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　　Since the late 1990s, we have run a number of studies in the Gaza Strip, with Dr Abdel Aziz Thabet and his research team. Our initial study, after the end of the first intifada (uprising), established a high prevalence rate (41%) of post-traumatic stress reactions among children (aged 6– 11 years) and their significant association with traumatic events experienced by the children, as well as with other behavioural and emotional problems (Thabet & Vostanis, ). The trauma experienced included injuries, death or imprisonment of family, relatives or friends, as well as day and night raids.

　　When we re-interviewed these children (n=234) 1 year later, well after the Oslo agreement and the renewal of the peace process in the region, the prevalence rate of post-traumatic stress reactions had decreased to 10% (Thabet & Vostanis, ). The findings suggested that most reactions were acute and resolved in the absence of further conflict, but there were also a substantial number of children who suffered chronic and resistant posttraumatic reactions, which could benefit from specialist treatment.

　　Palestinian children’s mental health problems were compounded by their extreme adverse socio-economic circumstances, which is a common finding in research with children who are victims of political conflict. Most traumatic events occur in refugee camps in the West Bank and the Gaza Strip, where generations of children have been born for 55 years with little hope of escape. There has been a continuous growth of the population, which has now reached a density of 2300/km2. Refugees make up 63% of the population, and 51% of refugees are under 15 years of age (Thabet & Vostanis, ).

　　Palestinian children’s mental health problems were compounded by their extreme adverse socioeconomic circumstances, which is a common finding in research with children who are victims of political conflict.

　　The second intifada (Al Aqsa) started in September 2000. Although we could not access all areas of the Gaza Strip to follow up the previous sample, we repeated the epidemiological study with a new cohort, and found that the prevalence rates of post-traumatic stress reactions had again risen dramatically, as a consequence of high exposure to new traumatic events. Children’s emotional presentations were strongly correlated with maternal psychopathology (i.e. mothers’ response to t