Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parents

Figures & data

Table 1. Percentages and frequencies of demographic family factors.

	%	n
Place of living
City	84.3	284
Refugee camp	3.3	11
Village	12.5	42
Status
Refugee	11.3	38
Citizen	88.7	299
Mother’s education
Elementary	19.6	66
Preparatory	32.4	109
Secondary	39.9	134
University	8.0	27
Father’s education
Elementary	21.1	71
Preparatory	28.3	95
Secondary	26.2	88
University	24.4	82
Father’s work situation
Unemployed	49.3	166
Worker	12.8	43
Public employee	24.9	84
Entrepreneur/self-employed	13.1	44
Mother’s work situation
Works at home	93.2	314
Worker	3.0	10
Public employee	3.9	13
Other
Family type
Immediate	61.9	210
Extended	28.9	98
Tribe	9.1	31
Family size
Small (1–4)	23.8	80
Medium (5–7)	50.0	168
Large (8 or more)	26.2	88

Figure 1. Occurrence (%) of war trauma among mothers and fathers.

Table 2. Pearson’s product model correlations between family variables of the cluster analysis.

		1	2	3	4	5	6	7	8	9	10	11	12	13	14
Family attachment
1	Maternal secure attachment
2	Paternal secure attachment	0.52**
3	Child secure attachment	0.09	0.08
4	Child insecure: avoidant	−0.09	0.10	−0.38**
5	Child insecure: ambivalent	0.04	0.08	0.28**	−0.48**
Sibling relations
6	Warmth	0.11	0.10	0.12*	−0.18**	0.14**
7	Intimacy	0.09	0.10	0.14*	−0.13*	0.09	0.38**
8	Conflict	−0.17**	−0.17*	−0.22**	0.11*	−0.03	−0.14**	−0.11*
9	Rivalry	−0.13	−0.13	−0.17**	0.03	−0.07	0.05	0.09	0.39**
Negative parenting
10	Emotional abuse (parents)	−0.38**	−0.38**	−0.20**	0.16**	−0.13**	−0.06	−0.06	0.13*	0.13*
11	Emotional neglect (parents)	−0.34**	−0.32**	−0.20**	0.15**	−0.11*	−0.08	−0.13*	0.16**	0.15*	0.89***
12	Harsh parenting (parents)	−0.13*	−0.07	−0.09	0.00	−0.04	−0.16*	−0.03	−0.01	−0.09	0.24**	0.26**
13	Emotional abuse (child)	−0.13*	−0.19	−0.20**	0.18**	−0.12*	−0.07	−0.06	0.08	0.11	0.73***	0.66***	0.11
14	Emotional neglect (child)	−0.16**	−0.19**	−0.19**	0.15**	−0.10	−0.09	−0.14*	0.09	0.12*	0.64***	0.73***	0.18**	0.83***
15	Harsh parenting (child)	−0.09	−0.06	−0.07	0.10*	−0.06	−0.03	−0.07	0.02	0.04	0.10*	0.12*	0.08	0.16**	0.16**

*p < 0.05, **p < 0.01, ***p < 0.001 (two-tailed; N = 304–334).

Table 3. Means (M) and standard errors (SE) of parental and child factors according to the family-type cluster membership.

	Security and positive relationships		Insecurity and negative relationships		Discrepant experiences		Moderate security and neutral relationships
	M	SE	M	SE	M	SE	M	SE	F (3,279)	Partial η^2
Family attachment
Maternal secure attachment	4.84^a	0.06	3.92^b	0.09	4.75^a	0.07	4.07^b	0.06	40.37****	0.30
Paternal secure attachment	4.87^a	0.06	3.91^b	0.09	4.64^a	0.07	4.05^b	0.06	42.34****	0.31
Child attachment
Secure attachment	3.64^a	0.08	2.66^b	0.09	2.80^b	0.09	3.84^a	0.08	20.95****	0.18
Insecure: avoidant	1.76^a	0.09	2.20^b	0.08	1.92^c	0.09	1.76^a	0.09	22.99****	0.20
Insecure: preoccupied	2.99^ac	0.06	2.63^b	0.06	2.90^c	0.08	3.07^a	0.09	14.69****	0.14
Siblingship
Warmth	2.70^a	0.07	2.19^b	0.10	2.52^a	0.08	2.70^a	0.07	6.79****	0.07
Intimacy	2.31^a	0.06	2.03^a	0.10	2.16^a	0.08	2.05^a	0.06	3.11***	0.03
Conflict	1.17^a	0.07	1.72^b	0.10	1.32^a	0.09	1.23^a	0.07	6.69****	0.07
Rivalry	1.02^a	0.08	1.62^b	0.11	1.20^a	0.09	1.01^a	0.08	7.52****	0.07
Negative parenting
Emotional abuse (parents)	1.47^a	0.05	2.91^b	0.08	1.60^a	0.06	2.45^c	0.05	123.85****	0.57
Emotional neglect (parents)	1.69^a	0.06	2.99^b	0.06	1.78^a	0.06	2.54^c	0.05	83.30****	0.47
Harsh parenting (parents)	2.98^a	0.06	3.46^b	0.09	3.07^ac	0.07	3.30^bc	0.07	8.69***	0.09
Emotional abuse (child)	1.22^a	0.07	2.47^b	0.11	3.15^c	0.09	2.08^d	0.08	101.30****	0.52
Emotional neglect (child)	1.28^a	0.08	2.63^b	0.12	3.16^c	0.10	2.23^d	0.09	85.34****	0.48
Harsh parenting (child)	2.94^a	0.07	3.64^b	0.11	3.56^b	0.09	3.01^a	0.09	15.62****	0.14

Distribution of family types: security and positive relationships, n = 102; insecurity and negative relationships, n = 44; discrepant experiences, n = 65; moderate security and neutral relationships, n = 71.

^a,b,c,dDifferent subscripts within columns indicate statistically significant differences between the family types, p <0.05.

*p <0.05, **p <0.01, ***p <0.001, ****p < 0.0001.

Table 4. Means (M) and standard errors (SE) of children’s mental health and post-traumatic cognitions according to family type.

	Security and positive relationships		Insecurity and negative relationships		Discrepant experiences		Moderate security and neutral relationships
	M	SE	M	SE	M	SE	M	SE	F (3,279)	Partial η^2
Children’s mental health
Internalizing (parents)	6.12^a	0.26	8.36^b	0.40	6.15^a	0.33	8.06^b	0.31	13.85****	0.13
Externalizing (parents)	5.19^a	0.29	8.04^b	0.44	6.35^cb	0.36	7.36^b	0.34	13.27****	0.12
Internalizing (child)	6.63^a	0.30	8.79^b	0.46	7.78^ab	0.38	7.97^b	0.36	6.20****	0.06
Externalizing (child)	4.12^a	0.32	7.09^b	0.49	5.92^bc	0.40	5.49^c	0.39	9.76****	0.09
Depressive symptoms	10.59^a	0.42	14.28^b	0.64	12.60^b	0.52	13.34^b	0.52	10.05****	0.10
PTSD symptoms	28.86	1.00	30.43	1.46	29.20	1.28	28.46	1.19	0.64	0.01
Children’s post-traumatic cognitions
Feeble person in scary world	23.93^a	0.55	27.36^b	0.85	27.46^b	0.69	26.51^b	0.66	7.12****	0.07
Permanent negative change	26.75^a	0.68	30.71^b	0.99	29.28^ab	0.85	29.38^ab	0.67	4.31**	0.04

Distribution of family types: security and positive relationships, n = 102; insecurity and negative relationships, n = 44; discrepant experiences, n = 65; moderate security and neutral relationships, n = 71.

PTSD, post-traumatic stress disorder.

^{a, b, c}Different subscripts within columns indicate statistically significant differences between the family types, p <0.05.

*p <0.05, **p <0.01, ***p <0.001, ****p < 0.0001.