Young Children's Reactions to War-Related Stress: A Survey and Assessment of an Innovative Intervention

Sadeh, Avi; Hen-Gal, Shai; Tikotzky, Liat

doi:10.1542/peds.2007-1348

Cited by 137Posttraumatic Stress Disorder ResearchChild Therapy and DevelopmentChild Abuse and Trauma

Young Children's Reactions to War-Related Stress: A Survey and Assessment of an Innovative Intervention

Sadeh, Avi, Hen-Gal, Shai, Tikotzky, Liat·2008·Pediatrics

DOI 10.1542/peds.2007-1348

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Abstract

OBJECTIVE. The goal was to assess stress reactions in young children during and after war and the effects of a new brief intervention. METHODS. Two separate studies were conducted. In study I, we assessed war exposure and stress reactions of 74 children (2–7 years of age) in a sheltered camp during the second Israel-Lebanon war (July to August 2006). Their exposure to war experiences and their stress reactions were assessed through parental reports during the last week of the war. In addition to standard care, 35 children received a brief intervention (Huggy-Puppy intervention) aimed at encouraging them to care for a needy Huggy-Puppy doll that was given to them as a gift. The effects of the Huggy-Puppy intervention were assessed in a follow-up interview 3 weeks after the war. Study II assessed the efficacy of group administration of the Huggy-Puppy intervention to 191 young children, compared with 101 control subjects. The effects of the intervention on stress-related symptoms after the war were assessed in telephone interviews with the parents. RESULTS. Study I indicated that, during the war, most children had significant exposure to war-related experiences and had severe stress reactions. The Huggy-Puppy intervention was associated with significant reductions in stress reactions in the postwar assessment. A higher level of attachment and involvement with the doll was associated with better outcomes. The results of study II indicated that group administration of the Huggy-Puppy intervention was associated with significant reductions in stress reactions. CONCLUSION. These studies suggest that the Huggy-Puppy intervention may offer pediatricians and other child health care professionals a promising, cost-effective intervention for children during stressful times.

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The study observed significant correlations among adherence to huggy-puppy, attachment to the doll, and better well-being.
“Significant correlations between child adherence to the intervention, child attachment to the doll, and improvements in well-being were observed.”
From Interventions for Children Affected by War: An Ecological Perspective on Psychosocial Support and Mental Health Care (2013) · cites this paper as [26]
Randomized trials in Israel using parent-report pre/post assessments found strong beneficial effects of huggy-puppy on traumatic stress symptoms.
“In randomized trials of the huggy-puppy intervention in Israel, pre/post-intervention parent-report assessments indicated that it had strong positive effects on symptoms of traumatic stress reactions.26”
From Interventions for Children Affected by War: An Ecological Perspective on Psychosocial Support and Mental Health Care (2013) · cites this paper as [26]

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ARTICLE Young Children’s Reactions to War-Related Stress: A Survey and Assessment of an Innovative Intervention
Sadeh, A., Hen-Gal, S., & Tikotzky, L. (2016)
Self-citation
Parent-delivered huggy-puppy intervention for war-related stress in children
Yankovitch, D., Ron, S., Wairauch, Y., Wassermann, O., Tikotzky, L., & Kahn, M. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02914-3
Self-citation
Reacciones de los niños al estrés relacionado con la guerra: encuesta y valoración de una intervención innovadora
Sadeh, A., Hen-Gal, S., & Tikotzky, L. (2008) · PEDIATRICS
Self-citation
Group crisis intervention for children during ongoing war conflict
Thabet, A. A., Vostanis, P., & Karim, K. (2005) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-005-0466-7 · Cited by 168 · see citing works
Effectiveness and specificity of a classroom‐based group intervention in children and adolescents exposed to war in Lebanon
KARAM, E. G., FAYYAD, J., KARAM, A. N., TABET, C. C., MELHEM, N., MNEIMNEH, Z., & DIMASSI, H. (2008) · World Psychiatry · doi:10.1002/j.2051-5545.2008.tb00170.x · Cited by 115 · see citing works

Authors: Sadeh, A., Hen-Gal, S., & Tikotzky, L.
Affiliations: Tel Aviv University (IL)
Corresponding author: Sadeh, Avi
ORCID: Sadeh, Avi
Tikotzky, Liat
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2008-01-01
Volume: 121
Issue: 1
Pages: 46-53
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2007-1348
OpenAlex: W2103689858
Cited by: 137
References: 57
Citations by year: 2026: 3 · 2025: 9 · 2024: 7 · 2023: 3 · 2022: 5 · 2021: 7 · 2020: 3 · 2019: 2 · 2018: 6 · 2017: 48 · 2016: 8 · 2015: 4 · 2014: 2 · 2013: 3 · 2012: 6
FWCI: 5.44
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords: combat stress, young children, brief psychological intervention, war exposure, group intervention, stress-related symptoms
MeSH terms: Adaptation, Psychological, Age Factors, Child, Child, Preschool, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Interviews as Topic, Israel, Male, Probability, Psychotherapy, Reference Values, Severity of Illness Index, Sex Factors, Stress Disorders, Post-Traumatic, Stress, Psychological, Warfare, Incidence, Case-Control Studies

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Young Children's Reactions to War-Related Stress: A Survey and Assessment of an Innovative Intervention

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