Social adversities and anxiety disorders in the Gaza Strip

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Abstract
AIM To investigate the rate and nature of anxiety symptoms and disorders in children, and their relation to social adversities in a cultural sample not previously researched. METHODS 237 children aged 9 to 13 years living in the Gaza Strip were selected randomly from 112 schools. Children completed the revised manifest anxiety scale (a questionnaire with yes/no answers for 28 anxiety items and nine lie items), and teachers completed the Rutter scale (a questionnaire of 26 items of child mental health problems rated on a scale of 0–2: “certainly applies”, “applies somewhat”, “doesn’t apply”). RESULTS Children reported high rates of significant anxiety problems (21.5%) and teachers reported high rates of mental health problems in the children (43.4%) that would justify clinical assessment. Anxiety problems, particularly negative cognitions, increased with age and were significantly higher among girls. Low socioeconomic status (father unemployed or unskilled worker) was the strongest predictor of general mental health problems. Living in inner city areas or camps, both common among refugees, was strongly associated with anxiety problems. CONCLUSIONS The rate and nature of anxiety disorders were similar to those established in Western societies. Factors reflecting social adversity and lack of stability were also similarly involved. There may be more similarities in the presentation of mental health symptoms across cultures than previously believed.