Impact of Conflict in Syria On Syrian Children at The Zaatari Refugee Camp in Jordan - Jabbar and Zaza

Early Child Development and Care, 2014
http://dx.doi.org/10.1080/03004430.2014.916074
Impact of conict in Syria on Syrian children at the Zaatari

refugee camp in Jordan
Sinaria Abdel Jabbara* and Haidar Ibrahim Zazab
a
Downloaded by [University of Toronto Libraries] at 04:21 19 June 2014
Curriculum & Instruction Department, University of Jordan, Amman 11942, Jordan;

Department of Educational Psychology, University of Jordan, Amman 11942, Jordan
(Received 27 March 2014; nal version received 15 April 2014)

This paper describes a study performed to investigate the impact of the conict in
Syria on Syrian refugee children. The Zaatari refugee camp in Jordan was chosen
for this task. Two control (comparison) groups of children were selected: one from
the Jordanian Ramtha district, which is just across the border from Syria, and that
indirectly feel the consequences of the Syrian conict, and the other from Amman,
the capital of Jordan, which is far away from the border. The study compared the
Zaatari, Ramtha and Amman groups in terms of expressed anxiety and
depression symptoms. They were also compared with respect to their gender and
age. The Zaatari children were more distressed than the others, and the symptom
thoughts of ending your life was expressed only by this group. The Ramtha
group also expressed some distress. The fact that this group indirectly
experiences the consequences of violence emphasises the dire circumstances of
children inside Syria who are trapped between ghting groups.
Keywords: Zaatari camp; refugees; Jordan; Syrian children; Syrian conict;
anxiety; depression; asylum seekers
Introduction
Inspired by the ideals of the so-called Arab Spring, and after the collapse of the
entrenched regimes in Tunisia, Libya, Yemen and Egypt, an increasing number of
Syrian citizens began taking to the streets. Their demonstrations were peaceful and
their demands focused on achieving political and economic reform; positive changes
in the regime leading to justice, human rights, equal opportunities and democracy for
all citizens.
The peaceful character of the demonstrations quickly gave way to violence. The
Syrian population began taking opposing sides, for or against the regime. This
divide engulfed other regimes in and outside the region, thus polarising them into
two camps striving to achieve military victory over each other. The ongoing war in
Syria has all the characteristics of a bloody and ugly conict. It is a civil war, as
described in ofcial and non-ofcial reports. It is a war supported diplomatically, nancially and militarily by regional and world powers. It has a sectarian element in it: Sunni
vs. Shia and Alawi, (Anzalone, 2013). It attracted foreign ghters and radicalised
Syrian ghters as well. It is a war that is fought mostly inside urban centres: cities,
town and villages, with the result that most of the damage occurs to the countrys infrastructure and economic sectors, and most of the victims are non-militant civilians.
*Corresponding author. Email: sinariajabbar@hotmail.com
2014 Taylor & Francis
S.A. Jabbar and H.I. Zaza
According to the United Nations, the death toll surpassed 100,000 in June 2013 and
reached 120,000 by September 2013 (Alliance News, 2013). As many as 3.6 million
Syrians may be internally displaced, i.e. left their homes and are living somewhere
inside Syria (Sharp & Blanchard, 2013). In addition, international relief agencies estimated that as of April 2013, more than 1,380,406 Syrians ed the country. Of those
more than 1.1 million had left since September 2012 to so-called safe areas outside
the Syrian borders. Turkey had 313,332 and Jordan had 441,756 registered refugees.
Over 80,000 refugees live in Zaatari refugee camp, which was opened in 28 June
2012 in Northern Jordan near the Mafraq Governorate according to United Nations
High Commissioner for Refugees ofcials who run the camp. Life in refugee camps
can be harsh with individuals and families living with uncertainty over their future
and anxiety for any members of the family still inside the war-torn areas. The impact
on children in terms of their future is of continuing concern occasioned by what
they witnessed prior to eeing Syria as well as by the insecurity of life in the camps.
Literature review
In 2000, an estimated 1.6 million people worldwide lost their lives to violence, a rate of
nearly 28.8 per 100,000 (WHO, 2002). According to information supplied by the US
Agency for International Development and the Ofce of Foreign Disaster Assistance,
the number of worldwide disasters causing complex humanitarian emergencies,
i.e. internal conicts with large-scale displacements of people (refugees) has been
increasing, with children less than ve years of age making up more than 50% of
them. According to Nicolai (2003), more than half of the people affected by war and
conicts are children or adolescents.
War and conict have damaging effects on children and their education (Al Zaroo &
Hundt, 2003; Davies, 2004; Macksoud & Aber, 1996). This point is made by Evans,
Garner, and Honig (2014) in their introductory chapter to this special issue. The grave
consequences for children entail their very survival as well as their development. They
may be killed, injured, imprisoned, abused, starved, humiliated and traumatised by
direct negative experiences or indirectly by what happens to their parents, relatives and
friends. The children may experience psychological problems, such as nightmares,
panic attacks, self-withdrawal, aggressive behaviour, insecurity and violence towards
family members and friends (Affouneh, 2007). According to Elbedour, Baker, and Charlesworth (1997), children exposed to conict situations may become adversely inuenced
by violence, hatred and aggression. For example, the United Nations Childrens Fund
(UNICEF, 2003) reported that Palestinian children who witnessed the death or injury
of relatives and friends consequently suffered from psychological problems, such as
self-doubt, withdrawal and a sense of hopelessness. The ndings by UNICEF (2004)
showed that 60% of Palestinian children suffered from emotional problems or behavioural changes. The same research carried out in 2002 on children aged 517 years reports
that 73% of children suffered from psychological symptoms, 48% of children had a
change in play behaviour, 46% of children suffered from negative social behaviour
and 6% had current thoughts of death and revenge (UNICEF, 2004, p. 16). Moreover,
teaching, most probably, becomes interrupted, and the schools become unable to teach
the children moral values or good citizenship (cf. Halstead & Pike, 2006).
Research in different contexts shows that wars and internal violence carry negative
consequences on children, including heightened aggression and violence, revenge
seeking, insecurity, anxiety, depression, withdrawal, post-traumatic stress and somatic
Early Child Development and Care
complaints, sleep disorders, fear and panic, poor school performance and engagement in
political violence (Qouta, Punamaki, & El Sarraj, 2008; Sagi-Schwartz, Seginer, &
Abdeen, 2008). The relation between armed conict and child development is not dependent only on the violence level, but also affected by changes occurring in the families,
communities and societies of the children as a consequence of the violence (Feerick &
Prinz, 2003). The termination of hostilities and associated violence is unlikely of itself
to bring about a rehabilitation of the psychological impact on children of the horrors
that they and young people have witnessed or experienced (Darby, 2006).Experience
drawn from the troubles in Northern Ireland illustrates how successive generations of
young children develop polarised views of the society they live in, which reect the
views and actions of the factions involved in civil strife (Leavitt & Fox, 1993).
With the rise in international terrorism and other types of violence at the outset of
the twenty-rst century, more attention has been paid to the consequences of violence
for children and youth (La Greca, Silverman, Vernberg, & Roberts, 2002; Masten &
Obradovic, 2008; Osofsky, Osofsky, & Harris 2007; Sagi-Schwarz, 2008). Various
studies tried to examine those consequences in relation to the development of children
in different age groups, experiences, cultures and contexts. Invariably, researchers
encountered the following obstacles:
(1) Longitudinal studies continue to be rare, making comparison between post- and
pre-conict situations untenable.
(2) Most of the available research in developmental sciences has been concentrated
on the more economically advanced societies, whereas most of the violence
occurs in the developing countries.
(3) The cultural traditions and bureaucratic procedures in the developing countries
tend to hinder data collection and interpretation.
Research literature which examines the long-term consequences of violence or the
effective interventions which were applied remains limited. A wide-ranging search
across multiple data bases indicated that many papers and sources dealt with the
subject but many of them were 20 and more years old. While in a real sense these
are not irrelevant, the nature of conicts in the twenty-rst century has changed in
so far as many are internal conicts between factional groups where the ideological
basis is often religious and conned to a single country. An important recent source
is provided by Werner (2012) who discusses ideas of risk, resiliency and recovery
for children who experience war. She notes however (Werner, 2012) that more longitudinal research with large-scale studies are required to better understand the course and
direction of risk and resilience in children who experience war. The purpose of such
studies would be to better understand mental health issues and interventions that are
likely to prove effective over the longer term. Much available research indicates that
children living in war-zone areas are at a high risk for developing various types of psychopathology, especially post-traumatic stress disorder (PTSD; AACAP; Tamar &
Zahava, 2005; Yule, 1999). It also indicates that it is common for co-morbid disorders
to exist, such as PTSD and depression, or anxiety and traumatic grief (AACAP, 1998;
Laurel & Zimmerman, 2001; Pfefferbaum, 1997; Shear, 2005). Research results
suggest that PTSD is a direct response to traumatic war experiences. If the warrelated trauma is prolonged and severe, it can lead to an initial grief reaction or the individual may develop co-morbid depression (Goenjian et al., 1995; Najarian, Goenjan,
Pelcovitz, Mandel, & Najarian, 1996; Terr et al., 1999). Some researchers claim that
the overlap between PTSD and co-morbid psychological symptoms, such as

depression, may be due to the fact that these symptoms are either direct responses to
trauma or that depression is a reaction to PTSD through mediating life events
(Eisenbrauch, 1991; Thabet, Abed, & Vostanis, 2004; Weems, Saltzman, Reiss, &
Carrion, 2003; Weine et al., 1995). Other researchers believe that co-morbidity is the
result of a complex interaction of many factors (Macksoud & Aber, 1996).
Observations and clinical interviews with children in Uganda and Mozambique
contradicted the simple conclusion that violent years caused a generation of violent
children (Raboteg-aric, uul, & Kereste, 1994). Many of the children neither identied with the aggressors nor adapted their moral standards. Most of the children wanted
peace (Raundalenand & Dyregrov, 1991). The experiences of war could increase the
pro-social behaviour of violence victims as a result of increased empathy for the
victims of violence. The pro-social and aggressive behaviours of victimised children
in Uganda and Mozambique were investigated using the Pro-social Behavior Rating
Scale designed by Zuzul, Kerestes, and Vlahovic-Stetic (1990).
In Iraq, as a consequence of the 2003 American invasion the UN Integrated
Regional Information Network (IRIN) was informed that almost 50% of children did
not go to school because their parents were too scared to send them school attendance
falling due to fear of abduction (IRIN, 2007). In the late 2004, a UNICEF spokeswoman told IRIN that because of poverty more than one million children were out
in the streets trying to work to support their families and, in the process, becoming vulnerable to exploitation and sexual abuse. And according to a May 2006 UNICEF report,
25% of Iraqi children between six months and veyears suffered from either acute or
chronic malnutrition.
In February 2003, an armed conict erupted in Darfur, between two Sudanese rebel
groups on the one hand and the Sudanese Government aided by a militia on the other
(Morgos, Worder, & Gupta, 2008). The armed conict was long standing and highly intensive. Among other results, it displaced a great number of adults and children, many of
whom ended up in refugee camps. A group of 331 internally displaced persons children,
ages 617 years from Southern Darfur were the subject of a research to identify the impact
of the armed conict there. The researchers used the Child Post-Traumatic Stress Reaction
Index (Pynoos, Frederick, & Nader, 1987), the Childrens Depression Inventory (CDI;
Kovacs, 1992) and the Extended Grief Inventory (Layne, Savjak, Saltzman, & Pynoos,
2001). The results indicated that the most frequently mentioned war exposures were:
forced to abandon homes, home invasions and witnessing homes burned. There were no
signicant gender differences in total exposure to war experiences. On the other hand,
older children were more aware of war experiences than younger children. Girls were
found to have higher depression levels than boys. However, age did not have a signicant
effect on the depression level. On the other hand, gender had no signicant effect on the
grief level, whereas age had a signicant effect: older children showed higher grief levels
than younger children. Regarding trauma levels, gender showed no differences, but age
did, whereby older children showed higher clinical levels than younger children. The
results also indicated that the strongest relationship between war exposure and depression
as well as grief is mediated through trauma.
The Republic of Croatia, which was part of former Yugoslavia, was recognised as an
independent state by the United Nations in January 1992. The Croatian designation for
independence was announced in 1991 and was followed by an armed attack on it by
the Yugoslav army. Among the many consequences of the war, there were large
numbers of displaced children who faced a whole range of losses: loss of home, loss
of parental support and protection, loss of traditional way of living, living with distressed
adults, loss of educational structure, poor physical environment, malnutrition and changes
in the community (Ajdukovic & Ajdukovic, 1998). The most extensive screenings
looking at the psychological impact of war upon Croatian children (914 years old)
were made through the UNICEF project Psychological and Educational Assistance to
War Affected Children (Kuterovac, Dyregrov, & Stuvland, 1994; Spoljaric, 1993).
The childrens distress was measured by the Impact of Events Scale (Horowitz,
Wilner, & Alvarez, 1979). Three indicators were used: mothers assessment of childrens
stress reactions; the post-traumatic stress reactions of children and the level of depression
of children during displacement. The psychological assessment by means of interviews
was done at three successive dates. The instruments used during interviews with children
were the Post-Traumatic Stress Reaction Scale (Child Version, PTSR-D: Ajdukovic,
1993), CDI (Kovacs, 1992) and Parental AcceptanceRejection Questionnaire
(Rohner, 1984). The assessment of stress symptoms among Croatian children indicated
that war-related stress had a negative impact on the psychological well-being of children
from babies to adolescents, and displaced and refugee children were especially affected.
This result agrees with the contention of (Mccallin & Fozzard, 1990), namely that
exposure to living in displacement is likely to result in a number of stress-related symptoms in children. Children who experienced traumatic situations immediately before displacement were potentially at risk. So were children who lived without or with parents
who coped poorly in displacement, or who lived with families that encountered many
stressful experiences or those who were housed in large collective refugee centres.
Intervention measures are normally implemented to help traumatised refugees cope
with their problems. One study investigated the effect of adding physical activity to biofeedback-based cognitive behavioural therapy (CBT-BF) intervention for refugees suffering from chronic pain (Liedl et al., 2011). The ndings indicated that physical
activity helped those refugees in coping with pain. It reduced their muscle tension
and heart rate in stressful situations. Instead of being overwhelmed by pain, the refugees learned to respond with coping strategies, including self-competence and
counter activities. Other effects of physical activity were also observed, namely
improvements in anxiety symptoms, development of controllability and self-efcacy.
It seems that physical activity acts as mood elevator whereby the biochemical
changes which result from it contribute to positive mood and help people to deal
with pain in the same manner as antidepressant medications. In essence, physical
activity can be a promising additional treatment component within a CBT-BF approach
to chronic pain management in survivors of war and torture.
Another study highlighted the importance of psychological needs for the PTSD and
displaced children in schools (Uguak, 2001). The study focused on children (814
years old) in especially difcult circumstances. It describes a therapeutic programme
designed to recognise and reduce the ill-effects and adverse consequences of trauma
among affected children and to integrate them into social institutions to lead normal
lives. The programme was developed by specialised psychologists and implemented
by a team consisting of applied psychologists, social workers, animators or pedagogical
personnel, community leaders, medical assistants and nurses. The programme consists
of the following activities: music, drawing, computer games, collective sport activities,
story-telling, constructive plays and puzzles. Those activities constitute psychological
treatments which bring about a change in behaviour of children, give them moral
support and develop a sense of boldness, credibility and democratic atmosphere
among them (Cohen, Mannarino, & Rogal, 2001).The programme was exible
enough to allow children to select activities of their choice and move to other activities
later on. Music is a therapeutic activity, which reduces tension of PSDT among the traumatised (EMDH, 2001; Mayers, 1995). It consists of songs, dances and drama and
enhances self-condence, self-expression and creativity in a child. Drawing is an
activity that relates mainly to psychosocial needs. Children may be organised in
pairs and asked to do certain tasks such as colouring. In this context, they are forced
to talk to each other and become more sociable. Psychologists can identify the problems
affecting the children and any improvement they make by examining their drawings at
different time intervals. Computer games that employ more language, rather than fun
games, were used in this programme. Collective sports are important activities, particularly football, running, volleyball and other competitive games. They provide entertainment for the children and enhance their self-condence and social behaviour. Children
were free to select the sport of their choice. This provided good feedback on their behaviour to the administrators of the programme. Tales (talk) Theatre allows children to
re-enact their experiences. The activity of storytelling promotes good behaviour. Constructive play encourages children to do tasks with the help of one another (Rigby,
2002; Smith, 1995). It helps children become sociable and gain good interpersonal
skills as they grow up. Puzzles enhance the childrens word recognition ability and
logical thinking in the process of solving a puzzle. If done in pairs, it can additionally
encourage partner children to talk to one another and become more sociable.
Turning to the situation in Syria, it seems that the provision of support for the
psychological and social well-being and recovery of children (psychosocial support)
has been inadequate. According to a report by the Global Child Protection Group,
98% of Syrian children surveyed reported deterioration in their psychosocial wellbeing. Out of the 2 million Syrian refugees,1 only 20% received some form of psychosocial support. In Jordan as of October 2013, about 113,000 children were able to
continue their education at KG and other levels, whereas about 87,000 children were
out of school. Thus, the enrolment rate stood at about 45% in the camps and 58%
outside the camps with an overall rate of about 55%. In addition, about 10,000 children
with specic needs had access to specialised education and psychological services in
camps and host communities, and about 32,000 school-aged children beneted from
informal and non-formal education services in camps and in host communities
(Syrian Refugees Education Country Prole, 2013).
Syrian children experience problems both in their home in Syria and as refugees in
other countries, as attested by War Child Holland in Lebanon.2 Those problems include:
(1) Fear of direct violence in their home communities in Syria (fear of attack, fear of buildings on re and fear at check points). (2) Displacement (lack of sense of belonging, resentment in the host countries against refugees, limited privacy and fear of physical and sexual
abuse). (3). Lack of access to education. This does not allow them to socialise, develop
skills and get away from the stress of their daily lives. 4. Lack of recreation and play.
This deprives them of a means of distraction from their unhappy lives. It does not allow
them to let out their energies and share feelings with their playmates. Children in the
camps were unable to play because the camps lacked safe places and because they
needed to work. The International Labor Organization (ILO) estimated earlier in 2013
that 30,000 Syrian children in Jordan were working rather than attending school.
UNICEF has launched an initial conditional cash transfer programme to promote school
attendance (Syrian Refugees Education, 2013, p. 2).
The psychosocial impact on the Syrian refugee children may be profound and long
lasting. The mental health of children may be evidenced through feelings of social
isolation, poor self-image, self-harm, aggression and depression. According to the

Child Protection Working Groups Syria Child Protection Assessment published in
September 2013, the main behaviour changes experienced by Syrian children include:
Unusual crying/screaming, disruption in sleep patterns, sadness, bedwetting and unwillingness to go to school.
Boys are more likely to display aggressive behaviour, including the desire to join armed
forces and armed groups. Girls are reported to show more self-harm and fear. Carers tend
to limit childrens mobility outside of home and are not always able to provide attention to
childrens needs. Their main sources of stress are the deteriorated security and also access
to basic needs (food, electricity, water and livelihoods), childrens safety and access to
health care. Main factors contributing to deterioration are change in behaviour of
carers, lack of access to education and recreation. (War Child Holland, 2013, p. 8)
The purpose of this study is to investigate some aspects of the impact of the war in
Syria on displaced children living in Zaatari refugee camp in Jordan. In particular, the
study aims:
To identify types and levels of anxiety and depression symptoms experienced by the
Syrian refugee children with reference to similar-age children in non-conict areas close by.
Method
In the absence of pre-conict data about the status of Syrian refugees, it was not possible to adopt the longitudinal method (comparison of post- to pre-conict status of refugees). Therefore, a reference group is used in which a sample of refugee children is
compared to a similar group of non-refugee children. And since it was not possible
to travel to Syria to collect data about children who had not been exposed to violence,
the control group, it was decided to do the following:
(1) To select a sample of 120 Syrian refugee children from Zaatari refugee camp
between 7 and 12 years of age that would include male and female children.
All the children must have lived in the Syrian Daraa district, on the other
side of the JordanianSyrian border, before the Syrian conict erupted.
(2) To select a sample of 120 Jordanian children with the same age and gender
composition from the Jordanian Ramtha district, which is across the border
from the Daraa district and has similar socio-economic characteristics, i.e.
people are mainly engaged in farming or small-scale businesses, and the communities are mostly tribal. This sample would serve as the reference group.
(3) As the eldwork was begun, i.e. interviews conducted with Syrian refugee children in Zaatari as well as with the comparison group (Jordanian children in
Ramtha), the violence in Syria became more intense and closer to the border.
And although the children in Ramtha did not directly experience violence,
they sometimes were able to hear gun and artillery explosions nearby. Thus,
it was decided to select a second comparison group of children, with similar
age and gender characteristics, but who lived far away from the border. We
chose 120 children from Amman, the capital of Jordan.
Sampling
A snowball sampling technique was used to select the Zaatari Syrian refugee camp
sample, with randomly chosen starting point in the camp. The sample included 120
Syrian refugee children (43 boys and 77 girls) aged between 7 and 12 years. All of
those children used to live in the Syrian Daraa district. The samples of the two
control or comparison groups, from Ramtha and Amman, were selected using a
quota sampling technique. The children were randomly selected from schools and
were all between 7 and 12 years old. The Ramtha sample included 120 children (64
boys and 56 girls) and the Amman sample included 120 children (69 boys and 51
girls). We designated children from 7 to 9 years of age as younger while those
from 10 to 12 years of age as older.
Instruments
The instruments used in the study were selected for their ability to be used in the population of children making it possible to obtain information directly from the children
(Appendix 1 refers)
This information is divided into two parts:
(1) Part one solicits demographic information regarding the childrens gender,
place of birth and age.
(2) Part two consists of Arabic translation of the Hopkins Symptom Checklist-25
(HSCL-25), which assesses symptoms of anxiety and depression for 712 years
of age. It was originally designed by Parloff, Kelman, and Frank (1954) at
Johns Hopkins University. It consists of 24 questions after one question
(No.14: Loss of sexual interest or pleasure) was omitted because it is not appropriate in the Arabian cultural context. Questions 110 relate to anxiety symptoms, whereas questions 1124 relate to depression symptoms, which the
children may have experienced during the week preceding the interviews.
The responses measure the symptoms on a 4-point Likert scale, which includes
1 = Not at all, 2 = A little, 3 = Quite a bit and 4 = Extremely. The checklist was
addressed to the children individually and directly during the interviews
without the presence of their parents. A score was computed for each scale
by averaging the scale value for responses to all the items in the scale, allowing
responses to be ordered from no symptoms to extreme symptoms based on the
average score.
Characteristics of samples (n = 360).
Sample N
Age group years
Gender
Zaatari (120)
Younger (79)
Younger (79)
Older (1012)
Older (1012)
Younger (79)
Younger (79)
Older (1012)
Older (1012)
Younger (79)
Younger (79)
Older (1012)
Older (1012)
Boys
Girls
Boys
Girls
Boys
Girls
Boys
Girls
Boys
Girls
Boys
Girls
11
20
32
57
10
23
54
33
28
12
41
39
Ramtha (120)
Amman (120)
The Checklist (HSCL-25) is well documented in terms of reliability and validity. It has
been validated against several instruments such as: the mini international neuro-psychiatric interview (Mahfoud et al., 2013), Harvard Trauma Questionnaire (Oruca
et al., 2008), Present State Examination (Nettelbladt, Hansson, Stefansson, Borgquist,
& Nordstrm, 1993; Lee, Kaaya, Mbwambo, Smith-Fawzi, & Leshabari, 2008).
Data analysis
Independent t-tests were used to compare the total and subtotal scores between boys
and girls and between older and younger children. For the comparison of anxiety
and depression symptoms between boys and girls and between older and younger children, the Pearson chi-squared statistic 2 was used.
Results
(1) The Zaatari sample, as given in Tables 1 and 2, shows results of the HSCL-25,
including total scores as well as gender and age subscales. There were no signicant differences in the total score or in the anxiety and depression subscales
between boys and girls. At the symptoms level, the symptom poor appetite
ranked rst while the symptom blaming yourself for things ranked last.
There were no differences between boys and girls except in two depression
symptoms: (1) feeling everything is an effort, (2) feeling low in energy,
slowed down. In both of these depression symptoms, boys were more inclined
to indicate than girls. There were signicant differences in total score as well as
in the anxiety subscale between younger and older children. Older children
(1012 yrs) evidenced more symptomology than younger children (79 yrs).
At the symptom level, the symptom poor appetite ranked rst while
blaming yourself for things ranked last. There were differences between
younger and older children in three symptoms: (1) nervousness or shakiness
inside. (2) heart pounding or racing and (3) thoughts of ending your life.
In all those anxiety and depression symptoms, older children were more indicated for than younger children.
(2) The Ramtha sample is presented in Tables 3 and 4. There were no statistically
signicant differences in the total score or in the anxiety and depression subscales which can be attributed to gender. The symptom suddenly scared for
no reason ranked rst, while the symptom thoughts of ending your life
ranked last. There was one anxiety symptom nervousness or shakiness
inside in which there was a statistically signicant difference between boys
and girls. Girls reported more distress than boys. There were no signicant
differences in total score or in anxiety and depression subscales between
younger and older children. At the symptom level, suddenly scared for no
reason ranked rst, while thoughts of ending your life ranked last. There
were statistically signicant differences between younger and older children
in two anxiety and depression symptoms: (1). nervousness or shakiness
inside, (2). crying easily. Older children were more distressed than
younger children.
(3) The Amman sample is given in Tables 5 and 6. There were statistically signicant differences in the total score and in the anxiety and depression subscales.
Girls were more distressed than boys. The symptom difculty falling asleep,
10
Not at all (%)

Symptoms!
Poor appetite
Feeling everything is an effort
Feeling low in energy, slowed down
Nervousness or shakiness inside
Heart pounding or racing
Feeling fearful
Headaches
Difculty falling asleep, staying asleep
Suddenly scared for no reason
Feeling blue
Worrying too much about things
Feeling no interest in things
Feeling of being trapped or caught
Feeling lonely
Feeling tense or keyed up
Crying easily
Feelings of worthlessness
Felling restless, cannot sit still
Trembling
Faintness, dizziness or weakness
Thoughts of ending your life
Spells of terror or panic
Feeling hopeless about the future
Blaming yourself for things
HSCL general anxiety
HSCL general depression
HSCL total
!: in descending order by average.
*p < .05
A little (%)
Quite a bit
(%)
Extremely (%)
SD
Boys
Girls
Boys
Girls
Boys
Girls
Boys
girls
2.53
2.38
2.31
2.24
2.18
2.11
2.10
2.07
2.03
1.94
1.94
1.94
1.94
1.93
1.90
1.88
1.86
1.84
1.84
1.83
1.79
1.78
1.75
1.43
.978
1.021
.906
1.061
1.012
.994
.947
.981
1.100
.863
.955
.866
.876
1.014
.920
1.014
.929
.917
.698
1.007
.934
.835
.981
.785
36.8
29.6
26.9
23.7
25.6
41.0
42.1
35.7
37.0
41.5
40.8
31.8
26.7
33.3
33.3
38.6
31.4
34.5
28.9
35.5
33.9
36.4
31.8
36.8
63.2
70.4
73.1
76.3
74.4
59.0
57.9
64.3
63.0
58.5
59.2
68.2
73.3
66.7
66.7
61.4
68.6
65.5
71.1
64.5
66.1
63.6
68.2
63.2
35.7
21.4
22.0
33.3
45.5
37.2
40.5
28.9
45.8
28.8
23.7
42.9
32.5
50.0
36.1
37.5
31.1
42.9
38.5
26.9
28.6
35.0
42.9
21.1
64.3
78.6
78.0
66.7
54.5
62.8
59.5
71.1
54.2
71.2
76.3
57.1
67.5
50.0
63.9
62.5
68.9
57.1
61.5
73.1
71.4
65.0
57.1
78.9
33.3
50.0
44.2
35.5
40.0
33.3
26.7
39.3
23.1
40.0
37.5
34.5
56.7
30.0
40.7
36.8
42.9
29.2
40.0
45.5
44.4
40.9
31.3
40.0
66.7
50.0
55.8
64.5
60.0
66.7
73.3
60.7
76.9
60.0
62.5
65.5
43.3
70.0
59.3
63.2
57.1
70.8
60.0
54.5
55.6
59.1
68.8
60.0
Boys
Girls
Boys
Girls
Boys
Girls
39.1
52.4
80.0
66.7
30.8
21.4
20.0
45.5
37.5
42.9
55.6
25.0
25.0
33.3
33.3
16.7
70.0
33.3
50.0
40.0
62.5
0
50.0
75.0
M = 2.00
M = 1.97
M = 2.07
M = 1.91
M = 2.04
M = 1.94
60.9
47.6
20.0
33.3
69.2
78.6
80.0
54.5
62.5
57.1
44.4
75.0
75.0
66.7
66.7
83.3
30.0
66.7
50.0
60.0
37.5
100.0
50.0
25.0
SD = .53
SD = .51
SD = .47
SD = .93
SD = .43
SD = .39
0.215
9.362*
14.123*
9.973
3.5
1.821
3.231
1.366
2.937
1.971
4.52
1.427
7.672
2.718
0.439
2.154
6.255
1.271
1.267
1.862
3.953
1.941
2.083
4.584
.295
1.942
1.345
Table 1. Anxiety and depression symptoms among Zaatari children and differences on screening instruments HSCL-25 by gender (n = 120).
Table 2. Anxiety and depression symptoms among Zaatari children and differences on screening instruments HSCL-25 by age (n = 120).
Symptoms
Poor appetite
Feeling fearful
Headaches
Feeling blue
Feeling lonely
Crying easily
Trembling
HSCL total
SD
2.53
2.38
2.31
2.24
2.18
2.11
2.10
2.07
2.03
1.94
1.94
1.94
1.94
1.93
1.90
1.88
1.86
1.84
1.84
1.83
1.79
1.78
1.75
1.43
0.98
1.02
0.91
1.06
1.01
0.99
0.95
0.98
1.10
0.86
0.96
0.87
0.88
1.01
0.92
1.01
0.93
0.92
0.70
1.01
0.93
0.83
0.98
0.78
A little (%)
Quite a bit (%)
Younger Older Younger Older Younger

42.1
22.2
23.1
44.7
48.7
25.6
31.6
38.1
25.9
31.7
34.7
25.0
31.1
31.6
37.3
26.3
27.5
36.4
28.9
25.8
22.0
34.5
24.2
23.0
57.9
77.8
76.9
55.3
51.3
74.4
68.4
61.9
74.1
68.3
65.3
75.0
68.9
68.4
62.7
73.7
72.5
63.6
71.1
74.2
78.0
65.5
75.8
77.0
28.6
19.0
31.7
21.2
15.2
30.2
19.0
18.4
29.2
30.8
13.2
33.3
22.5
29.2
19.4
28.1
20.0
20.0
24.6
26.9
42.9
20.0
28.6
42.1
71.4
81.0
68.3
78.8
84.8
69.8
81.0
81.6
70.8
69.2
86.8
66.7
77.5
70.8
80.6
71.9
80.0
80.0
75.4
73.1
57.1
80.0
71.4
57.9
25.0
33.3
25.6
12.9
11.4
25.0
33.3
25.0
19.2
10.0
33.3
13.8
13.3
16.7
14.8
31.6
42.9
12.5
26.7
27.3
16.7
18.2
31.3
30.0
Extremely (%)
Younger
75.0
66.7
74.4
87.1
88.6
75.0
66.7
75.0
80.8
90.0
66.7
86.2
86.7
83.3
85.2
68.4
57.1
87.5
73.3
72.7
83.3
81.8
68.8
70.0
Younger
Older
Younger
Older
Younger
older
8.7
33.3
10.0
16.7
23.1
14.3
10.0
9.1
31.3
0.00
11.1
50.0
100.0
11.1
16.7
8.3
20.0
16.7
0.00
20.0
0.00
0.00
20.0
0.00
M = 1.77
M = 2.06
M = 1.87
M = 2.00
M = 1.83
M = 2.03
Older
91.3
6.329
66.7
2.690
90.0
2.151
83.3
10.950*
76.9
16.467*
85.7
1.418
90.0
3.853
90.9
5.970
68.8
.976
100.0
6.455
88.9
6.917
50.0
4.634
0.00 14.733*
88.9
3.455
83.3
6.213
91.7
2.340
80.0
3.164
83.3
6.295
100.0
.945
80.0
.218
100.0
9.315*
100.0
4.606
80.0
.619
100.0
4.477
SD = .44
2.74*
SD = .52
SD = .36
1.56
SD = .44
SD = .33
2.43*
SD = .414
11
Older
Not at all (%)
12
Table 3. Anxiety and depression symptoms among Ramtha children and differences on screening instruments HSCL-25 by age (n = 120).
Symptoms
Feeling fearful
Crying easily
Headaches
Difculty Falling asleep, staying asleep
Poor appetite
Feeling blue
Trembling
Feeling lonely
feeling hopeless about the future
HSCL total
SD
2.35
2.27
2.23
2.23
2.16
1.92
1.9
1.88
1.88
1.8
1.75
1.67
1.64
1.64
1.62
1.61
1.61
1.58
1.48
1.47
1.44
1.35
1.29
1.27
1.05
0.99
1.04
0.92
1.04
0.77
0.97
0.87
0.99
0.76
0.76
0.93
0.72
0.84
0.79
0.75
0.76
0.71
0.78
0.70
0.74
0.56
0.67
0.51
A little (%)
Quite a bit (%)

31.3
22.6
40.0
29.0
42.5
25.6
39.6
19.6
29.8
36.2
32.7
23.6
23.7
30.9
27.7
28.6
32.3
33.8
26.3
27.6
24.7
24.1
24.7
23.9
68.8
77.4
60.0
71.0
57.5
74.4
60.4
80.4
70.2
63.8
67.3
76.4
76.3
69.1
72.3
71.4
67.7
66.2
73.8
72.4
75.3
75.9
75.3
76.1
17.6
40.0
28.6
30.0
21.6
31.5
22.9
36.7
29.0
21.2
28.9
40.9
30.4
23.3
27.5
31.8
23.7
20.0
24.0
31.3
27.6
31.3
46.2
41.7
82.4
60.0
71.4
70.0
78.4
68.5
77.1
63.3
71.0
78.8
71.1
59.1
69.6
76.7
72.5
68.2
76.3
80.0
76.0
68.8
72.4
68.8
53.8
58.3
38.2
21.2
16.7
22.5
25.9
20.0
17.4
27.8
18.2
26.3
10.0
30.0
35.7
21.1
27.3
10.0
21.4
20.0
50.0
18.2
33.3
60.0
37.5
25.0
Extremely (%)
Older
Younger
Older
61.8
78.8
83.3
77.5
74.1
80.0
82.6
72.2
81.8
73.7
90.0
70.0
64.3
78.9
72.7
90.0
78.6
80.0
50.0
81.8
66.7
40.0
62.5
75.0
Younger
Older
Younger
Older
Younger
Older
20.0
20.0
15.8
33.3
6.3
50.0
0.00
14.3
30.0
0.00
100.0
16.7
0.00
33.3
25.0
0.00
0.00
0.00
0.00
0.00
75.0
0.00
0.00
0.00
M = 1.86
M = 2.01
M = 1.55
M = 1.59
M = 1.68
M = 1.77
80.0
80.0
84.2
66.7
93.8
50.0
100.0
85.7
70.0
100.0
0.00
83.3
100.0
66.7
75.0
100.0
100.0
0.00
100.0
100.0
25.0
0.00
100.0
0.00
SD = .46
SD = .51
SD = .33
SD = .44
SD = .32
SD = .36
4.411
4.562
5.487
.817
8.813*
1.710
8.878*
4.162
1.180
3.594
6.376
2.946
1.473
1.099
.014
3.122
2.035
2.865
4.401
1.085
4.950
3.357
3.799
3.022
1.171
1.48
.559
Not at all (%)
Table 4. Anxiety and depression symptoms among Ramtha children and differences on screening instruments HSCL-25 by gender (n = 120).
Symptoms
Feeling fearful
Crying easily
Headaches
Poor appetite
Feeling blue
Trembling
Feeling lonely
HSCL total
A little (%)
Quite a bit (%)
Extremely%
SD
Boys
Girls
Boys
Girls
Boys
Girls
Boys
Girls
2.35
2.27
2.23
2.23
2.16
1.92
1.9
1.88
1.88
1.8
1.75
1.67
1.64
1.64
1.62
1.61
1.61
1.58
1.48
1.47
1.44
1.35
1.29
1.27
1.05
0.989
1.041
0.921
1.037
0.773
0.965
0.871
0.992
0.763
0.764
0.929
0.719
0.838
0.791
0.748
0.762
0.705
0.778
0.698
0.742
0.56
0.666
0.514
56.3
64.5
51.4
61.3
42.5
59.0
50.9
60.9
50.9
46.8
61.5
51.4
55.9
47.1
53.8
47.6
50.8
47.7
53.8
48.7
50.6
51.8
49.5
50.0
43.8
35.5
48.6
38.7
57.5
41.0
49.1
39.1
49.1
53.2
38.5
48.6
44.1
52.9
46.2
52.4
49.2
52.3
46.3
51.3
49.4
48.2
50.5
50.0
61.8
45.0
57.1
55.0
64.9
53.7
60.0
51.0
58.1
57.7
42.2
59.1
47.8
53.3
47.5
59.1
60.5
57.5
44.0
62.5
65.5
56.3
69.2
62.5
38.2
55.0
42.9
45.0
35.1
46.3
40.0
49.0
41.9
42.3
57.8
40.9
52.2
46.7
52.5
40.9
39.5
42.5
52.9
60.6
62.5
50.0
70.4
48.0
52.2
44.4
54.5
57.9
60.0
60.0
64.3
73.7
72.7
70.0
50.0
66.7
58.3
54.5
50.0
60.0
62.5
75.0
47.1
39.4
37.5
50.0
29.6
52.0
47.8
55.6
45.5
42.1
40.0
40.0
35.7
26.3
27.3
30.0
50.0
33.3
41.7
45.5
50.0
40.0
37.5
25.0
Boys
Girls
Boys
Girls
Boys
girls
35.0
40.0
36.8
33.3
25.0
0.00
44.4
42.9
50.0
50.0
0.00
33.3
0.00
66.7
50.0
33.3
0.00
0.00
100.0
100.0
25.0
0.00
100.0
0.00
M = 1.95
M = 2.01
M = 1.61
M = 1.56
M = 1.75
M = 1.75
65.0
60.0
63.2
66.7
75.0
100.0
55.6
57.1
50.0
50.0
100.0
66.7
100.0
33.3
50.0
66.7
100.0
0.00
0.00
0.00
75.0
0.00
0.00
0.00
SD = .52
SD = .49
SD = .36
SD = .29
SD = .39
SD = .31
3.783
4.442
3.182
2.458
12.173*
3.073
1.045
2.035
.475
1.369
5.139
1.724
2.538
4.452
2.234
3.011
3.299
2.181
3.626
2.622
3.287
.276
3.917
1.975
37.5
34.5
43.8
30.8
37.5
.295
1.942
0.036
13
Not at all (%)
14
Not at all (%)

Symptoms
Feeling fearful
Trembling
Crying easily
poor appetite
Feeling blue
Headaches
Feeling lonely
HSCL total
A little (%)
Quite a bit
(%)
Extremely (%)
SD
Boys
Girls
Boys
Girls
Boys
Girls
Boys
Girls
1.71
1.58
1.58
1.56
1.55
1.53
1.5
1.49
1.49
1.48
1.48
1.46
1.46
1.39
1.37
1.36
1.33
1.33
1.32
1.29
1.27
1.27
1.27
1.23
0.974
0.729
0.849
0.824
0.765
0.864
0.842
0.82
0.84
0.788
0.907
0.819
0.721
0.749
0.662
0.754
0.781
0.7
0.815
0.6
0.59
0.695
0.67
0.658
58.2
63.5
64.3
60.0
64.3
64.9
58.2
64.6
57.3
58.8
62.1
61.4
58.4
59.8
54.8
62.0
59.4
62.4
59.2
60.9
57.9
57.0
59.6
59.6
41.8
36.5
35.7
40.0
35.7
35.1
41.8
35.4
42.7
41.3
37.9
38.6
41.6
40.2
45.2
38.0
40.6
37.6
40.8
39.1
42.1
43.0
40.4
40.4
60.6
58.3
54.1
64.7
60.5
53.6
72.4
56.7
69.6
73.1
64.7
65.4
60.0
65.2
75.9
55.6
66.7
47.4
70.0
47.8
65.0
92.3
57.1
85.7
39.4
41.7
45.9
35.3
39.5
46.4
27.6
43.3
30.4
26.9
35.3
34.6
40.0
34.8
24.1
44.4
33.3
52.6
30.0
52.2
35.0
7.7
42.9
14.3
62.5
00.0
25.0
28.6
12.5
60.0
00.0
00.0
44.4
30.0
28.6
00.0
25.0
50.0
33.3
20.0
50.0
25.0
00.0
00.0
00.0
00.0
33.3
16.7
37.5
100.0
75.0
71.4
87.5
40.0
100.0
100.0
55.6
70.0
71.4
100.0
75.0
50.0
66.7
80.0
50.0
75.0
100.0
100.0
100.0
100.0
66.7
83.3
Boys
Girls
Boys
Girls
Boys
Girls
41.7
25.0
25.0
16.7
00.0
00.0
25.0
14.3
33.3
00.0
22.2
14.3
50.0
00.0
00.0
20.0
14.3
25.0
50.0
100.0
50.0
00.0
25.0
00.0
M = 1.35
M = 1.63
M = 1.29
M = 1.54
M = 1.31
M = 1.57
58.3
75.0
75.0
83.3
100.0
100.0
75.0
85.7
66.7
100.0
77.8
85.7
50.0
100.0
100.0
80.0
85.7
75.0
50.0
00.0
50.0
100.0
75.0
100.0
SD = .34
SD = .66
SD = .34
SD = .68
SD = .32
SD = .66
1.457
9.433*
6.665
7.379
13.502*
12.764*
10.193*
12.380*
3.433
11.139*
8.085*
11.951*
1.938
7.613
9.051*
6.530
6.049
5.157
3.620
6.845
4.571
15.926*
2.625
10.623*
3.058*
2.539*
2.848*
Table 5. Anxiety and depression symptoms among Amman children and differences on screening instruments HSCL-25 by gender (n= 120).
Table 6. Anxiety and depression symptoms among Amman children and differences on screening instruments HSCL-25 by age (n = 120).
Symptoms
Feeling fearful
Trembling
Crying easily
Poor appetite
Feeling blue
Headaches
Feeling lonely
HSCL total
SD
1.71
1.58
1.58
1.56
1.55
1.53
1.5
1.49
1.49
1.48
1.48
1.46
1.46
1.39
1.37
1.36
1.33
1.33
1.32
1.29
1.27
1.27
1.27
1.23
0.97
0.73
0.85
0.82
0.77
0.86
0.84
0.82
0.84
0.79
0.91
0.82
0.72
0.75
0.66
0.75
0.78
0.70
0.82
0.60
0.59
0.70
0.67
0.66
A little (%)
Quite a bit (%)

32.8
31.7
34.3
35.7
30.0
37.7
36.7
36.7
29.3
33.8
39.1
41.0
23.4
37.9
32.1
34.8
36.5
31.2
34.7
29.3
33.7
35.0
32.3
36.5
67.2
68.3
65.7
64.3
70.0
62.3
63.3
63.3
70.7
66.3
60.9
59.0
76.6
62.1
67.9
65.2
63.5
68.8
65.3
70.7
66.3
65.0
67.7
63.5
33.3
39.6
37.8
35.3
50.0
25.0
31.0
30.0
43.5
34.6
11.8
19.2
54.3
21.7
41.4
33.3
20.0
42.1
30.0
47.8
35.0
38.5
42.9
28.6
66.7
60.4
62.2
64.7
50.0
75.0
69.0
70.0
56.5
65.4
88.2
80.8
45.7
78.3
58.6
66.7
80.0
57.9
70.0
52.2
65.0
61.5
57.1
71.4
37.5
20.0
25.0
28.6
60.0
25.0
33.3
40.0
28.6
25.0
50.0
33.3
20.0
50.0
50.0
33.3
Older
Younger
33.3
12.5
16.7
25.0
14.3
50.0
22.2
14.3
50.0
20.0
14.3
25.0
25.0
100.0
50.0
25.0
M = 1.44
M = 1.48
M = 1.30
M = 1.48
M = 1.36
M = 1.45
Older
66.7
100.0
87.5
83.3
100.0
100.0
75.0
85.7
50.0
100.0
77.8
85.7
50.0
100.0
100.0
80.0
85.7
75.0
75.0
.070
3.315
2.041
1.008
11.100*
7.151
2.211
1.823
2.425
2.225
5.423
7.644
10.974*
5.193
2.384
.887
3.015
1.476
1.383
8.332
1.780
3.779
.742
5.052
50.0
100.0
75.0
100.0
SD = .37
SD = .57
SD = .40
SD = .57
SD = .36
SD = .56
.414
1.34
.946
15
62.5
80.0
75.0
71.4
100.0
40.0
100.0
75.0
66.7
60.0
71.4
100.0
75.0
50.0
66.7
80.0
50.0
50.0
100.0
100.0
100.0
100.0
66.7
100.0
Younger
Older
Younger
Older
Younger
Older
Extremely (%)
Not at all (%)
16
Table 7.
Differences in screening instruments HSCL-25 by group (n = 360).
Subscale
Anxiety
Depression
Total score
Between
Within
Between
Within
Between
Within
SS
df
MS
Sig.
21.123
94.664
20.747
67.301
18.675
64.796
2
357
2
357
2
357
10.562
0.265
10.373
0.189
9.338
0.182
39.830*
.000
55.026*
.000
51.446*
.000
*p < .05.
staying asleep ranked rst, while the symptom thoughts of ending your life
ranked last. There were differences between boys and girls in 11 symptoms,
namely: feeling fearful, heart pounding or racing, crying easily, worrying too
much about things, feeling restless and cannot sit still, nervousness or shakiness
inside, feeling hopeless about the future, feeling blue, headaches, feeling of
worthlessness and thoughts of ending your life. In all these symptoms, girls
were more distressed than boys.
There were no statistically signicant differences in total score or in anxiety
and depression subscales attributable to age. The symptom difculty falling
asleep, staying asleep ranked rst while the symptom thoughts of ending
your life ranked last. There were statistically signicant differences between
younger and older children in two symptoms: (1) heart pounding or racing,
(2) suddenly scared for no reason. In both these anxiety symptoms, older children were more distressed than younger children.
A one-way ANOVA was used to test for differences in anxiety and
depression subscales as well as the total score among the three groups
(samples) of children, (Table 7). The Scheffe post hoc comparisons of the
three groups indicated that both the Zaatari and Ramtha children displayed signicantly greater anxiety than the Amman children. However, there was no signicant difference between the Zaatari and Ramtha children in terms of anxiety
symptoms.
In terms of depression, the Zaatari children displayed signicantly greater
depression symptoms than the Ramtha or Amman children. The Ramtha children, on the other hand, displayed signicantly greater depression than the
Amman children.
Discussion and conclusions
With respect to depression symptoms, the Zaatari children were more implicated than
the Ramtha children, who in turn were more implicated than the Amman children. The
symptom thoughts of ending your life was expressed only by Zaatari children. This
result is perhaps not unexpected since the Zaatari children are the refugees who experienced the consequences of violence rst hand. With respect to anxiety symptoms, there
were no signicant differences between the Zaatari and Ramtha children. Perhaps there
is an inference here to the effect that although the Ramtha children were not exposed
directly to violence, they nevertheless felt the consequences of violence in Syria:
they lived nearby on the other side of the border with hostilities approaching. This
17
observation should help to draw attention to the dire circumstances of children inside
Syria who are trapped between ghting groups. The Zaatari children did not show
any differences with respect to anxiety or depression symptoms attributed to gender.
However, there were differences due to age. Older children were more likely to evidence symptoms than younger children. This is in line with the ndings of Werner
(2012) who noted that The more recent the exposure to war, and the older the child,
the higher was the likelihood of reported posttraumatic stress disorder symptoms.
(p. 664)
Further research at the Zaatari camp is planned. The results of this preliminary study
are not entirely unexpected. The further the children live away from the conict and
hostilities the more secure they appear to feel and the fewer are the symptoms of
anxiety and depression evidenced It is interesting that the older children those
beyond the middle years of childhood are evidently more susceptible to the implications of violence and strife than the younger children. Unsurprisingly perhaps, the
extreme depressive and anxiety symptoms were evidenced mainly in the group of children living in the Zaatari refugee camp they were the ones who had been at the heart
of the conict and many had experienced quite horric acts towards members of their
own families and others. Here, there were no gender differences boys and girls being
equally inuenced and the older more than the younger. With these children, there is
clearly a need for positive intervention towards rehabilitation and counselling. The
problem however is that resources for habilitation are scarce and the need is great.
Syria is not unique in this respect the need for restoration of positive images of
self is immense in all war-torn countries where children are the collateral damage of
savagery. Of course, the fear of war is but one aspect of a complex refugee problem
for many children the right to grow in safety, the right to nutrition, water, the right
to play and develop as healthy allround individuals are all rights that are daily
denied to the refugees in camps.
Educational activities during emergencies provide children with a safe space to
begin the trauma-healing process and to learn skills and values needed for a more
peaceful future. There is general consensus that child protection and education interventions support and promote the well-being of children in emergencies; however,
those measures are invariably inadequate in practice. This can be attributed to the
usual shortage of funding and to the fact that child protection is neither understood
nor prioritised within emergency responses. Funding for education is usually limited.
According to the inter-agency network for education in emergencies, only 2% of humanitarian aid goes to education.
Too little is known of the social and psychological impact of these deprivations as
the children reach maturity and equally little is known of interventions that could if
deployed help such children become happy, autonomous and self-actuating adults
committed to peaceful co-existence in complex world of political and sectarian
divisions. Future research is being planned that will provide longitudinal data aimed
at elucidating the longer term impact of the experience of violence and abuse
through internal conict.
Notes
1.
2.
UN Camps in Iraq, Turkey, Lebanon and Jordan by 2013.

An independent and impartial, international non-governmental organisation investing in a
peaceful future for children affected by armed conict.
18
Notes on contributors
Dr Sinaria Kamil Abdel Jabbar is an Assistant Professor of Education at the Department of

Curriculum and Instruction, The University of Jordan. Dr Jabbar also serves as Assistant to
the Director at the Ofce of International Relations at the University. She received her BA in
English Literature from Petra University in Jordan in 2002 and an M.ED and Ph.D. in Early
Childhood Education and Adult Education from The University of Missouri-Saint Louis, in
2005 and 2008, respectively. Her research interests encompass adult education, international
education, refugee studies, human rights, women studies, and youth and development and
have published over eight papers in world-class journals. Dr Jabbar is an active member in
various committees including parliamentary committees for education reform in Jordan. In
her free time, Dr Jabbar loves to read, travel and participate in humanitarian activities.
Dr Haidar Ibrahim Zaza is an Associate Professor of Educational Psychology/measurement and
evaluation. His current research interests include data analytics, Big Data main issues of
research, Educational Psychology Issues, scaling and Item Response Theory applications. He
received his B.A. degree in Educational Sciences from The University of Jordan (1997), MS
and Ph.D. degrees in Educational Psychology from The University of Jordan (2000 and
2006, respectively). Dr Zaza runs a number of local and regional projects, published over 15
papers in local, regional and world-class journals. Dr Zazas experience in measurement and
evaluation extends to 10 years in service, research, and development. Dr Zaza served in The University of Jordan as a head of Educational Psychology Department. and director of educational
psychology program.
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22
Appendix

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Early Child Development and Care, 2014

Impact of conict in Syria on Syrian children at the Zaatari

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Curriculum & Instruction Department, University of Jordan, Amman 11942, Jordan;

(Received 27 March 2014; nal version received 15 April 2014)

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S.A. Jabbar and H.I. Zaza

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Early Child Development and Care

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S.A. Jabbar and H.I. Zaza

the overlap between PTSD and co-morbid psychological symptoms, such as

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Early Child Development and Care

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S.A. Jabbar and H.I. Zaza

Early Child Development and Care

isolation, poor self-image, self-harm, aggression and depression. According to the

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S.A. Jabbar and H.I. Zaza

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Age group years

Early Child Development and Care

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Not at all (%)

S.A. Jabbar and H.I. Zaza

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Quite a bit (%)

Younger Older Younger Older Younger

Early Child Development and Care

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Not at all (%)

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Quite a bit (%)

Younger Older Younger Older Younger

S.A. Jabbar and H.I. Zaza

Not at all (%)

Quite a bit (%)

Early Child Development and Care

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Not at all (%)

Not at all (%)

S.A. Jabbar and H.I. Zaza

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Quite a bit (%)

Younger Older Younger Older Younger

Early Child Development and Care

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Not at all (%)

S.A. Jabbar and H.I. Zaza

Differences in screening instruments HSCL-25 by group (n = 360).

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Early Child Development and Care

UN Camps in Iraq, Turkey, Lebanon and Jordan by 2013.

S.A. Jabbar and H.I. Zaza

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Dr Sinaria Kamil Abdel Jabbar is an Assistant Professor of Education at the Department of

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Early Child Development and Care

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S.A. Jabbar and H.I. Zaza

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