Conference Agenda
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Symposium 7.E - Attachment Under Fire: Parent-Child Relationships and Trauma Under War Conditions
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11:30am - 12:30pm
Attachment Under Fire: Parent-Child Relationships and Trauma Under War Conditions This symposium addresses a critical and timely topic by examining how war trauma affects families across diverse populations and developmental stages. Specifically, the studies presented involved Israeli Jewish and Arab-Palestinian families (who constitute 21% of the Israel’s population), in the context of the recent prolonged war. The converging findings offer both theoretical advances in understanding intergenerational trauma transmission and immediate practical applications for supporting families during a collective crisis. Study 1 presents a large-scale community survey (N=1,168 mothers and children;15% Arab-Palestinian) applying the Family Stress Model to war contexts. Results reveal that maternal adverse childhood experiences (ACEs) combined with current war exposure sequentially heighten mothers' sense of danger, increase psychological distress, and compromise parenting capacity, ultimately affecting children's psychological symptoms. At 10 months post the war’s onset, over half of the mothers and the children showed clinical-level symptoms. Study 2 introduces an innovative integration of art-therapy and Child-Parent Psychotherapy (CPP) with displaced families. Clinical case illustrations demonstrate how artistic processes provide aesthetic distance, enable non-verbal trauma processing, and support co-construction of shared narratives for families who experienced a terror attack. Study 3 presents a qualitative examination of Jewish mothers’ perceptions of children with Autism Spectrum Disorder in the context of the war and displacement. Preliminary findings reveal unique vulnerabilities related to sensory sensitivities and communication challenges, while maternal trauma compromised emotional availability. The findings highlight bidirectional influences on the parent-child relationship. Study 4 extends these findings to vulnerable families in early intervention (N=176; 20% Arab-Palestinian). Both maternal ACEs and positive childhood experiences independently predicted trajectories of maternal distress and child behavior problems during war, with maternal sense of threat serving as a key mediating mechanism. Together, these studies illuminate the intergenerational transmission of trauma and resilience, demonstrate how maternal history shapes parenting under war, and offer evidence-based pathways for attachment-informed intervention in contexts of collective trauma. Presentations of the Symposium Study 1: From Danger to Distress to Parenting: Testing the Family Stress Model in War Conditions We examined the effects of prolonged war on Jewish and Arab-Palestinian mothers and children in Israel, extending prior research in three key ways: First, by applying the Family Stress Model, originally developed in the context of economic hardship. Second, by investigating whether mothers’ adverse childhood experiences (ACEs) heightened their vulnerability to the effects of war. Third, by focusing on infants and young toddlers, a population that has received little attention in war-related research. Participants were Israeli mothers, 877 mothers of children aged 3–18 years (Sample 1) and 291 mothers of infants and toddlers (birth–36 months; Sample 2). In both samples, 15% were Arab-Palestinian, and 14% were displaced due to the war. Mothers completed self-reports twice, 10 months after the war began and a year later. In Time 1, 52.8% of the mothers, 47.8% of the children, and 62.1% of the infants showed psychological symptoms above the normative range. Structural Equation Modelling analyses of Time 1 data revealed that maternal ACEs, childhood exposure to war/terror, and current war-related adversity were associated with more psychological symptoms in children. In line with the Family Stress Model, these effects were sequentially mediated by a heightened sense of danger, followed by increased maternal psychological distress, followed by a perception of lower co-parenting support, higher parenting burnout, and more avoidant war-related communication with the child (sample 1) and hostility towards the infants (sample 2). Time 2 data analysis is underway. Preliminary results suggest a slight improvement in the psychological symptoms of mothers and children, but not of infants. This study demonstrates the negative impact of war on mothers and children across ethno-cultural backgrounds, and illuminates potential mechanisms for intervention to mitigate its adverse psychological effects. Furthermore, it suggests that mothers with more ACEs may be particularly vulnerable in their ability to cope with war-related stress, increasing their risk for parenting difficulties. Study 2: Painting Together-Talking Together; Integrating Art Therapy into Child–Parent Psychotherapy (CPP) Following Exposure to a Terror Attack (Video Presentation) Following terror attacks in the onset of the war in Israel, Jewish families from southern communities were displaced under life-threatening conditions and relocated to hotels for an extended period. In this context, IsraAid (a leading Israeli NGO) rapidly established a multidisciplinary mental-health response, including a dedicated parent–child space that provided safety, play, creative materials, and community support. Within this setting, a need emerged for a dyadic and family-focused intervention to address acute traumatic stress, disrupted regulation, and threats to parental availability and children’s sense of security. This presentation introduces an integrative clinical approach combining Child–Parent Psychotherapy (CPP; Lieberman & Van Horn, 2005) with art therapy as an adaptation for wartime conditions. CPP is an attachment-based, trauma-focused model designed to strengthen the caregiver as a secure base, support co-regulation, and help families build a coherent shared narrative regarding overwhelming events. In situations of collective trauma, however, verbal processing may be limited by shock, avoidance, sensory intrusions, and developmental constraints. Artistic processes offer an additional pathway: they provide an “aesthetic distance,” enable non-verbal expression of implicit sensory memory, and create a shared symbolic space in which parent and child can externalize fear, negotiate proximity and distance, and restore agency. Using two clinical illustrations with nuclear families (mother, father, children) treated during displacement, we demonstrate how art-based CPP supports (1) parental reflective functioning and mentalization, (2) gentle construction of a shared trauma narrative (“speaking the unspeakable”), and (3) the repair of relational ruptures under conditions of ongoing threat. We conclude by discussing clinical principles, ethical and contextual considerations, and directions for further development and study of this emerging arts-based adaptation of CPP in war-related trauma. Maternal Perceptions of Autistic Children's Reactions to War and Displacement This qualitative study examined maternal perceptions of the impact of war and subsequent displacement on Israeli children with Autism Spectrum Disorder (ASD) and the parent-child relationship. Children with ASD face distinct challenges in processing traumatic events due to their sensory sensitivities and communication difficulties, potentially increasing their vulnerability during crisis situations. Thus far, nine Jewish mothers of boys with ASD aged 3-6, across various functioning levels, participated in the study. Inclusion criteria required that mothers resided in the Gaza border region during the war onset and were subsequently displaced. Participants were recruited through convenience sampling via professional networks, ASD support organizations, and social services. Data were collected through semi-structured interviews and analyzed using thematic analysis following Braun and Clarke's approach. Analysis focused on identifying themes related to mothers' perceptions of their children, themselves, the parent-child relationship, and factors that contributed to coping, hindered adjustment, or could have provided additional support. Preliminary findings reveal several key themes: a spectrum of post-traumatic responses in children—ranging from withdrawal and self-containment to anger outbursts; mothers minimizing the event's impact while simultaneously describing ongoing post-traumatic symptoms in their children; the need to escape the chaos of displacement—including the strain of confined living spaces and loss of educational frameworks; the closure of temporary settings as a driving factor for returning home despite ongoing security concerns; and the impact of maternal trauma on the parent-child relationship, with mothers acknowledging that their own traumatic experiences at times compromised their emotional availability to their child. The unique contribution of this study lies in giving voice to mothers who, alongside their children, have endured ongoing trauma. Compounding Vulnerabilities: Maternal Childhood Experiences and War Exposure in At-Risk Families This study examined the role of mothers’ adverse and positive childhood experiences in mothers’ and children’s adjustment when facing an ongoing armed conflict. The sample included 176 Israeli mothers and their children (79.55% Jewish, 20.45% Arab-Palestinian; Mean child age in months = 20.64, SD = 13.41; 53.41% of the children were female), who were referred to early intervention due to multiple vulnerability factors. At Time 1, mothers reported their adverse and positive childhood experiences, psychological distress, and their child’s behavior problems. Time 2 occurred seven months after the onset of the recent war in Israel (Range = 5 -11 months), on average 33.28 months after Time 1 (SD = 7.88, Range = 17 - 48 months after Time 1). Mothers reported exposure to war-related events, their perceived threat to life, psychological distress, and their child’s behavior problems. Results indicated that mothers’ adverse childhood experiences, fewer positive childhood experiences, and exposure to war-related events predicted a higher maternal sense of threat to life, as well as increases in maternal psychological distress and children’s behavior problems from Time 1 to Time 2. Moreover, mothers’ heightened sense of threat to life, followed by increased psychological distress, mediated the association between adverse childhood experiences and increases in children’s behavior problems. In contrast, the association between fewer positive childhood experiences and increases in children’s behavior problems was direct and not mediated by these maternal factors. Results reveal the interplay of childhood and lifetime risk and protective factors as predictors of adjustment in challenging environments such as armed conflicts. | ||