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Exposure to political violence can lead to various political and psychological outcomes. Using the protracted Israeli-Palestinian conflict as a natural laboratory, we explore the way in which exposure to conflict violence leads to changes in citizens' political attitudes and behavior, offering a model for a stress-based process of political extremism. This model encapsulates three basic components in a causal chain leading to political extremism: exposure to political violence, psychological distress, and enhanced perceptions of threat. We find that prolonged exposure to political violence increases psychological distress, which in turn evokes stronger perceptions of threat that foment political attitudes eschewing compromise and favoring militarism. This causal chain fuels a destructive cycle of violence that is hard to break. Understanding these psychological and political consequences of exposure to political violence can help to shed light on the barriers that too often stymie peacemaking efforts and contribute to the deterioration of intractable conflicts around the globe. Thus, this review offers insights applicable to conflict zones around the world and suggests policy implications for therapeutic intervention and potential pathways to conflict resolution.

What drives citizens' support for violence against domestic political actors? Despite its potentially devastating consequences, there is surprisingly little research on the antecedents of this unique form of political violence. Building upon recent insights on the psychological implications of exposure to conflict on support for political violence, we examined the motivations underlying public support for violence against politicians in the context of protracted conflict. Using a two-wave panel design among Jewish-Israelis, we examined the interactive effects of conflict-induced perceived threat, psychological distress, and political orientation on support for violence against politicians. Consistent with previous findings on the psychological implications of conflict, our findings suggest that conflict-induced threat perceptions play an important role in predicting support for violence against politicians. Nevertheless, our findings point to important boundary conditions to these effects: the strength of the relationship between perceived threat and attitudes towards political violence is qualified by the level of chronic conflict-related psychological distress, and the direction of the effects of perceived threat is qualified by individuals' self-placement on the left-right continuum. More specifically, we found that perceived threat increased rightists' support and decreases leftists' support for violence against politicians, only under high, but not low, conflict-related psychological distress. The main conclusion of this study is that support for violence against politicians can be seen as an ideology-driven protective strategy against the negative psychological implications of exposure to violent conflict. By pointing to the importance of understanding the interactive role of psychological and political factors in determining public support for such acts, our findings therefore contribute to the understanding of a relatively understudied phenomenon with potentially catastrophic effects on political stability.

AbstractObjectiveThis study aimed to investigate the longitudinal cross‐lagged association between family mutuality, depression, and anxiety among Chinese adolescents before and after the COVID‐19 lockdown in 2020.BackgroundLimited attention has been paid to the longitudinal links between family mutuality, depression, and anxiety in the context of the COVID‐19 pandemic.MethodWe used self‐administered questionnaires to collect data from three high schools and two middle schools in Chengdu City at two time points: Time 1 (T1), December 23, 2019–January 13, 2020; Time 2 (T2), June 16–July 8, 2020. The sample consisted of 7,958 participants who completed two wave surveys before and after the COVID‐19 lockdown. We analyzed the data using cross‐lagged structural equation modeling.ResultsThe longitudinal cross‐lagged model showed family mutuality at T1 significantly predicted depression, anxiety, and family mutuality at T2. We observed a decreasing prevalence of depression and anxiety after the COVID‐19 lockdown.ConclusionFamily mutuality plays an important role in mitigating long‐term mental health disorders, such as depression and anxiety. More family‐centered psychological interventions could be developed to alleviate mental health disorders during lockdowns.ImplicationsImproving family mutuality (e.g., mutual support, interaction, and caring among family members) could be beneficial for reducing mental health disorders among Chinese adolescents during the COVID‐19 pandemic.

Traditional mental illness concepts remain prevalent in China. Shenjing shuairuo (i.e., neurasthenia), a depressive-like syndrome less favored in Western psychiatric nosology, has a long tradition of acceptance among Chinese lay people. The concept may be more easily accepted in China due to the culturally informed view of the importance of harmony between mind and body and is consistent with Traditional Chinese Medicine. The goals of this study were to estimate the prevalence of shenjing shuairuo, the overlap between shenjing shuairuo and depression, and whether these two disorders share correlates. Data was obtained from 751 Chinese adults using stratified random sampling. Spatial epidemiological methods were utilized with face-to-face interviews conducted in Guangzhou, China. The Patient Health Questionnaire (PHQ-9) and the neurasthenia criteria from ICD-10 measured depression and shenjing shuairuo. The prevalence of depression and shenjing shuairuo were 5.3% and 15.4%, respectively. Participants with depression were nearly six times more likely to have shenjing shuairuo. Women were more likely than men to have comorbid depression and shenjing shuairuo. Poorer health was reported across disorders. Those with shenjing shuairuo were more likely to report medical diagnoses. Longer sleep latency was reported for those with shenjing shuairuo and those with depression reported fewer hours of sleep and lower sleep quality. Those with depression alone reported the poorest sleep. Significant diagnostic overlap and few distinct correlates were observed. Nevertheless, the difference in prevalence and acceptance among non-professionals suggests that shenjing shuairuo is a useful category of distress among Chinese adults in Southern China.

We conducted a four-wave prospective study of Palestinian adults living in the West Bank, Gaza Strip, and East Jerusalem, interviewed between 2007 and 2009 at 6-month intervals to explore transactional relationships among resource loss (i.e., intra- and inter-personal resource loss) and psychological distress (i.e., PTSD and depression symptoms). Initially, 1196 Palestinians completed the first wave interview and 752 of these participants completed all four interviews. A cross-lagged panel design was constructed to model the effects of trauma exposure on both resource loss and psychological distress and the subsequent reciprocal effects of resource loss and psychological distress across four time waves. Specifically, resource loss was modeled to predict distress, which in turn was expected to predict further resource loss. Structural equation modeling was used to test this design. We found that psychological distress significantly predicts resource loss across shorter, 6-month time waves, but that resource loss predicts distress across longer, 12-month intervals. These findings support the Conservation of Resources theory's corollary of loss spirals.

Global health has been an increasingly prominent component of foreign policy in the last decade. The term health diplomacy has been used to describe this growing interface between foreign policy and global health, and it encompasses both the concept of using health to further foreign policy objectives, as well as the idea that diplomatic tools can be helpful for attaining public health goals. The Chinese presence in Africa has grown in the last 15 years, generating increased interest in Sino-African relations. While much has been written in recent years about the Chinese presence in Africa, the growing numbers of Africans in China have attracted considerably less attention. Many are small-scale traders and might be expected to face many of the health challenges common among foreign migrants, but their health needs have been largely unrecognised. In this paper, we consider how a health diplomacy approach could be applied to African migrants in China, and the potential advantages and limitations of this strategy. We identify areas of overlap between public health, trade, and foreign policy goals that can be emphasised to generate support for improved services for African migrants in China and to engage partners from a diversity of sectors.

BackgroundSocial support is consistently associated with reduced risk of depression. Few studies have investigated how this relationship may be modified by alcohol use, the effects of which may be particularly relevant in traumatized populations in which rates of alcohol use are known to be high.MethodsIn 2008 a representative sample of 1622 Jewish and Palestinian citizens in Israel were interviewed by phone at two time points during a period of ongoing terrorism and war threat. Two multivariable mixed effects regression models were estimated to measure the longitudinal association of social support from family and friends on depression symptoms. Three-way interaction terms between social support, alcohol use and time were entered into the models to test for effect modification.ResultsFindings indicated that increased family social support was associated with less depression symptomatology (p=<.01); this relationship was modified by alcohol use and time (p=<.01). Social support from friends was also associated with fewer depression symptoms (p=<.01) and this relationship was modified by alcohol use and time as well (p=<.01). Stratified analyses in both models revealed that the effect of social support was stronger for those who drank alcohol regularly than those who did not drink or drank rarely.ConclusionsThese findings suggest that social support is a more important protective factor for depression among regular drinkers than among those who do not drink or drink rarely in the context of political violence. Additional research is warranted to determine whether these findings are stable in other populations and settings.

Background and objectiveThis study tested three alternative explanations for research indicating a positive, but heterogeneous relationship between self-reported posttraumatic growth (PTG) and posttraumatic stress symptoms (PSS): (a) the third-variable hypothesis that the relationship between PTG and PSS is a spurious one driven by positive relationships with resource loss, (b) the growth over time hypothesis that the relationship between PTG and PSS is initially a positive one, but becomes negative over time, and (c) the moderator hypothesis that resource loss moderates the relationship between PTG and PSS such that PTG is associated with lower levels of PSS as loss increases.Design and methodA nationally representative sample (N = 1622) of Israelis was assessed at three time points during a period of ongoing violence. PTG, resource loss, and the interaction between PTG and loss were examined as lagged predictors of PSS to test the proposed hypotheses.ResultsResults were inconsistent with all three hypotheses, showing that PTG positively predicted subsequent PSS when accounting for main and interactive effects of loss.ConclusionsOur results suggest that self-reported PTG is a meaningful but counterintuitive predictor of poorer mental health following trauma.