstudents, field instructors, and head teachers pinpointed the programs important role in facilitating student training.