High school students' posttraumatic symptoms, substance abuse and involvement in violence in the aftermath of war

Miriam Schiff, Ruth Pat-Horenczyk, Rami Benbenishty, Danny Brom, Naomi Baum, Ron Avi Astor

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


This study examined one-year after effects of exposure to war events on adolescents' Posttraumatic Stress Symptoms (PTS) and risk behaviors (substance use and involvement in school violence). In addition, it addressed two potential vulnerability factors: at the micro level, it examined whether childhood trauma raised the vulnerability of Israeli adolescents to PTS and risk behaviors when exposed to war events. At the macro level, we explored whether ethnicity, i.e., being an Israeli Arab, is a vulnerability factor to PTS and risk behaviors. We used a representative sample of 7th to 11th grade students from the north of Israel that included 4151 students: 1800 Jewish (54.4% boys) and 2351 Arab (41.5% boys). We assessed exposure to war events and childhood traumatic events, PTS and PTSD, substance use (alcohol, cannabis, Ecstasy) and involvement in school violence. The findings revealed extensive exposure to war events among both Jewish and Arab students. A year after the war, its effects on adolescents were still manifested in PTS, and involvement in school violence and substance use. Exposure to child physical abuse was associated with higher levels of PTS symptoms, substance use and involvement in violence. Exposure to other traumatic events was also associated with greater PTS symptoms and involvement in violence but not with greater substance use. Arab students were a more vulnerable population. They reported higher PTS symptoms, more cannabis use and greater involvement in school violence than Jewish students. However, exposure to war events had similar effects on both Arab and Jewish students. We conclude that war effects include a broad range of psychological distress and risk behaviors that last long after the war ends, especially among youth who have experienced childhood trauma and high exposure to war-related stressors.

Original languageEnglish
Pages (from-to)1321-1328
Number of pages8
JournalSocial Science and Medicine
Issue number7
StatePublished - Oct 2012

Bibliographical note

Funding Information:
This study was funded by the Herzog Israel Center for the Treatment of Psychotrauma and the Israel Trauma Coalition . We would like to thank the study coordinator Mr. Roni Holler for his hard work in the data collection and data entry process.


  • Adolescents
  • Arab students
  • Childhood traumatic events
  • Israel
  • PTSD
  • Political violence
  • Risk behaviors
  • School violence
  • Substance use


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