Understanding the Impact of War on Mothers and Children Through the Family Stress Model and Adverse Childhood Experiences Framework

Understanding the Impact of War on Mothers and Children Through the Family Stress Model and Adverse Childhood Experiences Framework | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Understanding the Impact of War on Mothers and Children Through the Family Stress Model and Adverse Childhood Experiences Framework Efrat Sher-Censor, Rinat Feniger-Schaal, David Oppenheim, Nina Koren-Karie, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9459838/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract We examined how war impacts mothers and children by applying the Family Stress Model (FSM) and Early Childhood Adversity (ACE) model. 877 Israeli mothers of children aged 3–18 years (Sample 1) and 291 Israeli mothers of infants and toddlers (birth–36 months; Sample 2) completed self-reports. Structural Equation Modeling analyses supported the FSM and the ACE model. In Sample 1, maternal ACEs, including childhood exposure to war/terror, and mothers’ current war-related adversities, were associated with children’s psychological symptoms. In line with the FSM, these effects were sequentially mediated by mothers’ heightened sense of danger, followed by their depression and anxiety symptoms, followed by poorer co-parenting and parenting. Similar patterns were found in Sample 2, yet childhood war/terror exposure and maternal anxiety symptoms were not linked to child symptoms. The study reveals the contribution of the FSM and ACE models for understanding how past and current parental adversities impact mothers and children. It demonstrates the detrimental effect of war on families and illuminates potential mechanisms for intervention. Furthermore, it highlights that mothers with more ACEs may be particularly vulnerable in their ability to cope with war-related stress, increasing their risk for psychological distress and subsequent parenting difficulties. War Family Stress Model ACE mother-child relationship Figures Figure 1 Figure 2 Figure 3 Introduction Research has documented the deleterious effects of war and armed conflicts on adults and children (e.g., Hyland et al., 2023; Sadeh et al., 2008). The current study examined the effect of war on mothers and children in Israel, and aimed to extend prior research in three key ways. First, it applied the Family Stress Model (Conger et al., 2000), originally developed in the context of economic hardship, to reveal family processes through which war influences children. Second, it investigated the interplay between past and present adversity by examining whether mothers’ adverse childhood experiences (Felitti et al., 1998) heightened their vulnerability to the effects of war. By employing the Family Stress (Conger et al., 2000) and Early Childhood Adversity frameworks, the study aimed to provide a more comprehensive understanding of the intergenerational transmission of trauma in the context of war. Finally, the study included two samples, one of which consisted of families of infants and young toddlers, a population that has received little attention in war-related and Family Stress research. On October 7, 2023, Hamas and Islamic Jihad militants launched an attack on Israel from Gaza. From that point through May 2024, when data collection for the present study began, families both in Israel and Gaza have endured significant and extended hardships due to the ongoing war. In this paper, we focus solely on the impact of war on families in Israel, both Jewish and Arab, as they were the ones to which we had access as researchers in Israel. Notably, 2 1 % of Israel's population is Arab (Israel Central Bureau of Statistics, 2024). The immediate losses of the October attack included over 1,150 Israeli fatalities, including 739 civilians, and the abduction of 251 individuals to the Gaza Strip. Since then, Jewish and Arab families across Israel have faced continuous rocket attacks, with loud warning sirens signaling the need to seek shelter within 15 to 120 seconds, causing frequent disruptions to daily life and triggering emotional responses of stress and fear of harm. By May 2024, the death toll in Israel had surpassed 1,600, including both civilians and soldiers, while more than 19,000 people were reported injured. The war also led to significant disruptions in the educational system due to security concerns, with extended closures of daycares, preschools, and schools. The prolonged military service of reservist parents, coupled with rising unemployment due to the war, further strained many families. Additionally, more than a quarter of a million citizens were evacuated from their homes in the southern and northern regions of the country. At the time of data collection, and still currently, many of them remain displaced (The Israel Democracy Institute, 2024; The National Security Agency, 2024). Exposure to war-related experiences such as the above is associated with increased depression and anxiety symptoms in adults (Levi-Belz et al., 2024; Mohammed Bilal et al., 2024), and risk of developing PTSD in a dose-response manner (Karatzias et al., 2023). War exposure is also associated with increased psychological symptoms in children (e.g., Sadeh et al., 2008; Yirmiya et al., 2022; see meta-analysis in Eltanamly et al., 2021). Possibly buffering these child effects, studies suggest that positive parent-child relationships are a source of protection against the impact of traumatic events (Feldman et al., 2014; Sloover et al., 2024). When both parents and children are exposed to continuous adverse experiences, however, parental buffering may be weakened or absent, increasing children’s vulnerability to these experiences (Nuttman-Shwartz, 2023). This is supported in a recent meta-analysis that showed that exposure to war is associated with parents’ higher hostility and less warmth towards their children, which in turn is related to more psychological symptoms in the children (Eltanamly et al., 2021). The current study aimed to identify additional factors and processes through which war exposure impacts mothers and their children by drawing on two models: the Family Stress Model (Conger et al., 2000) and the Adverse Childhood Experiences (Felitti et al., 1998) model. The Family Stress Model (FSM) The FSM explains how economic hardship impacts parents’ psychological well-being and children’s adjustment (Conger et al., 2000). The model suggests that economic hardship puts children at risk of maladjustment directly and indirectly through cascade effects in which economic hardship leads to parents’ heightened economic stress, which increases their psychological distress in terms of, for example, depression and anxiety symptoms (Newland et al., 2013). Parents’ psychological distress, in turn, leads to disrupted family processes in terms of interparental relationship problems (e.g., lower co-parenting support; Derlan et al., 2019) and disruptions in the parent-child relationship (e.g., hostile parenting, Parke et al., 2004). The model has been supported in numerous studies across different ethnic groups (e.g., African-Americans, Conger et al., 2002; Mexican-American, Derlan et al., 2019; Finnish, Solantaus et al., 2004; Chinese, Zhang et al., 2020) and child ages, by demonstrating that economic hardship puts children at risk of increased psychological symptoms, poorer academic performance, and poorer health through the above chain of family disruptions (see a review in Masarik & Conger, 2017). Although the FSM focuses on economic hardship, its developers suggested it may apply to additional environmental stressors. In support of this notion, the model was applied to study the effects of immigration (e.g., Lorenzo-Blanco et al., 2019; Sher-Censor & Mizrachi-Zinman, 2020), the COVID-19 pandemic (e.g., Lucassen et al., 2021) and military deployment (Gewirtz et al., 2018). The present study aimed to examine the model in the context of war and extend it downward to toddlers and infants who have not been studied before within this framework. Informed by the FSM, we examined whether maternal exposure to more war-related experiences would be associated with a heightened sense of danger , to parallel the construct of economic stress in the FSM. E conomic stress reflects the psychological burden of economic hardship due to financial strain (e.g., inability to pay bills), unmet basic material needs (e.g., housing), and necessary cutbacks in expenses. A sense of danger reflects a psychological burden resulting from a stressor in the environment. It includes perceived threats to personal and family safety and financial security, along with uncertainty about the future caused by the stressor (Solomon et al., 1989). When an environmental stressor like war is perceived as threatening, it can trigger emotional reactions in adults, including depression and anxiety symptoms (Kimhi et al., 2010; Sher-Censor et al., 2025; Solomon et al., 1989). In line with the FSM, we examined whether a higher sense of danger would be associated with depression and anxiety symptoms in mothers, and whether maternal symptoms would be subsequently related to disruptions in both the inter-parental and the parent-child relationships. To examine inter-parental relationship problems, similar to several FSM studies (e.g., Derlan et al., 2019; Lucassen et al., 2021), we examined mothers’ perceptions of co-parenting support, namely the level of support the mother receives from the father in her parenting role (e.g., agreement regarding parenting practices, supportive and reinforcing communication around parenting; Feinberg, 2003). We focused on three indicators of disruptions in the mother-child relationship. The first was parental burnout, which refers to exhaustion in the parenting role, feeling fed up with being a parent, and emotional distancing from the child. Parental burnout arises when parenting demands exceed the parent’s available resources (Roskam et al., 2018) and was found to be assoicated with psychological symptoms of both parents (Kerr et al., 2021; Mikolajczak et al., 2020) and their children (Kerr et al., 2021), including in wartime (Aviad et al., 2024). Following past FSM research (e.g., Parke et al., 2004), as well as research on the effects of war on parents (Eltanamly et al., 2021), the second disruption in parent-child relationship we assessed was maternal hostility towards her child, which include, for example, reacting angrily and using injuring words toward the child. The third indicator of mother-child relationship problems was mothers’ avoidant communication with their children about the war. Parents’ communication about distressing or potentially traumatic events with their children is thought to shape children’s processing of these experiences and affect their well-being. When parents are also exposed to these events and experience distress, they may avoid such conversations, potentially hindering children’s meaning-making and contributing to their increased psychological symptoms (see a review in Sloover et al., 2024). Research has supported these notions mostly in the context of relatively benign distressing daily child experiences (e.g., Koren-Karie et al., 2008) or personal potentially traumatic events (e.g., injury, death of father; Sloover et al., 2024). Yet a few studies also support them in the context of mass trauma (see a review in Sloover et al., 2024). For example, a study on parent-child communication about the 2013 Boston Marathon bombing and a study on parent-child communication about COVID-19 suggest that parents’ avoidant communication about these events was linked to greater psychological symptoms in children (Carpenter et al., 2017; Malloy et al., 2024). The COVID-19 study also found that parents with heightened psychological symptoms were more likely to use this communication pattern (Malloy et al., 2024). Together, these findings suggest that mothers experiencing heightened depression and anxiety symptoms may be more likely to show avoidant communication about the war with their child, which, in turn, may contribute to children’s increased psychological symptoms. See Figure 1 for a graphic illustration of the study model. Adverse Childhood Experiences (ACE ) The second framework that guided this study was the ACE model (Felitti et al., 1998), which suggests that exposure to an accumulation of adverse childhood experiences of abuse, (i.e., physical, emotional, and sexual abuse), neglect (i.e., emotional and physical neglect), and household dysfunction (e.g., mental illness in the household, exposure to substance abuse in the household) leads to psychological symptoms in a dose-response manner in both adults and their children (see meta-analyses in Cooke et al., 2021 and Hughes et al., 2017). We aimed to explore whether ACEs are associated with increased vulnerability of mothers and their children to the impact of war and whether the family process delineated in the FSM would help explain this impact. We are aware of only one study looking at the effects of ACEs in the context of war, showing that veterans in the US exposed to warfare showed more psychological symptoms than veterans not exposed to warfare, regardless of their ACEs (Morgan et al., 2020). A few studies on other potentially traumatic events (e.g., chronic illnesses and natural disasters such as hurricanes), however, found that adults who have experienced more ACEs perceived current potentially traumatic events as more threatening, and this increased sense of danger mediated the link between ACEs and psychological symptoms (Traino et al., 2022; Wilson-Genderson et al., 2021). ACEs research also shows that parents’ psychological symptoms and poor co-parenting and parenting are key mechanisms underlying the intergenerational effects of parents’ ACEs on their children (Sher-Censor et al., 2024; Zhang et al., 2023). Thus, it is possible that increased maternal ACEs would be associated with an increased sense of danger due to the war, which in turn would be associated with more psychological symptoms, more disruptions in both co-parenting and parenting and subsequently more psychological symptoms in children. Finally, because the study focused on the impact of mothers’ ACEs in the context of war, alongside the traditional ACEs of maltreatment, neglect, and family dysfunction, we explored the role of mothers’ exposure in childhood to war- or terror - related experiences (see Figure 1). The Current Study This study aimed to examine the effects of mothers’ ACEs and current war experiences on mothers and their children, as well as reveal familial mechanisms underlying these effects, as suggested by the FSM. To achieve this goal, we conducted two surveys, one for mothers of children from birth up to age three years and one for mothers of children from age 3 to 18 years. The two surveys assessed the same constructs with one exception. Avoidant communication about the war was assessed only among mothers of children at the ages of three and older. This was because, by age three years, children have the language, cognitive, and socio-emotional abilities to engage in conversations about emotionally laden events (Reese & Newcombe, 2007). To reduce the burden of self-reporting, these mothers did not report their hostility toward the child. Thus, maternal hostility was examined only in the survey of mothers of children from birth to age three years. Based on the FSM and ACE models, and as shown in Figure 1, we hypothesized that mothers' exposure to a higher number of ACEs, exposure to a war- or terror - related experience in childhood, and more current war-related adversities would be associated with their children's increased psychological symptoms. Following the FSM, we expected these links to be indirect through a sequential mediational pathway. Specifically, per both the FSM and ACE frameworks, we hypothesized that higher maternal exposure to childhood and current adversities would lead to an increased sense of danger due to the war, which would lead to elevated maternal depression and anxiety symptoms. In line with the FSM, we expected that maternal symptoms would result in disruptions in family relationships in terms of mothers’ perceptions of decreased co-parenting support and increased parental burnout, along with increased maternal hostility and more avoidant communication about war-related events with children. These disruptions in family relationships would, in turn, be related to children’s increased psychological symptoms. Method Participants Data were collected from two samples. Sample 1 included 877 mothers of children aged 3-18, and Sample 2 included 291 mothers of infants and toddlers aged birth to 3 years. See the participants’ demographic background in Table 1. Procedure This study was part of a larger ongoing longitudinal project on the effects of the current war in Israel on Jewish and Arab families in Israel (blinded for review). Announcements in Hebrew and Arabic inviting parents to complete an online survey about the impact of the war on families were distributed through social media. Sample 1 data were collected between May 21 and June 4, 2024. Sample 2 data were collected between June 4 and July 20, 2024. The survey was available in Hebrew and Arabic. The study was approved by the University's Ethics Committee (#157/24). Mothers provided written informed consent. Measures Adverse Childhood Experiences Checklist (Center for Disease Control, 2016; Felitti et al., 1998). This widely used checklist assess whether, before the age of 18 years, mothers experienced the following 10 adversities: physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, parental separation or divorce, domestic violence, addictions in the household, mental illness in the household, or incarceration of a member of the household. Scores were calculated by adding the total number of ‘yes’ responses. Exposure to War/Terror-Related Events in Childhood. This question was designed for the current study. Mothers reported whether, before the age of 18, they were present in an area where a terror attack occurred at the time it happened or whether they lived in an area that, during certain periods, experienced frequent sirens that alert of coming rockets or missiles. Exposure to Current War Adversities (Shai & Sher-Censor, 2023). Mothers reported whether they experienced the following 10 events resulting from the current war in Israel: A relative, friend, or acquaintance was killed; The mother, a relative, friend, or acquaintance were injured; A relative, friend, or acquaintance was kidnapped or is missing; Prolonged military service by the mother or a first-degree relative in war zone areas; Prolonged military service by the mother or a first-degree relative outside war zone areas; Evacuation from home due to the war; frequent sirens that alert of incoming missiles or rockets; Job loss or significant loss of income due to the war; Expressions of hatred based on ethnic/religious background due to the war; Acts of violence based on ethnic/religious background due to the war. Mothers’ scores were calculated by adding the total number of ‘yes’ responses. Sense of Danger (Solomon et al., 1992). This measure included five items, tapping perceived threats to personal, familial, physical, and economic well-being due to specific stressors. Mothers reported their sense of danger due to the current war using 5-point scales, ranging from 1 (“Not at all”) to 5 (“Very much”). Higher scores reflected a greater sense of danger. The measure was previously used in research of Jewish and Arab Israelis (Sher-Censor et al., 2025), including in the context of past wars in Israel (Kimhi et al., 2010; Solomon et al., 1992), and showed good reliability in the current study (Cronbach’s alpha Sample 1 =.81; Cronbach’s alpha Sample 2 = .77). The Depression, Anxiety and Stress Scale - 21 Items (DASS-21; Lovibond & Lovibond, 1995). Mothers reported the extent to which they experienced seven symptoms of depression (e.g., ‘I felt down-hearted and blue’) and seven symptoms of anxiety (e.g., ‘I felt scared without any good reason’) over the past month on a 4-point Likert scale ranging from 0 (‘does not apply’) to 3 (‘applies very much’). The DASS is widely used, including in its Hebrew and Arabic versions (e.g., Sher-Censor et al., 2024). Higher scores indicate more symptoms. After multiplying the scores by 2, scores above 9 in depression and above 7 in anxiety are considered above normal. For the current study, scores on each scale were summed and not multiplied. Thus, the equivalent thresholds are 4.5 for depression and 3.5 for anxiety. The scales demonstrated good internal consistency (Cronbach’s alpha Sample 1 depression = .88; Cronbach’s alpha Sample 2 anxiety = .87; infants/toddlers’ sample: Cronbach’s alpha Sample 2 depression = .89; Cronbach’s alpha Sample 2 anxiety = .83). Co-parenting Support (Bronte-Tinkew et al., 2007). This 5-item measure was used to assess mothers’ perceptions of the fathers’ support for the mothers in their parenting (e.g., ‘My child’s father respects the schedules or rules I makes for our child’). Items are rated on a 5-point scale ranging from 1 (‘very seldom’) to 5 (‘very often’). Higher scores reflect higher co-parenting support. The measure's developers used it in a large-scale nationally representative survey of infants, reporting an alpha of .68. Lower scores were more common among never-married couples than among married, cohabiting, separated, or divorced couples and were associated with paternal depression, poverty, and a history of substance use. Cronbach’s alpha in the current study was .89 in sample 1 and .77 in sample 2. The Brief Parental Burnout Scale (Aunola et al., 2021). This 5-item index is a brief version of the widely used Parental Burnout Assessment (Roskam et al., 2018). Mothers reported the extent to which they experience parenting burnout (e.g., ‘I’m no longer able to show my child how much I love her/him’) on a 5-point scale ranging from 1 (‘never’) to 5 (‘every day’). This brief version has been used in several studies (e.g.., Caviezel Schmitz & Krüger, 2024) and showed good internal consistency (e.g., alpha = .85; Aunola et al., 2021) and expected links with parents’ depressive symptoms, sleep disruptions (Aunola et al., 2021; Caviezel Schmitz & Krüger, 2024), child neglect and parental violence (Aunola et al., 2021). Cronbach’s alpha in the current study was .84 in sample 1 and .77 in sample 2. Event-related household discussions (Carpenter et al., 2017; Malloy et al., 2024). Mothers in Sample 1 completed the Avoidant Communication scale of this questionnaire, which includes five items (e.g., ‘I avoid talking to my child about the war’) using a scale ranging from 1 (‘never’) to 5 (‘very often’). The measure was developed in a study of parent-child communication about the 2013 Boston Marathon bombing (Carpenter et al., 2017). It was also validated in a study of parent-child communication about COVID-19, that showed that higher avoidance was associated with poorer parental mental health and predicted children’s poorer mental health problems six months later (Malloy et al., 2024). Cronbach’s alpha in the current study was .80. The Emotional Availability–Self Report (EA-SR; Biringen et al., 2005) . Mothers in sample 2 responded to the 6-item hostility scale (e.g., ‘It happens that I react in an angry way to my child’) using a 5-point Likert ranging from 1 (‘not agree at all’) to 5 (‘totally agree.’) This scale showed good internal reliability in past research. It was negatively associated with the non-hostility EA scale in observed mother-infant interactions (Vliegen et al., 2009). In addition, mothers’ scores on this scale decreased following participation in a brief early intervention (McConnell et al., 2020). Cronbach’s alpha in the current study was .85. The Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997). Mothers in Sample 1 completed the 20-item difficulties scale of the SDQ that is widely used for assessing children’s psychological symptoms, including in research of Jewish and Arab Israeli children (e.g., Hen et al., 2024; Ziv & Arbel, 2020). It assesses children’s emotional symptoms (e.g., “Many fears, easily scared”); conduct problems (e.g., “Often fights with other children or bullies them”); hyperactivity/ inattention (e.g., “Easily distracted, concentration wanders”); and peer relationship problems (e.g., “Rather solitary, tends to play alone”). Three items have a different version for ages 2-4 and 4-18 (e.g., “Often argumentative with adults for children” aged 2-4; “Often lies or cheats” for children aged four and up). The survey included both versions, and mothers were instructed to complete the items according to their child’s age. All items were rated on a 3‐point scale ranging from 0 (“not true”) to 2 (“certainly true”), For the current study, four symptoms were added in light of prior research suggesting that these are common symptoms among children in war zones (Sadeh et al., 2008): sleep disturbances, picky eating, bedwetting/fecal incontinence, and school truancy. Cronbach’s alpha in this study was .81. Items were summed to form the total difficulty score of the child. Notably, we also summed the original 20 items to compare them to the cutoff point between normal and above normal, which is 12 for ages three to four and 13 for ages four to 18. The Baby Pediatric Symptom Checklist (BPSC; Sheldrick et al., 2013). Mothers in Sample 2 completed the BPSC to assess infants and toddlers’ psychological symptoms. The BPSC includes 12 items, reflecting symptoms in three dimensions: irritability (“the child is fussy or irritable”), inflexibility (“The child has a hard time in new places”), and difficulties with routines (“Is it hard to put the child to sleep”). Items are rated on a 3‐point scale ranging from 0 (“not true”) to 2 (“very true/very often”). Three items were added for this study per research suggesting that they are common symptoms among infants and toddlers in war zones (Sadeh et al., 2008) : (“Clings to me”; “Easily startled [overreacts to noises and environmental stimuli]”; and “Does not gain enough weight and/or does not eat enough for their age”). Cronbach’s alpha in our study was .85. Items were summed to form the total symptoms score of the child. In addition, we calculated the percentage of children who scored 3 or higher in at least one of the three original BPSC dimensions, a level considered above normal. Data Preparation and Analytic Plan The distribution of all variables was sufficiently normal to render parametric statistics valid, (Afifi et al., 2007), except for infants and toddlers’ age (Skewness = 2.04; Kurtosis = 1.09), which was thus transformed to its square root (Skewness = .22; Kurtosis = .29). Preliminary analyses included Pearson correlations and t -tests to examine the links between background and study variables. To test the study hypotheses, Pearson correlations between study variables were examined, and structural equation modeling (SEM) analyses were performed using Amos 29 statistical software (IBM Corp., 2022). In line with the hypotheses, SEM models included both the direct associations of mothers’ ACEs and war-related adverse experiences with children’s psychological symptoms and the indirect links through mothers’ sense of danger, depression and anxiety symptoms, co-parenting support, parental burnout, and avoidant communication with the child in the model of Sample 1, and maternal hostility in the model of Sample 2. The models included relevant background variables and the paths between them and study variables, as identified in the preliminary analyses. To rule out children’s effects on mothers, we also examined alternative models with paths from children’s psychological symptoms to mothers’ co-parenting support, parenting burnout, and avoidant communication with the child (or hostility in the case of infants/toddlers), and from the latter three to mothers’ depression and anxiety symptoms. Model fit was evaluated using a combination of absolute and incremental goodness-of-fit indices, including Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR). Good model fit is represented CFI ≥ .95, RMSEA ≤ .06 and SRMR < .05. A CFI of .90 or higher, an RMSEA ≤ .08 or less and SRMR ≤ .08 are considered acceptable fit (Hu & Bentler, 1999). The smallest Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values were also used to determine the most parsimonious of the competing models (Hooper et al., 2008). We also reported the X 2 values but did not rely on them for interpretation, as the test is sensitive to sample size, and it is almost always significant in large samples such as the ones of the current study (Schermelleh-Engel et al., 2003). To examine whether the sequential mediation models were supported, we estimated the significance of indirect effects using a bootstrap approach, a nonparametric method based on repeated random resampling with replacement. This yielded 95% bootstrapped confidence intervals (CIs). A significant indirect effect was indicated when zero was outside the 95% CI, suggesting that the mediation effect was statistically different from zero at p < .05. Results Preliminary Analyses Sample 1 Descriptive statistics are shown in Table 2. As can be seen in the table, the average score of mothers’ psychological symptoms was above the "normal" cutoff (see cutoff scores in the Method section above). Children’s average psychological symptoms scores were also above the "normal" cutoff ( M = 13.37, SD = 6.10, Range = 1-35). It is important to note that because we added four items to the SDQ measure of children's psychological symptoms, the comparison to the clinical cutoff point is based on children’s scores using the original SDQ (Goodman, 1997; see the Method section). The following significant associations were found between family background variables and study variables. Jewish mothers reported more ACEs, more war-related adverse experiences, a lower sense of danger, fewer anxiety symptoms, and more psychological symptoms of their children ( M = 1.02, SD = 1.37, M = 2.24, SD = 1.72, M = 2.75, SD =.87, M = 3.68, SD = 3.88, and M = 15.89, SD = 6.97 respectively) than Arab mothers ( M = .68, SD = 1.11, M = .97, SD = 1.30, M = 3.32, SD =.94, M = 4.63, SD = 5.01, and M = 12.46, SD = 6.71 respectively), t (213.16) = 3.12, p = .002, t (226.14) = 9.82, p < .001, t (875) = -6.82, t (162.91) = -2.09, p = .038, and t (875) = 5.27, p < .001 respectively. Jewish mothers were also more likely than Arab mothers to report war or terror-related experiences in their childhood, c 2 (1) = 7.42, p Fisher’s Exact Test = .006. Older maternal age was associated more war-related experiences ( r = .09, p = .006), lower sense of danger ( r = -.14, p < .001), fewer anxiety symptoms ( r = -.08, p = .019), less co-parenting support ( r = -.11, p = .001), lower burnout ( r = -.20, p < .001), and less avoidance in communication with the child ( r = -.39, p < .001). Non-married/cohabiting mothers reported more anxiety symptoms and lower co-parenting support ( M = 5.33, SD = 4.54, and M = 2.74 SD = 1.11 respectively) than married/cohabiting mothers ( M = 3.77, SD = 4.06, and M = 4.16 SD =.79 respectively), t (872) = 2.25, p = .025, and t (36.54) = -7.62, p < .001 respectively. Mothers’ years of education were associated with reports of higher co-parenting support ( r = .10, p = .004), lower avoidance from communication with the child ( r = -.10, p = .004), and fewer psychological symptoms of their children ( r = -.11, p = .001). Mothers of girls reported more depression and anxiety symptoms and tended more to report avoidant communication with their child ( M = 6.48, SD = 4.66, and M = 4.18 SD = 4.25, M = 3.20, SD = .94 respectively) than mothers of boys ( M = 5.72, SD = 4.31, and M = 3.48, SD = 3.89, and M = 3.00, SD = .96 respectively), t (874) = 2.50, p = .013, t (874) = 2.55, p = .011, t (874) = 3.17, p = .002, respectively. Children’s older age was associated with mothers’ reports of more war-related experiences ( r = .07, p = .033), lower sense of danger ( r = -.07, p = .037), less co-parenting support ( r = -.09, p = .012), lower burnout ( r = -.18, p < .001), less avoidant communication ( r = -.48, p < .001), and fewer psychological symptoms of their child ( r = -.09, p = .008). Mothers of firstborns reported higher sense of danger ( M = 2.93, SD = .93), more symptoms of depression ( M = 6.56, SD = 4.79) and anxiety ( M = 4.15, SD = 4.35), more parenting burnout ( M = 2.33, SD = .89), and more avoidant communication with the child ( M = 3.05, SD = .76) than mothers of later-born ( M = 2.76, SD = .88, M = 5.72, SD = 4.20, M = 3.55, SD = 3.82, M = 2.16, SD =.90, and M = 2.69, SD = .80 respectively), t (875) = 2.90, p = .004, t (812.33) = 2.71, p = .007, t (812.37) = 2.17, p = .030, t (875) = 2.83, p = .005, and t (875) = 6.88, p < .001 respectively. Mothers’ age, marital status, children’s age, and first-born status were interrelated ( p ’s < .020). To avoid multicollinearity concerns, subsequent analyses included only ethnocultural background (Jewish or Arab), child gender, child age, and mother’s education as covariates. Sample 2 Descriptive statistics are shown in Table 2. The average score of mothers’ psychological symptoms was just below the cutoff between "normal" and "above normal" (see cutoff scores in the Method section). 65% of the infants received a score above "normal" in at least one of the three symptom dimensions of irritability, inflexibility, and difficulties with routines (not shown in the table). The following significant associations were found between the background and study variables. Jewish mothers reported more war-related experiences, lower sense of danger, and more hostility ( M = 2.08, SD = 1.64, M = 2.86, SD = .87, and M = 1.92, SD = .88 respectively) than Arab mothers ( M = 1.17, SD = 1.60, and M = 3.16, SD = 1.00, and M = 1.57, SD = .68 respectively), t (289) = 3.28, p = .001, t (289) = -2.00, p = .047, and t (64.35) = 2.92, p = .005 respectively. Older mothers’ age was associated with less co-parenting support ( r = -.13, p = .031). Mothers’ years of education were associated with reports of fewer war-related experiences ( r = -.13, p = .030). Older infant and toddler age was associated with mothers’ reports of a lower sense of danger ( r = -.12, p = .047), higher hostility ( r = .13, p = .028), and more psychological symptoms of the child ( r = .12, p = .041). Finally, mothers of firstborns tended more to experience war/terror-related events than mothers of later-born children, c 2 (1) = 8.78, p Fisher exact test = .005. Mothers of firstborns also reported more co-parenting support, less parenting burnout, and less hostility ( M = 4.53, SD = .63, and M = 1.86, SD = .78, and M = 1.60, SD = .71) than mothers of later-born ( M = 4.29, SD = .79, and M = 2.14, SD =.81, and M = 2.02, SD = .91 respectively), t (252.13) = 2.89, p = .004, t (288) = -2.89, p = .004, and t (252.98) = -4.37, p < .001, respectively. Mothers and children’s ages were interrelated ( p ’s < .001). To avoid multicollinearity concerns, subsequent analyses included only child age, first-born status, and mothers’ education as covariates. Because the number of Arab mothers of infants and toddlers was small ( n = 41), it was not included as a covariate. Associations between ACEs, Childhood War/Terror Exposure, and Current War-Related Adverse Experiences and Mothers’ and Children’s Wellbeing Sample 1 As shown in Table 3, most intercorrelations between study variables were significant. We describe here those that were hypothesized. As expected, mothers who reported more ACEs, a childhood war/terror-related experience, and more current war-related experiences reported more psychological symptoms in the child as well as a higher sense of danger. Also, as hypothesized, a higher sense of danger was associated with more symptoms of depression and anxiety, and these symptoms were associated with reports of lower co-parenting support, increased parenting burnout, and more avoidant communication with the child about the war. As hypothesized, the three latter variables were significantly associated with increased psychological symptoms in the child. Next, we conducted SEM analysis to examine the hypothesized sequential mediation model, in which ACEs, exposure to war or terror-related experience in childhood, and more current war-related experiences are each indirectly related to children’s increased psychological symptoms through sense of danger, followed by depression and anxiety symptoms, followed by lower co-parenting support, increased parenting burnout, and more avoidant communication with the child about the war. Preliminary analyses guided the inclusion of covariates in the model. The model showed adequate fit to the data, χ 2 (53) = 183.71, p < .001, CFI = .93, RMSEA = .053, SRMR = .051, AIC = 287.71, BIC = 536.09. As shown in Figure 2 and Table 4, all hypothesized indirect effects were supported. The direct effects of ACE and current war-related experiences on children's increased psychological symptoms remained significant when accounting for indirect effects. This suggests that the sense of danger, depressive and anxiety symptoms, lower co-parenting, parenting burnout, and avoidant communication partially mediated these effects. Sample 2 As shown in Table 3, several intercorrelations between study variables were significant. We describe here those that were hypothesized. As expected, mothers who reported more ACEs and more current war-related experiences reported more psychological symptoms in their infant/toddler as well as a higher sense of danger. However, unexpectedly, a childhood war/terror-related experience was not significantly related to infants’/toddlers’ psychological symptoms nor to mothers’ sense of danger. As hypothesized, a higher sense of danger was associated with more symptoms of depression and anxiety, and these symptoms were related to reports of lower co-parenting support, increased burnout, and higher hostility toward the infant/toddler. The three latter variables were, as expected, significantly associated with increased psychological symptoms in the infant/toddler. Next, we conducted SEM analysis to examine the hypothesized sequential mediation model, in which ACEs and current war-related experiences are each directly related to infants’/toddlers’ increased psychological symptoms and that ACEs, exposure to war or terror-related experiences in childhood and current war-related experiences are each indirectly associated with infants’/toddlers’ increased psychological symptoms through higher sense of danger, followed by more depression and anxiety symptoms, followed by lower co-parenting support, increased burnout, and higher hostility. Preliminary analyses guided the inclusion of covariates in the model. Based on modification indices, we added two direct paths from ACEs to depression and anxiety symptoms. These modifications were also theoretically justifiable (see a review and meta-analysis in Hughes et al., 2017). The model showed good fit to the data, χ2(46) = 63.09, p = .048, CFI = .97, RMSEA = .036, SRMR = .052, AIC = 153.09, BIC = 318.39. As shown in Figure 3 and Table 4, most hypothesized indirect effects were supported. The association of ACEs and more current war-related experiences with infants’/toddlers’ psychological symptoms were indirect, through a higher sense of danger, followed by more depression symptoms, followed by decreased co-parenting support, increased parenting burnout, and more hostility. The direct effects of ACEs and war-related experiences on infants’ and toddlers’ psychological symptoms became non-significant when accounting for indirect effects. This suggests that the sense of danger, depressive symptoms, lower co-parenting, burnout, and hostility fully mediated these effects. Childhood war/terror-related experiences were not associated with a sense of danger (see Figure 3). In addition, although the sense of danger was associated with anxiety symptoms, which in turn were associated with lower co-parenting, this sequential indirect path was not significant, CIs = -0.01, 0.10, p = . 147. Finally, as shown in Figure 3, anxiety symptoms were not associated with parenting burnout or hostility. Alternative Models The alternative models, reflecting children’s effects on their mothers, showed a poorer fit to the data. The fit indices of the model in Sample 1 were as follows: CFI = .88; RMSEA = .071, SRMR = .070; AIC = 391.20, BIC = 639.58. The fit indices of the model in Sample 2 were as follows: CFI = .95; RMSEA = .051; SRMR = .066. AIC = 170.03; BIC = 335.331. Hence, the models reflecting the study hypotheses of paths from mothers’ experiences to children’s psychological symptoms were the best fit for the data. Discussion The study examined the impact of war on mothers and children. Although this was a community sample of educated mothers with relatively few ACEs, from mostly intact families, who, for the most part, did not reside near the war front, results revealed a high level of symptoms in both mothers and children. The average level of psychological symptoms in mothers of children aged three and up and in children in both samples exceeded the normative range, while the average level of maternal symptoms in the sample of mothers of infants and toddlers was just below the cutoff point (Lovibond, 2025; Mansbach-Kleinfeld et al., 2010; Sheldrick et al., 2013 ). Furthermore, in both samples, the average rates of maternal symptoms were higher than those reported in pre-war studies of mothers in Israel (e.g., Alon-Tirosh et al., 2021; Sher-Censor et al., 2024 ; Sher-Censor et al., 2020). This difference was striking because the pre-war data were of high-risk mothers whereas the present study involved a low-risk sample. Although we do not have pre-war maternal and child symptom data, the fact that average symptom levels exceeded what would typically be expected in a low-risk group underscores the significant psychological burden of war on mothers and children. These findings are consonant with those reported in research of adults and children facing wars and armed conflict in Israel and other countries, and highlight the deleterious psychological effects of war (e.g., Hyland et al., 2023; Sade et al., 2008). Beyond the relatively high levels of maternal and child symptoms, we examined factors and family dynamics that may contribute to some mothers and children being more severely impacted by war than others. Guided by the FSM and ACEs frameworks, we found that mothers’ exposure to more ACEs and more current war-related experiences were associated with their own and their children’s increased psychological symptoms. These effects were mediated by mothers' heightened sense of danger due to the war, which, in turn, was linked to elevated levels of maternal psychological symptoms. Increased symptoms in mothers were further associated with more disruptions in both co-parenting and parenting, which, in turn, were linked to children’s psychological symptoms. The current study was among the few to examine war’s impact on infants and toddlers. In our sample of older children, exposure to more war experiences was both directly and indirectly related to children’s psychological symptoms. In the sample of infants and toddlers, the effects were indirect and fully mediated by maternal sense of danger, depression symptoms, and disruptions in family relationships. This is consistent with the notion that children's direct exposure to the broader environment is relatively limited in infancy and toddlerhood. Thus, especially at very young ages, maternal buffering of environmental adversity appears to have a particularly pronounced effect (Halevi et al., 2017; Sung et al. 2016 ). An innovative aspect of our study lies in introducing avoidant communication about the war as a mediator between war exposure and children’s psychological symptoms and as one of the mechanisms that can explain how parents’ psychological symptoms contribute to their children’s symptoms. Our findings align with two studies that showed that avoidant parental communication about collective adversity [the 2013 Boston Marathon bombing (Carpenter et al., 2017 ) and COVID-19 (Malloy et al., 2024)] was associated with increased psychological symptoms in both parents and children. Together, they support the notion that without supportive parent-child communication, children may have difficulties formulating coherent meaning and resolving war experiences, which may increase their distress. A key contribution of this study was to shed light on the process of intergenerational transmission of trauma in the context of war by employing both the FSM and the ACEs models. As mentioned above, mothers’ ACEs increased their own and their children’s vulnerability to the effects of war. Prior ACEs studies suggested that mothers’ depression and anxiety symptoms mediate the link between mothers’ ACEs and their children’s increased psychological symptoms (Hughes et al., 2017). Our results support these findings and reveal additional mediating mechanisms. First, we found that cumulative ACEs may intensify mothers’ sense of danger due to the war, which in turn was related to elevated depression and anxiety symptoms. This aligns with two studies showing that adults who have experienced more ACEs perceive greater danger when facing a chronic illness or a natural disaster (Traino et al., 2022; Wilson-Genderson et al., 2021 ). Thus, experiencing early adversity of maltreatment, neglect, and family dysfunction appears to shape cognitive appraisals in a way that amplifies threat sensitivity in response to war. Furthermore, our study suggests that four types of disruptions in family dynamics are associated with cumulative ACEs and mediate the intergenerational associations between mothers’ ACEs, sense of danger, and psychological symptoms and their children’s psychological symptoms during war. Specifically, we documented the mediating role of reduced co-parenting support, in line with the findings of Zhang and colleagues ( 2023 ). Second, we revealed the role of parental burnout, which has received little attention in the ACEs literature. Third, we showed that maternal hostility toward infants and toddlers also served as a mediator, supporting the notion that ACEs may lead to poorer parent-child interactions, which has yielded mixed findings in the past (e.g., Racine and colleagues [ 2018 ] found such links, whereas Coe and colleagues [ 2020 ] did not). Fourth, we identified avoidant communication with the child about war as an additional mediator. We did not find a direct effect between ACEs and avoidant communication, but rather an indirect effect through an increased sense of danger and mothers’ psychological symptoms. A related possible mechanism that may explain the link between mothers’ ACEs and their children’s psychological symptoms may be the processing or resolution of past traumatic events. Research has shown that among mothers who have experienced sexual abuse, those who had not resolved their past trauma were less supportive of their child when reminiscing about emotional experiences compared to those who had resolved their trauma (Koren-Karie et al., 2008 ). Future research may benefit from examining not only the extent to which mothers have experienced ACEs and war-related events and their impact on mothers’ communication, as we did, but also whether mothers resolved these adverse past and present experiences. Importantly, alongside the assessment of ACEs using the traditional ACEs questionnaire (Felitti et al., 1998), we added a question about mothers’ childhood exposure to war or terrorism, given the study’s war-exposure context. This childhood exposure was associated with children’s increased psychological symptoms through mothers’ heightened sense of danger, psychological symptoms, and disruptions in family dynamics (albeit only in the sample of mothers of children aged three and up). This finding raises concern about the intergenerational effect of armed conflicts. It appears that war exposure may not only impact individuals during their childhood but might also increase their vulnerability to future war-related stressors and perpetuate intergenerational trauma. Notably, childhood war exposure was linked to low perceived co-parenting support and parental burnout, but unexpectedly, it was not associated with avoidant communication with the child about war. These findings underscore the need for further research to clarify the mechanisms through which childhood exposure to war/terror affects parenting. These could inform prevention programs aimed at breaking the cycle of intergenerational war-related trauma. Finally, the study offers contributions to the FSM literature. First, it extends the FSM by pointing to its relevance for understanding the impact of distal stressors in a child’s ecology other than economic hardship. This aligns with the few studies that have applied the FSM in the context of other stressors, such as immigration (Sher-Censor & Mizrachi-Zinman, 2020) and COVID-19 (Lucassen et al., 2021 ). Second, it demonstrates the relevance of the FSM to infants and toddlers who were previously understudied within this framework. A third contribution lies in identifying avoidant communication as a disruption in the parent-child relationship. More research may explore whether avoidant communication about other environmental stressors, including economic hardship, plays a similar role. Limitations, Conclusions, and Implications The lack of data on families before the war and the concurrent data collection are limitations of this study. Although we compared mothers’ and children’s average psychological symptoms to established cutoff points and tested alternative SEM models to demonstrate that the data best supported the direction of effects proposed by the FSM and ACEs models, longitudinal research is needed to elucidate causal relationships. This is especially important because recent FSM studies demonstrated child effects on parental distress and family disruption (Şengül-İnal et al., 2024 ). In addition, this was a survey-based study relying solely on maternal reports. Maternal perceptions were collected using valid measures, and their perspective during a sensitive time, such as war, provides valuable insight. The available resources, given the conditions of an ongoing war, for both the research team and mothers, defined the scope of data that could be collected. Nevertheless, future research should incorporate multiple informants (e.g., fathers, educators) and diverse methodologies (e.g., observations) to mitigate shared informant and method biases that may inflate associations between variables. Third, the sample consisted of a convenience-based community sample, and the findings showed that even in such a relatively advantaged sample the level of psychological symptoms in mothers and children was high. This raises concern regarding the well-being of families from less advantaged backgrounds during wartime. Future research should include more diverse samples who enjoy fewer economic, social, and psychological resources, including, for example, single-parent families and those from lower socioeconomic backgrounds. Relatedly and aligned with recent ACE studies of adults (Briggs et al., 2021 ; Sayyah et al., 2022 ), future research with more significant variability in maternal ACEs may benefit from exploring the distinct effects of child maltreatment, child neglect and family dysfunction, as well as the combined impact of different types of ACEs, on how mothers and children are affected by war. Another important avenue for future research is investigating the role of sociocultural background. The size of the Jewish and Arab subsamples was unbalanced, limiting our ability to compare them systematically. Notably, despite lower war-related exposure among Arab participants, their distress levels were comparable to those of Jewish participants, aligning with findings from a recent survey of adults in Israel (Mayer et al., 2024 ). Nevertheless, future research should explore similarities and differences in the impact of war on parents and children from diverse sociocultural groups. Relatedly, war impacts families on both sides of the conflict. As we did not have access to families in the Gaza Strip, we were unable to study the war’s impact on them. Despite these limitations, the current study highlights the destructive and broad psychological impact of war on mothers and children and provides insight into the mechanisms through which war exposure affects them. Each of these mechanisms could guide interventions with families by identifying those at increased risk of being more severely affected by the war and by serving as potential “ports of entry” for interventions to mitigate the effects of war exposure on children and break the cycle of intergenerational trauma. Statements and Declarations Ethical Approval . The procedure and measures of this study were approved by the Human Research Review Board of the participating university (#157/24). The procedures used in this study adhere to the tenets of the Declaration of Helsinki. Informed Consent. Mothers provided written informed consent. Data Availability Statement. Data supporting the findings are available at https://osf.io/[Blinded for review]. Competing interest. The authors state that there is no conflict of interest. Funding. The Research Authority of the participating university supported the study. Authors' contributions . Author 1 conceptualized the study, conducted data analyses, and wrote the manuscript. Author 2 conceptualized the study and reviewed and revised the manuscript. Author 3 conceptualized the study, participated in data analyses, and reviewed and revised the manuscript. Author 4 conceptualized the study, and reviewed and revised the manuscript. Authors 5 and 6 took part in conceptualizing the study, collecting the data, and reviewing the manuscript. All authors read and approved the final version of the manuscript. References Afifi, A. A., Kotlerman, J. B., Ettner, S. L., & Cowan, M. (2007). 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Parenting practices, aggressive response evaluation and decision, and social difficulties in kindergarten children: The role of fathers. Aggressive Behavior , 47 (2), 148-160.https://doi.org/10.1002/ab.21932 Tables Table 1 Families’ Demographic Characteristics Sample 1: Mothers of children aged 3-18 years ( N = 877) Sample 2: Mother of infants/toddlers ( N = 291) Mean/n SD/% Range Mean/n SD/% Range Place of residence In a war zone a 127 14.48 40 13.75 Outside the war zones 748 85.29 251 86.25 Ethnocultural group Jewish 743 84.72 250 85.91 Arab 134 15.28 41 14.09 Mothers’ age 4.09 6.79 24-64 33.66 4.65 22-50 Mothers’ years of education 16.88 2.62 12-30 16.14 2.71 8-25 Marital status Married/cohabiting 838 95.56 288 99.0 Not married/cohabiting 36 4.10 3 1.0 Child gender Female 443 50.51 164 56.36 Male 433 49.37 127 43.64 Child age b 8.39 3.81 3-18 6.44 4.24 0-36 Child birth order First-born 406 46.29 103 35.40 Later-born 471 53.71 187 64.30 Note. a By the time mothers completed the survey, all families were displaced to areas outside the war zones. b Child age in Sample 1 refers to the age in years; Child age in the Sample 2 refers to the age in months. Table 2 Descriptive Statistics of Study Variables Sample 1: Mothers of children aged 3-18 years ( N = 877) Sample 2: Mother of infants/toddlers ( N = 291) Mean/n SD/% Range Mean/n SD/% Range M number of ACEs .96 1.34 0-8 .88 1.31 0-8 M childhood exposure to war/terror Yes 189 21.55 55 18.90 No 686 78.22 236 81.10 M current war exposure 2.04 1.73 0-10 1.95 1.67 0-8 M sense of danger 2.84 .90 1-5 2.90 .89 1-5 M depression symptoms 6.11 4.50 0-21 4.35 4.05 0-19 M anxiety symptoms 3.83 4.08 0-21 2.95 3.41 0-20 M co-parenting support 4.11 .85 1-5 4.37 .74 1-5 M parental burnout 2.24 .90 1-5 2.04 .81 1-4.80 M avoidant communication 2.85 .80 1-5 -- -- -- M hostility -- -- -- 1.87 .87 1-4.83 Child symptoms a 15.36 7.04 1-42 7.69 5.56 0-27 Note. M = mothers . a Mothers in Sample 1 reported their children’s symptoms using an adapted 24-item version of the SDQ (Goodman, 1997); Mothers in Sample 2 reported their children’s symptoms using an adapted 16-item version of the BPSC (Sheldrick et al., 2013). Table 3 Bivariate Correlations Between Study Variables Variable 1 2 3 4 5 6 7 8 9 10 1. M number of ACEs – .09 ** .13*** .10** .14*** .20*** .09** -.17*** .04 .21*** 2. M childhood exposure to war/terror a .11 – .18*** .15*** .09** .17*** .11** -.07* .03 .14*** 3. M current war exposure .12* .28*** – .15*** .10** .16*** .08* -.08* -.07* .22*** 4. M sense of danger .23*** .11 .24*** – .42** .42*** .31*** -.11*** .24*** .27** 5. M depression symptoms .29*** .10 .14* .34*** – .55*** .51*** -.22*** .19*** .34*** 6. M anxiety symptoms .43*** .11 .15* .32*** .64*** – .35*** -.22*** .18 .31*** 7. M co-parenting support .21*** .01 .11 .23*** .62*** .43*** – -.245*** .30*** .45*** 8. M parental burnout -.24*** -.03 -.19** -.12* -.34*** -.33*** -.38*** – -.04 -.22*** 9. M avoidant communication / hostility .06 -.03 .04 .06 .34*** .20*** .46*** -.15** – .20*** 10. Children’s psychological symptoms .14* .09 .12* .11 .23*** .30*** .31*** -.26*** . 26*** – Note. M = mothers . a no exposure = 0, exposure = 1. Correlations for Sample 1 are presented above the diagonal. Correlations for Sample 2 are presented below the diagonal . * p < .05. ** p < .01. *** p danger –> dep –> coparenting–> c symptoms .003 .001 .01 .005 ACEs –> danger –> dep –> burnout–> c symptoms .04 .010 .07 .007 ACEs –> danger –> dep –> avoidant comm–> c symptoms .002 .001 .01 .004 ACEs –> danger –> anx –> coparenting–> c symptoms .003 .001 .01 .005 ACEs –> danger –> anx –> burnout–> c symptoms .01 .000 .02 .030 ACEs –> danger –> anx –> avoidant comm–> c symptoms .001 .000 .01 .018 War/terror ACE –> danger –> dep –> coparenting–> c symptoms .01 .004 .03 .002 War/terror ACE –> danger –> dep –> burnout–> c symptoms .17 .08 .29 .000 War/terror ACE –> danger –> dep –> avoidant comm–> c symptoms .01 .004 .03 .001 War/terror ACE –> danger –> anx –> coparenting–>c symptoms .01 .004 .03 .002 War/terror ACE –> danger –> anx –> burnout–> c symptoms .03 .003 .07 .033 War/terror ACE –> danger –> anx –> avoidant comm–> c symptoms .01 .001 .02 .017 Current war–> danger –> dep –> coparenting–> c symptoms .01 .001 .01 .002 Current war –> danger –> dep –> burnout–> c symptoms .06 .038 .09 .000 Current war –> danger –> dep –> avoidant comm–> c symptoms .004 .001 .01 .002 Current war –> danger –> anx –> coparenting–> c symptoms .01 .001 .01 .002 Current war –> danger –> anx –> burnout–> c symptoms .01 .001 .02 .040 Current war –> danger –> anx –> avoidant comm–> c symptoms .002 .000 .01 .023 Sample 2 ACEs –> danger –> dep –> coparenting–> c symptoms .01 .001 .03 .027 ACEs –> danger –> dep –> burnout–> c symptoms .03 .006 .07 .006 ACEs –> danger –> dep –> hostility–> c symptoms .01 .002 .04 .011 Current war –> danger –> dep –> coparenting–> c symptoms .01 .00 0 .0 2 .027 Current war –> danger –> dep –> burnout–> c symptoms .0 2 .00 4 .0 5 .006 Current war –> danger –> dep –> hostility–> c symptoms .01 .002 .0 3 .01 0 Note. War/terror ACE = mothers’ exposure to war/terror in childhood; Current war = mothers’ current war exposure; dep = mothers’ depression symptoms; anx = mothers’ anxiety symptoms; coparenting = mothers’ perception of co-parenting support; avoidant comm = mothers’ avoidant communication; C = child. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9459838","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":633709367,"identity":"a599f34d-f588-4634-b4f5-eae045a34087","order_by":0,"name":"Efrat Sher-Censor","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYFACHiCugDISbCBiBx4Q1HIGpiUNqiWBkBbGNpheqBYGfFr4+c8efFw57469wQHegx8eJNgx8LcfYMRri+SMvGTDs9ueJW44wJcskZCQzCBxJgG/wwxu8JhJNm47nGBwgMdAIvEHMwPDDQJ+sT9/xvxn45zDQIfxGP9ISKhnkCekxYAhx4yxseEw44YDPGZAhx0G2ktAi8SNHGPJhmPPEmce5jGzSEg4zmN4JrEBrxb+/jOGHxtq7tjzHe8xvvkjoVpO7vjhwx8+4NECBQcYFA5DWKBoaiCsAaRFnih1o2AUjIJRMCIBADmRUtzVdtEYAAAAAElFTkSuQmCC","orcid":"","institution":"University of Haifa","correspondingAuthor":true,"prefix":"","firstName":"Efrat","middleName":"","lastName":"Sher-Censor","suffix":""},{"id":633709370,"identity":"8417b505-8192-48a0-b983-6b335f378fc8","order_by":1,"name":"Rinat Feniger-Schaal","email":"","orcid":"","institution":"University of Haifa","correspondingAuthor":false,"prefix":"","firstName":"Rinat","middleName":"","lastName":"Feniger-Schaal","suffix":""},{"id":633709372,"identity":"705313a0-5d14-4a51-9ae5-0a90e6dedf67","order_by":2,"name":"David Oppenheim","email":"","orcid":"","institution":"University of Haifa","correspondingAuthor":false,"prefix":"","firstName":"David","middleName":"","lastName":"Oppenheim","suffix":""},{"id":633709374,"identity":"719361b6-daa7-48f2-8b0f-f940243106a8","order_by":3,"name":"Nina Koren-Karie","email":"","orcid":"","institution":"University of Haifa","correspondingAuthor":false,"prefix":"","firstName":"Nina","middleName":"","lastName":"Koren-Karie","suffix":""},{"id":633709375,"identity":"75bf0fa2-7fa0-4072-b241-9fc32a9d2457","order_by":4,"name":"Maysan Raya","email":"","orcid":"","institution":"University of Haifa","correspondingAuthor":false,"prefix":"","firstName":"Maysan","middleName":"","lastName":"Raya","suffix":""},{"id":633709379,"identity":"2da36b63-5be1-42a8-a5a1-f4503c7d9146","order_by":5,"name":"Olga Klertag","email":"","orcid":"","institution":"University of Haifa","correspondingAuthor":false,"prefix":"","firstName":"Olga","middleName":"","lastName":"Klertag","suffix":""}],"badges":[],"createdAt":"2026-04-19 06:53:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9459838/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9459838/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108793640,"identity":"72caf0c5-d32b-4db4-8496-dac02ae5c1c1","added_by":"auto","created_at":"2026-05-08 12:58:43","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":125768,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eThe Study Model.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9459838/v1/a23d7ab8272c5677dfd7b83a.png"},{"id":108807571,"identity":"604b26f8-64f8-41d5-9cd7-449ed283ae08","added_by":"auto","created_at":"2026-05-08 15:30:41","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":131883,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eResults of Structural Equation Model Predicting Psychological Symptoms of Children Aged 3-18 Years: Standardized Coefficients (N = 877).\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eFor clarity, paths involving covariates (ethnocultural background, maternal years of education, child age, and child gender) are not shown in the Figure. Table 1 in the Online Resource shows details of these covariate relationships. Solid lines indicate that standardized coefficients are significant (\u003cem\u003ep\u003c/em\u003e \u0026lt; .05).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9459838/v1/5909c1c13c76830b0cf27032.png"},{"id":108793641,"identity":"32f68ea8-b4e2-49b4-9a80-d5686ff59db4","added_by":"auto","created_at":"2026-05-08 12:58:43","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":171032,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eResults of Structural Equation Model Predicting Psychological Symptoms of Infants and Toddlers: Standardized Coefficients (N = 291).\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNote\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eFor clarity, paths involving covariates (ethnocultural background, maternal years of education, birth order, child age, and child gender) are not shown in the Figure. Table 2 in the Online Resource material shows details of these covariate relationships. Solid lines indicate that standardized coefficients are significant (\u003cem\u003ep\u003c/em\u003e \u0026lt; .05). Dashed lines indicate that standardized coefficients are nonsignificant (\u003cem\u003ep\u003c/em\u003e \u0026gt; .05).\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-9459838/v1/c6226f23cd8b326dc61d315d.png"},{"id":108809888,"identity":"8bb6fc6f-e832-4b00-b259-7d5dc8ab9f71","added_by":"auto","created_at":"2026-05-08 15:56:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1083460,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9459838/v1/fabcc9ba-9152-474e-8bdf-b05761c9df8c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Understanding the Impact of War on Mothers and Children Through the Family Stress Model and Adverse Childhood Experiences Framework","fulltext":[{"header":"Introduction","content":"\u003cp\u003eResearch has documented the deleterious effects of war and armed conflicts on adults and children (e.g., Hyland et al., 2023; Sadeh et al., 2008). The current study examined the effect of war on mothers and children in Israel, and aimed to extend prior research in three key ways. First, it applied the Family Stress Model (Conger et al., 2000), originally developed in the context of economic hardship, to reveal family processes through which war influences children. Second, it investigated the interplay between past and present adversity by examining whether mothers\u0026rsquo; adverse childhood experiences (Felitti et al., 1998) heightened their vulnerability to the effects of war. By employing the Family Stress (Conger et al., 2000) and Early Childhood Adversity frameworks, the study aimed to provide a more comprehensive understanding of the intergenerational transmission of trauma in the context of war. Finally, the study included two samples, one of which consisted of families of infants and young toddlers, a population that has received little attention in war-related and Family Stress research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOn October 7, 2023, Hamas and Islamic Jihad militants launched an attack on Israel from Gaza. From that point through May 2024, when data collection for the present study began, families both in Israel and Gaza have endured significant and extended hardships due to the ongoing war.\u0026nbsp;In this paper, we focus solely on the impact of war on families in Israel, both Jewish and Arab, as they were the ones to which we had access as researchers in\u0026nbsp;Israel. Notably, 2\u003cspan dir=\"RTL\"\u003e1\u003c/span\u003e% of Israel\u0026apos;s population is Arab (Israel\u0026nbsp;Central Bureau of Statistics, 2024). The immediate losses of the October attack included over 1,150 Israeli fatalities, including 739 civilians, and the abduction of 251 individuals to the Gaza Strip. Since then, Jewish and Arab families across Israel have faced continuous rocket attacks, with loud warning sirens signaling the need to seek shelter within 15 to 120 seconds, causing frequent disruptions to daily life\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eand triggering emotional responses of stress and fear of harm. By May 2024, the death toll in Israel had surpassed 1,600, including both civilians and soldiers, while more than 19,000 people were reported injured. The war also led to significant disruptions in the educational system due to security concerns, with extended closures of daycares, preschools, and schools. The prolonged military service of reservist parents, coupled with rising unemployment due to the war, further strained many families. Additionally, more than a quarter of a million citizens were evacuated from their homes in the southern and northern regions of the country. At the time of data collection, and still currently, many of them remain displaced (The Israel Democracy Institute, 2024; The National Security Agency, 2024).\u003c/p\u003e\n\u003cp\u003eExposure to war-related experiences such as the above is associated with increased depression and anxiety symptoms in adults (Levi-Belz et al., 2024; Mohammed Bilal et al., 2024), and risk of developing PTSD in a dose-response manner (Karatzias et al., 2023). War exposure is also associated with increased psychological symptoms in children (e.g., Sadeh et al., 2008; Yirmiya et al., 2022; see meta-analysis in Eltanamly et al., 2021). Possibly buffering these child effects, studies suggest that positive parent-child relationships are a source of protection against the impact of traumatic events (Feldman et al., 2014; Sloover et al., 2024). When both parents and children are exposed to continuous adverse experiences, however, parental buffering may be weakened or absent, increasing children\u0026rsquo;s vulnerability to these experiences (Nuttman-Shwartz, 2023). This is supported in a recent meta-analysis that showed that exposure to war is associated with parents\u0026rsquo; higher hostility and less warmth towards their children, which in turn is related to more psychological symptoms in the children (Eltanamly et al., 2021). The current study aimed to identify additional factors and processes through which war exposure impacts mothers and their children\u0026nbsp;by drawing on \u0026nbsp;two models: the\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eFamily Stress Model (Conger et al., 2000) and the Adverse Childhood Experiences (Felitti et al., 1998) model.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Family Stress Model\u003c/strong\u003e \u003cstrong\u003e(FSM)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe FSM explains how economic hardship impacts parents\u0026rsquo; psychological well-being and children\u0026rsquo;s adjustment (Conger et al., 2000). The model suggests that economic hardship puts children at risk of maladjustment directly and indirectly through cascade effects in which economic hardship leads to parents\u0026rsquo; heightened economic stress, which increases their psychological distress in terms of, for example, depression and anxiety symptoms (Newland et al., 2013). Parents\u0026rsquo; psychological distress, in turn, leads to disrupted family processes in terms of interparental relationship problems (e.g., lower co-parenting support; Derlan et al., 2019) and disruptions in the parent-child relationship (e.g., hostile parenting, Parke et al., 2004). The model has been supported in numerous studies across different ethnic groups (e.g., African-Americans, Conger et al., 2002; Mexican-American, Derlan et al., 2019; Finnish, Solantaus et al., 2004; Chinese, Zhang et al., 2020) and child ages, by demonstrating that economic hardship puts children at risk of increased psychological symptoms, poorer academic performance, and poorer health through the above chain of family disruptions (see a review in Masarik \u0026amp; Conger, 2017).\u003c/p\u003e\n\u003cp\u003eAlthough the FSM focuses on economic hardship, its developers suggested it may apply to additional environmental stressors. In support of this notion, the model was applied to study the effects of immigration (e.g., Lorenzo-Blanco et al., 2019; Sher-Censor \u0026amp; Mizrachi-Zinman, 2020), the COVID-19 pandemic (e.g., Lucassen et al., 2021) and military deployment (Gewirtz et al., 2018). The present study aimed to examine the model in the context of war and extend it downward to toddlers and infants who have not been studied before within this framework.\u003c/p\u003e\n\u003cp\u003eInformed by the FSM, we examined whether maternal exposure to more war-related experiences would be associated with a heightened \u003cem\u003esense of danger\u003c/em\u003e, to parallel the construct of \u003cem\u003eeconomic stress\u003c/em\u003e in the FSM. E\u003cem\u003economic stress\u003c/em\u003e reflects the psychological burden of economic hardship due to financial strain (e.g., inability to pay bills), unmet basic material needs (e.g., housing), and necessary cutbacks in expenses.\u0026nbsp;A sense of danger reflects a psychological burden resulting from a stressor in the environment. It includes perceived threats to personal and family safety and financial security, along with uncertainty about the future caused by the stressor (Solomon et al., 1989). When an environmental stressor like war is perceived as threatening, it can trigger emotional reactions in adults, including depression and anxiety symptoms\u0026nbsp;\u0026nbsp;(Kimhi et al., 2010; Sher-Censor et al., 2025; Solomon et al., 1989).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In line with the FSM, we examined whether a higher sense of danger would be associated with depression and anxiety symptoms in mothers, and whether maternal symptoms would be subsequently related to disruptions in both the inter-parental and the parent-child relationships. To examine inter-parental relationship problems, similar to several FSM studies (e.g., Derlan et al., 2019; Lucassen et al., 2021), we examined mothers\u0026rsquo; perceptions of co-parenting support, namely the level of support the mother receives from the father in her parenting role (e.g., agreement regarding parenting practices, supportive and reinforcing communication around parenting; Feinberg,\u0026nbsp;2003).\u003c/p\u003e\n\u003cp\u003eWe focused on three indicators of disruptions in the mother-child relationship. The first was parental burnout, which refers to exhaustion in the parenting role, feeling fed up with being a parent, and emotional distancing from the child. Parental burnout arises when parenting demands exceed the parent\u0026rsquo;s available resources (Roskam et al., 2018) and was found to be assoicated with psychological symptoms of both parents (Kerr et al., 2021; Mikolajczak et al., 2020)\u0026nbsp;and their children (Kerr et al., 2021), including in wartime (Aviad et al., 2024). Following past FSM research (e.g.,\u0026nbsp;Parke et al., 2004), as well as research on the effects of war on parents (Eltanamly et al., 2021), the second disruption in parent-child relationship we assessed was maternal hostility towards her child, which include, for example, reacting angrily and using injuring words toward the child.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe third indicator of mother-child relationship problems was mothers\u0026rsquo; avoidant communication with their children about the war. Parents\u0026rsquo; communication about distressing or potentially traumatic events with their children is thought to shape children\u0026rsquo;s processing of these experiences and affect their well-being. When parents are also exposed to these events and experience distress, they may avoid such conversations, potentially hindering children\u0026rsquo;s meaning-making and contributing to their increased psychological symptoms (see a review in Sloover et al., 2024). Research has supported these notions mostly in the context of relatively benign distressing daily child experiences (e.g., Koren-Karie et al., 2008) or personal potentially traumatic events (e.g., injury, death of father; Sloover et al., 2024). Yet a few studies also support them in the context of mass trauma (see a review in Sloover et al., 2024). For example, a study on parent-child communication about the 2013 Boston Marathon bombing and a study on parent-child communication about COVID-19 suggest that parents\u0026rsquo; avoidant communication about these events was linked to greater psychological symptoms in children (Carpenter et al., 2017; Malloy et al., 2024). The COVID-19 study also found that parents with heightened psychological symptoms were more likely to use this communication pattern (Malloy et al., 2024). Together, these findings suggest that mothers experiencing heightened depression and anxiety symptoms may be more likely to show avoidant communication about the war with their child, which, in turn, may contribute to children\u0026rsquo;s increased psychological symptoms. See Figure 1 for a graphic illustration of the study model.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdverse Childhood Experiences (ACE\u003c/strong\u003e)\u003c/p\u003e\n\u003cp\u003eThe second framework that guided this study was the ACE model (Felitti et al., 1998), which suggests that exposure to an accumulation of adverse childhood experiences of\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eabuse, (i.e., physical, emotional, and sexual abuse), neglect (i.e., emotional and physical neglect), and household dysfunction (e.g., mental illness in the household, exposure to substance abuse in the household) leads to psychological symptoms in a dose-response manner in both adults and their children (see meta-analyses in Cooke et al., 2021 and Hughes et al., 2017). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe aimed to explore whether ACEs are associated with increased vulnerability of mothers and their children to the impact of war and whether the family process delineated in the FSM would help explain this impact. We are aware of only one study looking at the effects of ACEs in the context of war, showing that veterans in the US\u0026nbsp;exposed to warfare showed more psychological symptoms than veterans not exposed to warfare, regardless of their ACEs (Morgan et al., 2020). A\u0026nbsp;few studies on other potentially traumatic events (e.g., chronic illnesses and natural disasters such as hurricanes), however, found that adults who have experienced more ACEs perceived current potentially traumatic events as more threatening, and this increased sense of danger mediated the link between ACEs and psychological symptoms (Traino et al., 2022; Wilson-Genderson et al., 2021). ACEs research also shows that\u0026nbsp;parents\u0026rsquo; psychological symptoms and poor co-parenting and parenting are key mechanisms underlying the intergenerational effects of parents\u0026rsquo; ACEs on their children (Sher-Censor et al., 2024; Zhang et al., 2023).\u0026nbsp;Thus, it is possible that increased maternal ACEs would be associated with an increased sense of danger due to the war, which in turn would be associated with more psychological symptoms, more disruptions in both co-parenting and parenting and subsequently more psychological symptoms in children. Finally, because the study focused on the impact of mothers\u0026rsquo; ACEs in the context of war, alongside the traditional ACEs of maltreatment, neglect, and family dysfunction, we explored the role of mothers\u0026rsquo; exposure in childhood to war- or terror\u003cspan dir=\"RTL\"\u003e-\u003c/span\u003erelated experiences (see Figure 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Current Study\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study aimed to examine the effects of mothers\u0026rsquo; ACEs and current war experiences on mothers and their children, as well as reveal familial mechanisms underlying these effects, as suggested by the FSM. To achieve this goal, we conducted two surveys, one for mothers of children from birth up to age three years and one for mothers of children from age 3 to 18 years. The two surveys assessed the same constructs with one exception. Avoidant communication about the war was assessed only among mothers of children at the ages of three and older. This was because, by age three years, children have the language, cognitive, and socio-emotional abilities to engage in conversations about emotionally laden events (Reese \u0026amp; Newcombe, 2007). To reduce the burden of self-reporting, these mothers did not report their hostility toward the child. Thus, maternal hostility was examined only in the survey of mothers of children from birth to age three years.\u003c/p\u003e\n\u003cp\u003eBased on the FSM and ACE models, and as shown in Figure 1, we hypothesized that mothers\u0026apos; exposure to a higher number of ACEs, exposure to a war- or terror\u003cspan dir=\"RTL\"\u003e-\u003c/span\u003erelated experience in childhood, and more current war-related adversities would be associated with their children\u0026apos;s increased psychological symptoms. Following the FSM, we expected these links to be indirect through a sequential mediational pathway. Specifically, per both the FSM and ACE frameworks, we hypothesized that higher maternal exposure to childhood and current adversities would lead to an increased sense of danger due to the war, which would lead to elevated maternal depression and anxiety symptoms. In line with the FSM, we expected that maternal symptoms would result in disruptions in family relationships in terms of mothers\u0026rsquo; perceptions of decreased co-parenting support and increased parental burnout, along with increased maternal hostility and more avoidant communication about war-related events with children. These disruptions in family relationships would, in turn, be related to children\u0026rsquo;s increased psychological symptoms.\u0026nbsp;\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003e\u003cstrong\u003eParticipants\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were collected from two samples. Sample 1 included 877 mothers of children aged 3-18, and Sample 2 included 291 mothers of infants and toddlers aged birth to 3 years. See the participants\u0026rsquo; demographic background in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was part of a larger ongoing longitudinal project on the effects of the current war in Israel on Jewish and Arab families in Israel (blinded for review). Announcements in Hebrew and Arabic inviting parents to complete an online survey about the impact of the war on families were distributed through social media. Sample 1 data were collected between May 21 and June 4, 2024. Sample 2 data were collected between June 4 and July 20, 2024. The survey was available in Hebrew and Arabic. The study was approved by the University\u0026apos;s Ethics Committee (#157/24). Mothers provided written informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasures\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAdverse Childhood Experiences Checklist (Center for Disease Control, 2016; Felitti et al., 1998).\u003c/em\u003e\u003c/strong\u003e This widely used checklist assess whether, before the age of 18 years, mothers experienced the following 10 adversities: physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, parental separation or divorce, domestic violence, addictions in the household, mental illness in the household, or incarceration of a member of the household. Scores were calculated by adding the total number of \u0026lsquo;yes\u0026rsquo; responses.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eExposure to War/Terror-Related Events in Childhood.\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eThis question was designed for the current study. Mothers reported whether, before the age of 18, they were present in an area where a terror attack occurred at the time it happened or whether they lived in an area that, during certain periods, experienced frequent sirens that alert of coming rockets or missiles. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eExposure to Current War Adversities (Shai \u0026amp; Sher-Censor, 2023).\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eMothers reported whether they experienced the following 10 events resulting from the current war in Israel: A relative, friend, or acquaintance was killed; The mother, a relative, friend, or acquaintance were injured; A relative, friend, or acquaintance was kidnapped or is missing; Prolonged military service by the mother or a first-degree relative in war zone areas; Prolonged military service by the mother or a first-degree relative outside war zone areas; Evacuation from home due to the war; frequent sirens that alert of incoming missiles or rockets; Job loss or significant loss of income due to the war; Expressions of hatred based on ethnic/religious background due to the war; Acts of violence based on ethnic/religious background due to the war.\u0026nbsp;Mothers\u0026rsquo; scores were calculated by adding the total number of \u0026lsquo;yes\u0026rsquo; responses.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSense of Danger (Solomon et al., 1992).\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eThis measure included five items, tapping perceived threats to personal, familial, physical, and economic well-being due to specific stressors. Mothers reported their sense of danger due to the current war using 5-point scales, ranging from 1 (\u0026ldquo;Not at all\u0026rdquo;) to 5 (\u0026ldquo;Very much\u0026rdquo;). Higher scores reflected a greater sense of danger. The measure was previously used in research of Jewish and Arab Israelis (Sher-Censor et al., 2025), including in the context of past wars in Israel (Kimhi et al., 2010; Solomon et al., 1992), and showed good reliability in the current study (Cronbach\u0026rsquo;s alpha \u003csub\u003eSample 1\u003c/sub\u003e =.81; Cronbach\u0026rsquo;s alpha \u003csub\u003eSample 2\u0026nbsp;\u003c/sub\u003e= .77).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe Depression, Anxiety and Stress Scale - 21 Items (DASS-21; Lovibond \u0026amp; Lovibond, 1995).\u003c/em\u003e\u003c/strong\u003e Mothers\u0026nbsp;reported the extent to which they experienced seven symptoms of depression (e.g., \u0026lsquo;I felt down-hearted and blue\u0026rsquo;) and seven symptoms of anxiety (e.g., \u0026lsquo;I felt scared without any good reason\u0026rsquo;) over the past month on a 4-point Likert scale ranging from 0 (\u0026lsquo;does not apply\u0026rsquo;) to 3 (\u0026lsquo;applies very much\u0026rsquo;). \u0026nbsp;The DASS is widely used, including in its Hebrew and Arabic versions (e.g., Sher-Censor et al., 2024). Higher scores indicate more symptoms. After multiplying the scores by 2, scores above 9 in depression and above 7 in anxiety are considered above normal. For the current study, scores on each scale were summed and not multiplied. Thus, the equivalent thresholds are 4.5 for depression and 3.5 for anxiety.\u0026nbsp;The scales demonstrated good internal consistency (Cronbach\u0026rsquo;s alpha \u003csub\u003eSample 1 depression\u0026nbsp;\u003c/sub\u003e= .88; Cronbach\u0026rsquo;s alpha \u003csub\u003eSample 2 anxiety\u0026nbsp;\u003c/sub\u003e= .87; infants/toddlers\u0026rsquo; sample: Cronbach\u0026rsquo;s alpha \u003csub\u003eSample 2 depression\u0026nbsp;\u003c/sub\u003e= .89; Cronbach\u0026rsquo;s alpha \u003csub\u003eSample 2 anxiety\u0026nbsp;\u003c/sub\u003e= .83).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCo-parenting Support\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e(Bronte-Tinkew et al., 2007).\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eThis 5-item measure was used to assess mothers\u0026rsquo; perceptions of the fathers\u0026rsquo; support for the mothers in their parenting (e.g., \u0026lsquo;My child\u0026rsquo;s father respects the schedules or rules I makes for our child\u0026rsquo;). Items are rated on a 5-point scale ranging from 1 (\u0026lsquo;very seldom\u0026rsquo;) to 5 (\u0026lsquo;very often\u0026rsquo;). Higher scores reflect higher co-parenting support. The measure\u0026apos;s developers used it in a large-scale nationally representative survey of infants, reporting an alpha of .68. Lower scores were more common among never-married couples than among married, cohabiting, separated, or divorced couples and were associated with paternal depression, poverty, and a history of substance use. Cronbach\u0026rsquo;s alpha in the current study was .89 in sample 1 and .77 in sample 2.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe Brief Parental Burnout Scale (Aunola et al., 2021).\u003c/em\u003e\u003c/strong\u003e This 5-item index is a brief version of the widely used Parental Burnout Assessment (Roskam et al., 2018). Mothers reported the extent to which they experience parenting burnout (e.g., \u0026lsquo;I\u0026rsquo;m no longer able to show my child how much I love her/him\u0026rsquo;) on a 5-point scale ranging from 1 (\u0026lsquo;never\u0026rsquo;) to 5 (\u0026lsquo;every day\u0026rsquo;). This brief version has been used in several studies (e.g..,\u0026nbsp;Caviezel Schmitz \u0026amp;\u0026nbsp;Kr\u0026uuml;ger,\u0026nbsp;2024) and showed good internal consistency (e.g., alpha = .85; Aunola et al., 2021) and expected links with parents\u0026rsquo; depressive symptoms, sleep disruptions (Aunola et al., 2021; Caviezel Schmitz \u0026amp;\u0026nbsp;Kr\u0026uuml;ger,\u0026nbsp;2024), child neglect and parental violence (Aunola et al., 2021). Cronbach\u0026rsquo;s alpha in the current study was .84 in sample 1 and .77 in sample 2.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEvent-related household discussions (Carpenter et al., 2017; Malloy et al., 2024).\u0026nbsp;\u003c/em\u003e\u0026nbsp;\u003c/strong\u003eMothers in Sample 1 completed the Avoidant Communication scale of this questionnaire, which includes five items (e.g., \u0026lsquo;I avoid talking to my child about the war\u0026rsquo;) using a scale ranging from\u0026nbsp;1 (\u0026lsquo;never\u0026rsquo;) to 5 (\u0026lsquo;very often\u0026rsquo;).\u0026nbsp;The measure was developed in a study of parent-child communication about the 2013\u0026nbsp;Boston Marathon bombing (Carpenter et al., 2017). It was also validated in a study of parent-child communication about COVID-19, that showed that higher avoidance was associated with poorer parental\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003emental health and predicted children\u0026rsquo;s poorer mental health problems six months later (Malloy et al., 2024).\u0026nbsp;Cronbach\u0026rsquo;s alpha in the current study was .80.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe Emotional Availability\u0026ndash;Self Report (EA-SR; Biringen et al., 2005)\u003c/em\u003e.\u003c/strong\u003e Mothers in sample 2 responded to the 6-item hostility scale (e.g., \u0026lsquo;It happens that I react in an angry way to my child\u0026rsquo;) using a 5-point Likert ranging from 1 (\u0026lsquo;not agree at all\u0026rsquo;) to 5 (\u0026lsquo;totally agree.\u0026rsquo;) This scale showed good internal reliability in past research. It was negatively associated with the non-hostility EA scale in observed mother-infant interactions (Vliegen et al., 2009). In addition, mothers\u0026rsquo; scores on this scale decreased following participation in a brief early intervention (McConnell et al., 2020). Cronbach\u0026rsquo;s alpha in the current study was .85.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997).\u003c/em\u003e\u003c/strong\u003e Mothers in Sample 1 completed the 20-item difficulties scale of the SDQ that is widely used for assessing children\u0026rsquo;s psychological symptoms, including in research of Jewish and Arab Israeli children (e.g., Hen et al., 2024; Ziv \u0026amp; Arbel, 2020). It assesses children\u0026rsquo;s emotional symptoms (e.g., \u0026ldquo;Many fears, easily scared\u0026rdquo;); conduct problems (e.g., \u0026ldquo;Often fights with other children or bullies them\u0026rdquo;); hyperactivity/ inattention (e.g., \u0026ldquo;Easily distracted, concentration wanders\u0026rdquo;); and peer relationship problems (e.g., \u0026ldquo;Rather solitary, tends to play alone\u0026rdquo;). Three items have a different version for ages 2-4 and 4-18 (e.g., \u0026ldquo;Often argumentative with adults for children\u0026rdquo; aged 2-4; \u0026ldquo;Often lies or cheats\u0026rdquo; for children aged four and up). The survey included both versions, and mothers were instructed to complete the items according to their child\u0026rsquo;s age. All items were rated on a 3‐point scale ranging from 0 (\u0026ldquo;not true\u0026rdquo;) to 2 \u0026nbsp; (\u0026ldquo;certainly true\u0026rdquo;), For the current study, four symptoms were added in light of prior research suggesting that these are common symptoms among children in war zones (Sadeh et al., 2008): sleep disturbances, picky eating, bedwetting/fecal incontinence, and school truancy. Cronbach\u0026rsquo;s alpha in this study was .81. Items were summed to form the total difficulty score of the child. Notably, we also summed the original 20 items to compare them to the cutoff point between normal and above normal, which is 12 for ages three to four and 13 for ages four to 18.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe Baby Pediatric Symptom Checklist (BPSC; Sheldrick et al., 2013).\u003c/em\u003e\u003c/strong\u003e Mothers in Sample 2 completed the BPSC\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eto assess infants and toddlers\u0026rsquo; psychological symptoms. The BPSC includes 12 items, reflecting symptoms in three dimensions: irritability (\u0026ldquo;the child is fussy or irritable\u0026rdquo;), inflexibility (\u0026ldquo;The child has a hard time in new places\u0026rdquo;), and difficulties with routines (\u0026ldquo;Is it hard to put the child to sleep\u0026rdquo;). Items are rated on a 3‐point scale ranging from 0 (\u0026ldquo;not true\u0026rdquo;) to 2 \u0026nbsp;(\u0026ldquo;very true/very often\u0026rdquo;). Three items were added for this study per research suggesting that they are common symptoms among infants and toddlers in war zones (Sadeh et al., 2008)\u003cspan dir=\"RTL\"\u003e:\u003c/span\u003e (\u0026ldquo;Clings to me\u0026rdquo;; \u0026ldquo;Easily startled [overreacts to noises and environmental stimuli]\u0026rdquo;; and \u0026ldquo;Does not gain enough weight and/or does not eat enough for their age\u0026rdquo;). Cronbach\u0026rsquo;s alpha in our study was .85. Items were summed to form the total symptoms score of the child. In addition, we calculated the percentage of children who scored 3 or higher in at least one of the three original BPSC dimensions, a level considered above normal.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Preparation and Analytic Plan \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe distribution of all variables was sufficiently normal to render parametric statistics valid, (Afifi et al., 2007), except for infants and toddlers\u0026rsquo; age (Skewness = 2.04; Kurtosis = 1.09), which was thus transformed to its square root (Skewness = .22; Kurtosis = .29). Preliminary analyses included Pearson correlations and \u003cem\u003et\u003c/em\u003e-tests to examine the links between background and study variables.\u003c/p\u003e\n\u003cp\u003eTo test the study hypotheses, Pearson correlations between study variables were examined, and\u0026nbsp;structural equation modeling (SEM)\u0026nbsp;analyses were performed using Amos 29 statistical software (IBM Corp., 2022). In line with the hypotheses, SEM models included both the direct associations of mothers\u0026rsquo; ACEs and war-related adverse experiences with children\u0026rsquo;s psychological symptoms and the indirect links through mothers\u0026rsquo; sense of danger, depression and anxiety symptoms, co-parenting support, parental burnout, and avoidant communication with the child in the model of Sample 1, and maternal hostility in the model of Sample 2. The models included relevant background variables and the paths between them and study variables, as identified in the preliminary analyses.\u0026nbsp;To rule out children\u0026rsquo;s effects on mothers, we also examined alternative models with paths from children\u0026rsquo;s psychological symptoms to mothers\u0026rsquo; co-parenting support, parenting burnout, and avoidant communication with the child (or hostility in the case of infants/toddlers), and from the latter three to mothers\u0026rsquo; depression and anxiety symptoms.\u003c/p\u003e\n\u003cp\u003eModel fit was evaluated using a combination of absolute and incremental goodness-of-fit indices, including Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR). Good model fit is represented CFI \u0026ge; .95, RMSEA \u0026le; .06 and SRMR \u0026lt; .05. A CFI of .90 or higher, an RMSEA \u0026le; .08 or less and SRMR \u0026le; .08 are considered acceptable fit (Hu \u0026amp; Bentler, 1999). The smallest\u0026nbsp;Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values were also used to determine the most parsimonious of the competing models (Hooper et al., 2008).\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eWe also reported the X\u003csup\u003e2\u003c/sup\u003e values but did not rely on them for interpretation, as the test is sensitive to sample size, and it is almost always significant in large samples such as the ones of the current study (Schermelleh-Engel et al., 2003). To examine whether the sequential mediation models were supported, we estimated the significance of indirect effects using a bootstrap approach, a nonparametric method based on repeated random resampling with replacement. This yielded 95% bootstrapped confidence intervals (CIs). A significant indirect effect was indicated when zero was outside the 95% CI, suggesting that the mediation effect was statistically different from zero at p \u0026lt; .05.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003ePreliminary Analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSample 1\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive statistics are shown in Table 2. As can be seen in the table, the average score of mothers\u0026rsquo; psychological symptoms was above the \u0026quot;normal\u0026quot; cutoff (see cutoff scores in the Method section above). Children\u0026rsquo;s average psychological symptoms scores were also above the \u0026quot;normal\u0026quot; cutoff (\u003cem\u003eM\u003c/em\u003e = 13.37, \u003cem\u003eSD\u003c/em\u003e = 6.10, \u003cem\u003eRange\u0026nbsp;\u003c/em\u003e= 1-35). It is important to note that because we added four items to the SDQ measure of children\u0026apos;s psychological symptoms, the comparison to the clinical cutoff point is based on children\u0026rsquo;s scores using the original SDQ (Goodman, 1997; see the Method section).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe following significant associations were found between family background variables and study variables. Jewish mothers reported more ACEs, more war-related adverse experiences, a lower sense of danger, fewer anxiety symptoms, and more psychological symptoms of their children (\u003cem\u003eM\u003c/em\u003e = 1.02, \u003cem\u003eSD\u003c/em\u003e = 1.37, \u003cem\u003eM\u003c/em\u003e = 2.24, \u003cem\u003eSD\u003c/em\u003e = 1.72, \u003cem\u003eM\u003c/em\u003e = 2.75, \u003cem\u003eSD\u003c/em\u003e =.87, \u003cem\u003eM\u003c/em\u003e = 3.68, \u003cem\u003eSD\u003c/em\u003e = 3.88, and \u003cem\u003eM\u003c/em\u003e = 15.89, \u003cem\u003eSD\u003c/em\u003e = 6.97 respectively) than Arab mothers (\u003cem\u003eM\u003c/em\u003e = .68, \u003cem\u003eSD\u003c/em\u003e = 1.11, \u003cem\u003eM\u003c/em\u003e = .97, \u003cem\u003eSD\u003c/em\u003e = 1.30, \u003cem\u003eM\u003c/em\u003e = 3.32, \u003cem\u003eSD\u003c/em\u003e =.94, \u003cem\u003eM\u003c/em\u003e = 4.63, \u003cem\u003eSD\u003c/em\u003e = 5.01, and \u003cem\u003eM\u003c/em\u003e = 12.46, \u003cem\u003eSD\u003c/em\u003e = 6.71 respectively), \u003cem\u003et\u0026nbsp;\u003c/em\u003e(213.16) = 3.12, \u003cem\u003ep\u003c/em\u003e = .002,\u003cem\u003e\u0026nbsp;t\u0026nbsp;\u003c/em\u003e(226.14) = 9.82, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, \u003cem\u003et\u0026nbsp;\u003c/em\u003e(875) = -6.82,\u003cem\u003e\u0026nbsp;t\u0026nbsp;\u003c/em\u003e(162.91) = -2.09, \u003cem\u003ep\u003c/em\u003e = .038, and\u003cem\u003e\u0026nbsp;t\u0026nbsp;\u003c/em\u003e(875) = 5.27, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001 respectively. Jewish mothers were also more likely than Arab mothers to report war or terror-related experiences in their childhood, c\u003csup\u003e2\u003c/sup\u003e(1) = 7.42, \u003cem\u003ep\u003c/em\u003e \u003csub\u003eFisher\u0026rsquo;s Exact Test\u003c/sub\u003e = .006. Older maternal age was associated more war-related experiences (\u003cem\u003er\u003c/em\u003e = .09, \u003cem\u003ep\u003c/em\u003e = .006), lower sense of danger (\u003cem\u003er\u003c/em\u003e = -.14, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001), fewer anxiety symptoms (\u003cem\u003er\u003c/em\u003e = -.08, \u003cem\u003ep\u003c/em\u003e = .019), less co-parenting support (\u003cem\u003er\u003c/em\u003e = -.11, \u003cem\u003ep\u003c/em\u003e = .001), lower burnout (\u003cem\u003er\u003c/em\u003e = -.20, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001), and less avoidance in communication with the child (\u003cem\u003er\u003c/em\u003e = -.39, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001). Non-married/cohabiting mothers reported more anxiety symptoms and lower co-parenting support (\u003cem\u003eM\u003c/em\u003e = 5.33, \u003cem\u003eSD\u003c/em\u003e = 4.54, and \u003cem\u003eM\u003c/em\u003e = 2.74 \u0026nbsp; \u003cem\u003eSD\u003c/em\u003e = 1.11 respectively) than married/cohabiting mothers (\u003cem\u003eM\u003c/em\u003e = 3.77, \u003cem\u003eSD\u003c/em\u003e = 4.06, and \u003cem\u003eM\u003c/em\u003e = 4.16 \u0026nbsp; \u003cem\u003eSD\u003c/em\u003e =.79 respectively), \u003cem\u003et\u003c/em\u003e (872) = 2.25, \u003cem\u003ep\u003c/em\u003e = .025, and \u003cem\u003et\u0026nbsp;\u003c/em\u003e(36.54) = -7.62, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001 respectively. Mothers\u0026rsquo; years of education were associated with reports of higher co-parenting support (\u003cem\u003er\u003c/em\u003e = .10, \u003cem\u003ep\u003c/em\u003e = .004), lower avoidance from communication with the child (\u003cem\u003er\u003c/em\u003e = -.10, \u003cem\u003ep\u003c/em\u003e = .004), and fewer psychological symptoms of their children (\u003cem\u003er\u003c/em\u003e = -.11, \u003cem\u003ep\u003c/em\u003e = .001).\u003c/p\u003e\n\u003cp\u003eMothers of girls reported more depression and anxiety symptoms and tended more to report avoidant communication with their child (\u003cem\u003eM\u003c/em\u003e = 6.48, \u003cem\u003eSD\u003c/em\u003e = 4.66, and \u003cem\u003eM\u003c/em\u003e = 4.18 \u0026nbsp;\u003cem\u003eSD\u003c/em\u003e = 4.25, \u003cem\u003eM\u003c/em\u003e = 3.20, \u003cem\u003eSD\u003c/em\u003e = .94 respectively) than mothers of boys (\u003cem\u003eM\u003c/em\u003e = 5.72, \u003cem\u003eSD\u003c/em\u003e = 4.31, and \u003cem\u003eM\u003c/em\u003e = 3.48, \u003cem\u003eSD\u003c/em\u003e = 3.89, and \u003cem\u003eM\u003c/em\u003e = 3.00, \u003cem\u003eSD\u003c/em\u003e = .96 respectively), \u003cem\u003et\u003c/em\u003e (874) = 2.50, \u003cem\u003ep\u003c/em\u003e = .013, \u003cem\u003et\u0026nbsp;\u003c/em\u003e(874) = 2.55, \u003cem\u003ep\u003c/em\u003e = .011, \u003cem\u003et\u0026nbsp;\u003c/em\u003e(874) = 3.17, \u003cem\u003ep\u003c/em\u003e = .002, respectively. Children\u0026rsquo;s older age was associated with \u0026nbsp;mothers\u0026rsquo; reports of more war-related experiences (\u003cem\u003er\u003c/em\u003e = .07, \u003cem\u003ep\u003c/em\u003e = .033), lower sense of danger (\u003cem\u003er\u003c/em\u003e = -.07, \u003cem\u003ep\u003c/em\u003e = .037), less co-parenting support (\u003cem\u003er\u003c/em\u003e = -.09, \u003cem\u003ep\u003c/em\u003e = .012), lower burnout (\u003cem\u003er\u003c/em\u003e = -.18, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001), less avoidant communication (\u003cem\u003er\u003c/em\u003e = -.48, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001), and fewer psychological symptoms of their child (\u003cem\u003er\u003c/em\u003e = -.09, \u003cem\u003ep\u003c/em\u003e = .008). Mothers of firstborns reported higher sense of danger (\u003cem\u003eM\u003c/em\u003e = 2.93, \u003cem\u003eSD\u003c/em\u003e = .93), more symptoms of depression (\u003cem\u003eM\u003c/em\u003e = 6.56, \u003cem\u003eSD\u003c/em\u003e = 4.79) and anxiety (\u003cem\u003eM\u003c/em\u003e = 4.15, \u003cem\u003eSD\u003c/em\u003e = 4.35), more parenting burnout (\u003cem\u003eM\u003c/em\u003e = 2.33, \u003cem\u003eSD\u003c/em\u003e = .89), and more avoidant communication with the child (\u003cem\u003eM\u003c/em\u003e = 3.05, \u003cem\u003eSD\u003c/em\u003e = .76) than mothers of later-born (\u003cem\u003eM\u003c/em\u003e = 2.76, \u003cem\u003eSD\u003c/em\u003e = .88, \u003cem\u003eM\u003c/em\u003e = 5.72, \u003cem\u003eSD\u003c/em\u003e = 4.20, \u003cem\u003eM\u003c/em\u003e = 3.55, \u003cem\u003eSD\u003c/em\u003e = 3.82, \u003cem\u003eM\u003c/em\u003e = 2.16, \u003cem\u003eSD\u003c/em\u003e =.90, and \u003cem\u003eM\u003c/em\u003e = 2.69, \u003cem\u003eSD\u003c/em\u003e = .80 respectively), \u003cem\u003et\u003c/em\u003e (875) = 2.90, \u003cem\u003ep\u003c/em\u003e = .004, \u003cem\u003et\u003c/em\u003e (812.33) = 2.71, \u003cem\u003ep\u003c/em\u003e = .007, \u003cem\u003et\u0026nbsp;\u003c/em\u003e(812.37) = 2.17, \u003cem\u003ep\u003c/em\u003e = .030, \u003cem\u003et\u0026nbsp;\u003c/em\u003e(875) = 2.83, \u003cem\u003ep\u003c/em\u003e = .005, and \u003cem\u003et\u0026nbsp;\u003c/em\u003e(875) = 6.88, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001 respectively.\u003c/p\u003e\n\u003cp\u003eMothers\u0026rsquo; age, marital status, children\u0026rsquo;s age, and first-born status were interrelated (\u003cem\u003ep\u003c/em\u003e\u0026rsquo;s \u0026lt; .020). To avoid multicollinearity concerns, subsequent analyses included only ethnocultural background (Jewish or Arab), child gender, child age, and mother\u0026rsquo;s education as covariates.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSample 2\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive statistics are shown in Table 2. The average score of mothers\u0026rsquo; psychological symptoms was just below the cutoff between \u0026quot;normal\u0026quot; and \u0026quot;above normal\u0026quot; (see cutoff scores in the Method section). 65% of the infants received a score above \u0026quot;normal\u0026quot; in at least one of the three symptom dimensions of irritability, inflexibility, and difficulties with routines (not shown in the table).\u003c/p\u003e\n\u003cp\u003eThe following significant associations were found between the background and study variables. Jewish mothers reported more war-related experiences, lower sense of danger, and more hostility (\u003cem\u003eM\u003c/em\u003e = 2.08, \u003cem\u003eSD\u003c/em\u003e = 1.64, \u003cem\u003eM\u003c/em\u003e = 2.86, \u003cem\u003eSD\u003c/em\u003e = .87, and \u003cem\u003eM\u003c/em\u003e = 1.92, \u003cem\u003eSD\u003c/em\u003e = .88 respectively) than Arab mothers (\u003cem\u003eM\u003c/em\u003e = 1.17, \u003cem\u003eSD\u003c/em\u003e = 1.60, and \u003cem\u003eM\u003c/em\u003e = 3.16, \u003cem\u003eSD\u003c/em\u003e = 1.00, and \u003cem\u003eM\u003c/em\u003e = 1.57, \u003cem\u003eSD\u003c/em\u003e = .68 \u0026nbsp;respectively), \u003cem\u003et\u0026nbsp;\u003c/em\u003e(289) = 3.28, \u003cem\u003ep\u003c/em\u003e = .001,\u003cem\u003e\u0026nbsp;t\u0026nbsp;\u003c/em\u003e(289) = -2.00, \u003cem\u003ep\u003c/em\u003e = .047,\u003cem\u003e\u0026nbsp;\u003c/em\u003eand\u003cem\u003e\u0026nbsp;t\u0026nbsp;\u003c/em\u003e(64.35) = 2.92, \u003cem\u003ep\u003c/em\u003e = .005 respectively. Older mothers\u0026rsquo; age was associated with less co-parenting support (\u003cem\u003er\u003c/em\u003e = -.13, \u003cem\u003ep\u003c/em\u003e = .031). Mothers\u0026rsquo; years of education were associated with reports of fewer war-related experiences (\u003cem\u003er\u003c/em\u003e = -.13, \u003cem\u003ep\u003c/em\u003e = .030). Older infant and toddler age was associated with mothers\u0026rsquo; reports of a lower sense of danger (\u003cem\u003er\u003c/em\u003e = -.12, \u003cem\u003ep\u003c/em\u003e = .047), higher hostility (\u003cem\u003er\u003c/em\u003e = .13, \u003cem\u003ep\u003c/em\u003e = .028), and more psychological symptoms of the child (\u003cem\u003er\u003c/em\u003e = .12, \u003cem\u003ep\u003c/em\u003e = .041). Finally, mothers of firstborns tended more to experience war/terror-related events than mothers of later-born children, c\u003csup\u003e2\u003c/sup\u003e(1) = 8.78, \u003cem\u003ep\u003c/em\u003e \u003csub\u003eFisher exact test\u003c/sub\u003e = .005. Mothers of firstborns also reported more co-parenting support, less parenting burnout, and less hostility (\u003cem\u003eM\u003c/em\u003e = 4.53, \u003cem\u003eSD\u003c/em\u003e = .63, and \u003cem\u003eM\u003c/em\u003e = 1.86, \u003cem\u003eSD\u003c/em\u003e = .78, and \u003cem\u003eM\u003c/em\u003e = 1.60, \u003cem\u003eSD\u003c/em\u003e = .71) than mothers of later-born (\u003cem\u003eM\u003c/em\u003e = 4.29, \u003cem\u003eSD\u003c/em\u003e = .79, and \u003cem\u003eM\u003c/em\u003e = 2.14, \u003cem\u003eSD\u003c/em\u003e =.81, and \u003cem\u003eM\u003c/em\u003e = 2.02, \u003cem\u003eSD\u003c/em\u003e = .91 respectively), \u003cem\u003et\u003c/em\u003e (252.13) = 2.89, \u003cem\u003ep\u003c/em\u003e = .004, \u003cem\u003et\u0026nbsp;\u003c/em\u003e(288) = -2.89, \u003cem\u003ep\u003c/em\u003e = .004, and \u003cem\u003et\u0026nbsp;\u003c/em\u003e(252.98) = -4.37, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, respectively.\u003c/p\u003e\n\u003cp\u003eMothers and children\u0026rsquo;s ages were interrelated (\u003cem\u003ep\u003c/em\u003e\u0026rsquo;s \u0026lt; .001). To avoid multicollinearity concerns, subsequent analyses included only child age, first-born status, and mothers\u0026rsquo; education as covariates. Because the number of Arab mothers of infants and toddlers was small (\u003cem\u003en\u003c/em\u003e = 41), it was not included as a covariate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssociations between ACEs, Childhood War/Terror Exposure, and Current War-Related Adverse Experiences and Mothers\u0026rsquo; and Children\u0026rsquo;s Wellbeing\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSample 1\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs shown in Table 3, most intercorrelations between study variables were significant. We describe here those that were hypothesized. As expected, mothers who reported more ACEs, a childhood war/terror-related experience, and more current war-related experiences reported more psychological symptoms in the child as well as a higher sense of danger. Also, as hypothesized, a higher sense of danger was associated with more symptoms of depression and anxiety, and these symptoms were associated with reports of lower co-parenting support, increased parenting burnout, and more avoidant communication with the child about the war. As hypothesized, the three latter variables were significantly associated with increased psychological symptoms in the child.\u003c/p\u003e\n\u003cp\u003eNext, we conducted SEM analysis to examine the hypothesized sequential mediation model, in which ACEs, exposure to war or terror-related experience in childhood, and more current war-related experiences are each indirectly related to children\u0026rsquo;s increased psychological symptoms through sense of danger, followed by depression and anxiety symptoms, followed by lower co-parenting support, increased parenting burnout, and more avoidant communication with the child about the war. Preliminary analyses guided the inclusion of covariates in the model. The model showed adequate fit to the data, \u0026chi;\u003csup\u003e2\u003c/sup\u003e(53) = 183.71, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001, CFI = .93, RMSEA = .053, SRMR = .051, AIC = 287.71, BIC = 536.09. As shown in Figure 2 and Table 4, all hypothesized indirect effects were supported.\u0026nbsp;The direct effects of ACE and current war-related experiences on children\u0026apos;s increased psychological symptoms remained significant when accounting for indirect effects. This suggests that the sense of danger, depressive and anxiety symptoms, lower co-parenting, parenting burnout, and avoidant communication partially mediated these effects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSample 2\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs shown in Table 3, several intercorrelations between study variables were significant. We describe here those that were hypothesized. As expected, mothers who reported more ACEs and more current war-related experiences reported more psychological symptoms in their infant/toddler as well as a higher sense of danger. However, unexpectedly, a childhood war/terror-related experience was not significantly related to infants\u0026rsquo;/toddlers\u0026rsquo; psychological symptoms nor to mothers\u0026rsquo; sense of danger. As hypothesized, a higher sense of danger was associated with more symptoms of depression and anxiety, and these symptoms were related to reports of lower co-parenting support, increased burnout, and higher hostility toward the infant/toddler. The three latter variables were, as expected, significantly associated with increased psychological symptoms in the infant/toddler.\u003c/p\u003e\n\u003cp\u003eNext, we conducted SEM analysis to examine the hypothesized sequential mediation model, in which ACEs and current war-related experiences are each directly related to infants\u0026rsquo;/toddlers\u0026rsquo; increased psychological symptoms and that ACEs, exposure to war or terror-related experiences in childhood and current war-related experiences are each indirectly associated with infants\u0026rsquo;/toddlers\u0026rsquo; increased psychological symptoms through higher sense of danger, followed by more depression and anxiety symptoms, followed by lower co-parenting support, increased burnout, and higher hostility. Preliminary analyses guided the inclusion of covariates in the model.\u003c/p\u003e\n\u003cp\u003eBased on modification indices, we added two direct paths from ACEs to depression and anxiety symptoms. These modifications were also theoretically justifiable (see a review and meta-analysis in Hughes et al., 2017). The model showed good fit to the data, \u0026chi;2(46) = 63.09, \u003cem\u003ep\u003c/em\u003e = .048, CFI = .97, RMSEA = .036, SRMR = .052,\u0026nbsp;AIC = 153.09, BIC = 318.39.\u0026nbsp;As shown in Figure 3 and Table 4, most hypothesized indirect effects were supported. The association of ACEs and more current war-related experiences with infants\u0026rsquo;/toddlers\u0026rsquo; psychological symptoms were indirect, through a higher sense of danger, followed by more depression symptoms, followed by decreased co-parenting support, increased parenting burnout, and more hostility.\u0026nbsp;The direct effects of ACEs and war-related experiences on infants\u0026rsquo; and toddlers\u0026rsquo; psychological symptoms became non-significant when accounting for indirect effects. This suggests that the sense of danger, depressive symptoms, lower co-parenting, burnout, and hostility fully mediated these effects.\u003c/p\u003e\n\u003cp\u003eChildhood war/terror-related experiences were not associated with a sense of danger (see Figure 3). In addition, although\u0026nbsp;the sense of danger was associated with anxiety symptoms, which in turn were associated with lower co-parenting, this sequential indirect path was not significant,\u0026nbsp;CIs = -0.01, 0.10, \u003cem\u003ep\u003c/em\u003e = \u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e147.\u0026nbsp;Finally, as shown in Figure 3, anxiety symptoms were not associated with parenting burnout or hostility. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAlternative Models\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe alternative models, reflecting children\u0026rsquo;s effects on their mothers, showed a poorer fit to the data. The fit indices of the model in Sample 1 were as follows: CFI = .88; RMSEA = .071, SRMR = .070; AIC = 391.20, BIC = 639.58. The fit indices of the model in Sample 2 were as follows: CFI = .95; RMSEA = .051; SRMR = .066. AIC = 170.03; BIC = 335.331. Hence, the models reflecting the study hypotheses of paths from mothers\u0026rsquo; experiences to children\u0026rsquo;s psychological symptoms were the best fit for the data.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study examined the impact of war on mothers and children. Although this was a community sample of educated mothers with relatively few ACEs, from mostly intact families, who, for the most part, did not reside near the war front, results revealed a high level of symptoms in both mothers and children. The average level of psychological symptoms in mothers of children aged three and up and in children in both samples exceeded the normative range, while the average level of maternal symptoms in the sample of mothers of infants and toddlers was just below the cutoff point (Lovibond, 2025; Mansbach-Kleinfeld et al., 2010; Sheldrick et al., \u003cspan citationid=\"CR104\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Furthermore, in both samples, the average rates of maternal symptoms were higher than those reported in pre-war studies of mothers in Israel (e.g., Alon-Tirosh et al., 2021; Sher-Censor et al., \u003cspan citationid=\"CR105\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Sher-Censor et al., 2020). This difference was striking because the pre-war data were of high-risk mothers whereas the present study involved a low-risk sample. Although we do not have pre-war maternal and child symptom data, the fact that average symptom levels exceeded what would typically be expected in a low-risk group underscores the significant psychological burden of war on mothers and children. These findings are consonant with those reported in research of adults and children facing wars and armed conflict in Israel and other countries, and highlight the deleterious psychological effects of war (e.g., Hyland et al., 2023; Sade et al., 2008).\u003c/p\u003e \u003cp\u003eBeyond the relatively high levels of maternal and child symptoms, we examined factors and family dynamics that may contribute to some mothers and children being more severely impacted by war than others. Guided by the FSM and ACEs frameworks, we found that mothers\u0026rsquo; exposure to more ACEs and more current war-related experiences were associated with their own and their children\u0026rsquo;s increased psychological symptoms. These effects were mediated by mothers' heightened sense of danger due to the war, which, in turn, was linked to elevated levels of maternal psychological symptoms. Increased symptoms in mothers were further associated with more disruptions in both co-parenting and parenting, which, in turn, were linked to children\u0026rsquo;s psychological symptoms.\u003c/p\u003e \u003cp\u003eThe current study was among the few to examine war\u0026rsquo;s impact on infants and toddlers. In our sample of older children, exposure to more war experiences was both directly and indirectly related to children\u0026rsquo;s psychological symptoms. In the sample of infants and toddlers, the effects were indirect and fully mediated by maternal sense of danger, depression symptoms, and disruptions in family relationships. This is consistent with the notion that children's direct exposure to the broader environment is relatively limited in infancy and toddlerhood. Thus, especially at very young ages, maternal buffering of environmental adversity appears to have a particularly pronounced effect (Halevi et al., 2017; Sung et al. \u003cspan citationid=\"CR118\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAn innovative aspect of our study lies in introducing avoidant communication about the war as a mediator between war exposure and children\u0026rsquo;s psychological symptoms and as one of the mechanisms that can explain how parents\u0026rsquo; psychological symptoms contribute to their children\u0026rsquo;s symptoms. Our findings align with two studies that showed that avoidant parental communication about collective adversity [the 2013 Boston Marathon bombing (Carpenter et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) and COVID-19 (Malloy et al., 2024)] was associated with increased psychological symptoms in both parents and children. Together, they support the notion that without supportive parent-child communication, children may have difficulties formulating coherent meaning and resolving war experiences, which may increase their distress.\u003c/p\u003e \u003cp\u003eA key contribution of this study was to shed light on the process of intergenerational transmission of trauma in the context of war by employing both the FSM and the ACEs models. As mentioned above, mothers\u0026rsquo; ACEs increased their own and their children\u0026rsquo;s vulnerability to the effects of war. Prior ACEs studies suggested that mothers\u0026rsquo; depression and anxiety symptoms mediate the link between mothers\u0026rsquo; ACEs and their children\u0026rsquo;s increased psychological symptoms (Hughes et al., 2017). Our results support these findings and reveal additional mediating mechanisms. First, we found that cumulative ACEs may intensify mothers\u0026rsquo; sense of danger due to the war, which in turn was related to elevated depression and anxiety symptoms. This aligns with two studies showing that adults who have experienced more ACEs perceive greater danger when facing a chronic illness or a natural disaster (Traino et al., 2022; Wilson-Genderson et al., \u003cspan citationid=\"CR127\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Thus, experiencing early adversity of maltreatment, neglect, and family dysfunction appears to shape cognitive appraisals in a way that amplifies threat sensitivity in response to war.\u003c/p\u003e \u003cp\u003eFurthermore, our study suggests that four types of disruptions in family dynamics are associated with cumulative ACEs and mediate the intergenerational associations between mothers\u0026rsquo; ACEs, sense of danger, and psychological symptoms and their children\u0026rsquo;s psychological symptoms during war. Specifically, we documented the mediating role of reduced co-parenting support, in line with the findings of Zhang and colleagues (\u003cspan citationid=\"CR132\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Second, we revealed the role of parental burnout, which has received little attention in the ACEs literature. Third, we showed that maternal hostility toward infants and toddlers also served as a mediator, supporting the notion that ACEs may lead to poorer parent-child interactions, which has yielded mixed findings in the past (e.g., Racine and colleagues [\u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e2018\u003c/span\u003e] found such links, whereas Coe and colleagues [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2020\u003c/span\u003e] did not). Fourth, we identified avoidant communication with the child about war as an additional mediator. We did not find a direct effect between ACEs and avoidant communication, but rather an indirect effect through an increased sense of danger and mothers\u0026rsquo; psychological symptoms. A related possible mechanism that may explain the link between mothers\u0026rsquo; ACEs and their children\u0026rsquo;s psychological symptoms may be the processing or resolution of past traumatic events. Research has shown that among mothers who have experienced sexual abuse, those who had not resolved their past trauma were less supportive of their child when reminiscing about emotional experiences compared to those who had resolved their trauma (Koren-Karie et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). Future research may benefit from examining not only the extent to which mothers have experienced ACEs and war-related events and their impact on mothers\u0026rsquo; communication, as we did, but also whether mothers resolved these adverse past and present experiences.\u003c/p\u003e \u003cp\u003eImportantly, alongside the assessment of ACEs using the traditional ACEs questionnaire (Felitti et al., 1998), we added a question about mothers\u0026rsquo; childhood exposure to war or terrorism, given the study\u0026rsquo;s war-exposure context. This childhood exposure was associated with children\u0026rsquo;s increased psychological symptoms through mothers\u0026rsquo; heightened sense of danger, psychological symptoms, and disruptions in family dynamics (albeit only in the sample of mothers of children aged three and up). This finding raises concern about the intergenerational effect of armed conflicts. It appears that war exposure may not only impact individuals during their childhood but might also increase their vulnerability to future war-related stressors and perpetuate intergenerational trauma. Notably, childhood war exposure was linked to low perceived co-parenting support and parental burnout, but unexpectedly, it was not associated with avoidant communication with the child about war. These findings underscore the need for further research to clarify the mechanisms through which childhood exposure to war/terror affects parenting. These could inform prevention programs aimed at breaking the cycle of intergenerational war-related trauma.\u003c/p\u003e \u003cp\u003eFinally, the study offers contributions to the FSM literature. First, it extends the FSM by pointing to its relevance for understanding the impact of distal stressors in a child\u0026rsquo;s ecology other than economic hardship. This aligns with the few studies that have applied the FSM in the context of other stressors, such as immigration (Sher-Censor \u0026amp; Mizrachi-Zinman, 2020) and COVID-19 (Lucassen et al., \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Second, it demonstrates the relevance of the FSM to infants and toddlers who were previously understudied within this framework. A third contribution lies in identifying avoidant communication as a disruption in the parent-child relationship. More research may explore whether avoidant communication about other environmental stressors, including economic hardship, plays a similar role.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eLimitations, Conclusions, and Implications\u003c/h2\u003e \u003cp\u003eThe lack of data on families before the war and the concurrent data collection are limitations of this study. Although we compared mothers\u0026rsquo; and children\u0026rsquo;s average psychological symptoms to established cutoff points and tested alternative SEM models to demonstrate that the data best supported the direction of effects proposed by the FSM and ACEs models, longitudinal research is needed to elucidate causal relationships. This is especially important because recent FSM studies demonstrated child effects on parental distress and family disruption (Şeng\u0026uuml;l-İnal et al., \u003cspan citationid=\"CR102\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn addition, this was a survey-based study relying solely on maternal reports. Maternal perceptions were collected using valid measures, and their perspective during a sensitive time, such as war, provides valuable insight. The available resources, given the conditions of an ongoing war, for both the research team and mothers, defined the scope of data that could be collected. Nevertheless, future research should incorporate multiple informants (e.g., fathers, educators) and diverse methodologies (e.g., observations) to mitigate shared informant and method biases that may inflate associations between variables.\u003c/p\u003e \u003cp\u003e Third, the sample consisted of a convenience-based community sample, and the findings showed that even in such a relatively advantaged sample the level of psychological symptoms in mothers and children was high. This raises concern regarding the well-being of families from less advantaged backgrounds during wartime. Future research should include more diverse samples who enjoy fewer economic, social, and psychological resources, including, for example, single-parent families and those from lower socioeconomic backgrounds. Relatedly and aligned with recent ACE studies of adults (Briggs et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Sayyah et al., \u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), future research with more significant variability in maternal ACEs may benefit from exploring the distinct effects of child maltreatment, child neglect and family dysfunction, as well as the combined impact of different types of ACEs, on how mothers and children are affected by war.\u003c/p\u003e \u003cp\u003eAnother important avenue for future research is investigating the role of sociocultural background. The size of the Jewish and Arab subsamples was unbalanced, limiting our ability to compare them systematically. Notably, despite lower war-related exposure among Arab participants, their distress levels were comparable to those of Jewish participants, aligning with findings from a recent survey of adults in Israel (Mayer et al., \u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Nevertheless, future research should explore similarities and differences in the impact of war on parents and children from diverse sociocultural groups. Relatedly, war impacts families on both sides of the conflict. As we did not have access to families in the Gaza Strip, we were unable to study the war\u0026rsquo;s impact on them.\u003c/p\u003e \u003cp\u003eDespite these limitations, the current study highlights the destructive and broad psychological impact of war on mothers and children and provides insight into the mechanisms through which war exposure affects them. Each of these mechanisms could guide interventions with families by identifying those at increased risk of being more severely affected by the war and by serving as potential \u0026ldquo;ports of entry\u0026rdquo; for interventions to mitigate the effects of war exposure on children and break the cycle of intergenerational trauma.\u003c/p\u003e \u003c/div\u003e"},{"header":"Statements and Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e. The\u0026nbsp;procedure and measures of this study were approved by the Human Research Review Board of the participating university\u0026nbsp;(#157/24). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eConsent.\u0026nbsp;\u003c/strong\u003eMothers provided written informed consent.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement.\u0026nbsp;\u003c/strong\u003eData supporting the findings are available at https://osf.io/[Blinded for review].\u0026nbsp;\u003cbr\u003e\u003cstrong\u003eCompeting interest.\u003c/strong\u003e The authors state that there is no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding.\u003c/strong\u003e The Research Authority of the participating university supported the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e. Author 1 conceptualized the study, conducted data analyses, and wrote the manuscript. Author 2 conceptualized the study and reviewed and revised the manuscript. Author 3 conceptualized the study, participated in data analyses, and reviewed and revised the manuscript. Author 4 conceptualized the study, and reviewed and revised the manuscript. Authors 5 and 6 took part in conceptualizing the study, collecting the data, and reviewing the manuscript. All authors read and approved the final version of the manuscript.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAfifi, A. A., Kotlerman, J. B., Ettner, S. L., \u0026amp; Cowan, M. (2007). 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Shaping children\u0026apos;s internal working models through mother\u003cspan dir=\"RTL\"\u003e-\u003c/span\u003echild dialogues: The importance of resolving past maternal trauma. \u003cem\u003eAttachment \u0026amp; Human Development\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e, 465\u003cspan dir=\"RTL\"\u003e\u0026ndash;\u003c/span\u003e483. https://doi.org/ 10.1080/14616730802461482.\u003c/li\u003e\n \u003cli\u003eLee, J. Y., Lee, S. J., Yoon, S., Kirsch, J., Pace, G. T., \u0026amp; Schoppe-Sullivan, S. J. (2024). Family stress processes underlying material hardship and parental detachment and warmth amongst racially diverse fathers and mothers with low income. \u003cem\u003eJournal of Family Violence\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e(6), 1075-1091. https://doi.org/10.1007/s10896-023-00583-x\u003c/li\u003e\n \u003cli\u003eLevi-Belz, Y., Groweiss, Y., Blank, C., \u0026amp; Neria, Y. (2024). PTSD, depression, and anxiety after the October 7, 2023 attack in Israel: a nationwide prospective study. \u003cem\u003eEClinicalMedicine\u003c/em\u003e, \u003cem\u003e68\u003c/em\u003e. https://doi.org/10.1016/j.eclinm.2023.102418\u003c/li\u003e\n \u003cli\u003eLovibond, S., \u0026amp; Lovibond, P. (1995). \u003cem\u003eManual for the depression anxiety stress scales\u003c/em\u003e. Psychology Foundation Lorenzo‐Blanco, E. I., Meca, A., Pi\u0026ntilde;a‐Watson, B., Zamboanga, B. L., Szapocznik, J., Cano, M. A., ... \u0026amp; Schwartz, S. J. (2019). Longitudinal trajectories of family functioning among recent immigrant adolescents and parents: Links with adolescent and parent cultural stress, emotional well‐being, and behavioral health. \u003cem\u003eChild Development\u003c/em\u003e, \u003cem\u003e90\u003c/em\u003e(2), 506-523. https://doi.org/10.1111/cdev.12914\u003c/li\u003e\n \u003cli\u003eLucassen, N., de Haan, A. D., Helmerhorst, K. O., \u0026amp; Keizer, R. (2021). Interrelated changes in parental stress, parenting, and coparenting across the onset of the COVID-19 pandemic. \u003cem\u003eJournal of Family Psychology\u003c/em\u003e, \u003cem\u003e35\u003c/em\u003e(8), 1065-1076. https://doi.org/10.1037/fam0000908\u003c/li\u003e\n \u003cli\u003eMalloy, L. C., Dykstra, V. W., Steen, L. A. R., Filoso, D., Salem, H., Comer, J. S., ... \u0026amp; Evans, A. D. (2024). Avoidant parent-child communication about COVID-19: A longitudinal investigation of associations with youth adjustment across the first 6 months of the pandemic. \u003cem\u003eResearch on Child and Adolescent Psychopathology\u003c/em\u003e, \u003cem\u003e52\u003c/em\u003e(2), 253-266. https://doi.org/10.1007/s10802-023-01133-1\u003c/li\u003e\n \u003cli\u003eMasarik, A. S., \u0026amp; Conger, R. D. (2017). Stress and child development: A review of the Family Stress Model. \u003cem\u003eCurrent Opinion in Psychology, 13\u003c/em\u003e, 85\u0026ndash;90. https://doi.org/10.1016/j.copsyc.2016.05.008\u003c/li\u003e\n \u003cli\u003eMayer, Y., Shiffman, N., Bergmann, E., Natoor, M., Khazen, S., Lurie, I., \u0026amp; Enav, Y. (2024). Mental health outcomes of Arab and Jewish populations in Israel a month after the mass trauma events of October 7, 2023: A cross-sectional survey of a representative sample. \u003cem\u003ePsychiatry Research\u003c/em\u003e, 116042. https://doi.org/10.1016/j.psychres.2024.116042\u003c/li\u003e\n \u003cli\u003eMcConnell, M., Closson, L., Morse, B., Wurster, H., Flykt, M., Sarche, M., \u0026amp; Biringen, Z. The \u0026ldquo;EA brief\u0026rdquo;: A single session of parent feedback and coaching to improve emotional attachment and emotional availability (EA). \u003cem\u003eInfant Mental Health Journal\u003c/em\u003e, \u003cem\u003e41\u003c/em\u003e(6), 783-792. https://doi.org/10.1002/imhj.21867\u003c/li\u003e\n \u003cli\u003eMikolajczak, M., Gross, J. J., Stinglhamber, F., Lindahl Norberg, A., \u0026amp; Roskam, I. (2020). Is parental burnout distinct from job burnout and depressive symptoms?. \u003cem\u003eClinical Psychological Science\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(4), 673-689. https://doi.org/10.1177/2167702620917447\u003c/li\u003e\n \u003cli\u003eMohammed Bilal, M., Moawia Balla Elnour, S., Mohamed Elmahdi, Z. Z., \u0026amp; Mustafa Mudawi Ahmed, E. (2024). Mental health consequences among Sudanese due to the armed conflicts and civil unrest of 2023: A cross-sectional study. \u003cem\u003eThe International Journal of Social Psychiatry\u003c/em\u003e, 207640231221101. https://doi.org/10.1177/00207640231221101\u003c/li\u003e\n \u003cli\u003eMorgan, N. R., Aronson, K. R., Perkins, D. F., Doucette, C. E., Bleser, J. A., Davenport, K., Vogt, D., Copeland, L. A., Finley, E. P., \u0026amp; Gilman, C. L. (2022). The interaction of exposure to adverse childhood and combat experiences on the current mental health of new post‐9/11 veterans. \u003cem\u003eJournal of Community Psychology\u003c/em\u003e, \u003cem\u003e50\u003c/em\u003e(1), 204-220. https://doi.org/10.1002/jcop.22523\u003c/li\u003e\n \u003cli\u003eNewland, R. P., Crnic, K. A., Cox, M. J., Mills-Koonce, W. R., \u0026amp; Family Life Project Key Investigators. (2013). The family model stress and maternal psychological symptoms: Mediated pathways from economic hardship to parenting. \u003cem\u003eJournal of Family Psychology, 27\u003c/em\u003e(1), 96\u0026ndash;105. https://doi.org/10.1037/a0031112\u003c/li\u003e\n \u003cli\u003eNuttman-Shwartz, O. (2023). The long-term effects of living in a shared and continuous traumatic reality: The case of Israeli families on the border with gaza. \u003cem\u003eTrauma, Violence, \u0026amp; Abuse\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(3), 1387-1404. https://doi.org/10.1177/15248380211063467\u003c/li\u003e\n \u003cli\u003eParke, R. D., Coltrane, S., Duffy, S., Buriel, R., Dennis, J., Powers, J., ... \u0026amp; Widaman, K. F. Economic stress, parenting, and child adjustment in Mexican American and European American families. \u003cem\u003eChild development\u003c/em\u003e, \u003cem\u003e75\u003c/em\u003e(6), 1632-1656. https://doi.org/10.1111/j.1467-8624.2004.00807.x\u003c/li\u003e\n \u003cli\u003eRacine, N., Plamondon, A., Madigan, S., McDonald, S., \u0026amp; Tough, S. (2018). Maternal adverse childhood experiences and infant development. \u003cem\u003ePediatrics, 141\u003c/em\u003e(4), e20172495. https://doi.org/10.1542/peds.2017-2495\u003c/li\u003e\n \u003cli\u003eReese, E., \u0026amp; Newcombe, R. (2007). Training mothers in elaborative reminiscing enhances children\u0026rsquo;s autobiographical memory and narrative. \u003cem\u003eChild Development\u003c/em\u003e, \u003cem\u003e78\u003c/em\u003e(4), 1153-1170. https://doi.org/10.1111/j.1467-8624.2007.01058.x\u003c/li\u003e\n \u003cli\u003eRoskam, I., Brianda, M.-E., \u0026amp; Mikolajczak, M. (2018). A step forward in the conceptualization and measurement of parental burnout: The Parental Burnout Assessment (PBA). Frontiers in Psychology, 9, Article 758. https://doi.org/10.3389/fpsyg.2018.00758\u003c/li\u003e\n \u003cli\u003eSadeh, A., Hen-Gal, S., \u0026amp; Tikotzky, L. (2008). Young children\u0026apos;s reactions to war-related stress: A survey and assessment of an innovative intervention. \u003cem\u003ePediatrics\u003c/em\u003e, \u003cem\u003e121\u003c/em\u003e(1), 46-53. https://doi.org /10.1542/peds.2007-1348\u003c/li\u003e\n \u003cli\u003eSayyah, M. D., Merrick, J. S., Larson, M. D., \u0026amp; Narayan, A. J. (2022). Childhood adversity subtypes and young adulthood mental health problems: Unpacking effects of maltreatment, family dysfunction, and peer victimization. \u003cem\u003eChildren and Youth Services Review, 137\u003c/em\u003e, 106455. https://doi.org/10.1016/j.childyouth.2022.106455\u003c/li\u003e\n \u003cli\u003eSchermelleh-Engel, K., Moosbrugger, H., \u0026amp; M\u0026uuml;ller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. \u003cem\u003eMethods of Psychological Research Online\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(2), 23-74.\u003c/li\u003e\n \u003cli\u003eŞeng\u0026uuml;l-İnal, G., Borgen, N. T., Dearing, E., \u0026amp; Zachrisson, H. D. (2024). The double jeopardy of low family income and negative emotionality: The family stress model revisited. \u003cem\u003eDevelopment and Psychopathology\u003c/em\u003e, 1-18. https://doi.org/10.1017/S0954579424000373\u003c/li\u003e\n \u003cli\u003eSheldrick, R. C., Henson, B. S., Neger, E. N., Merchant, S., Murphy, J. M., \u0026amp; Perrin, E. C. The baby pediatric symptom checklist: development and initial validation of a new social/emotional screening instrument for very young children. \u003cem\u003eAcademic Pediatrics\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(1), 72-80. https://doi.org/10.1016/j.acap.2012.08.003\u003c/li\u003e\n \u003cli\u003eSher-Censor, E., Feniger-Schaal, R., Slonim, M., \u0026amp; Koren-Karie, N. (2024). Effects of adverse childhood experiences on observed parenting and children\u0026rsquo;s behavior problems among Jewish and Arab Muslim families in Israel. \u003cem\u003eDevelopment and Psychopathology\u003c/em\u003e, 1-11. doi:10.1017/S0954579424001111\u003c/li\u003e\n \u003cli\u003eSher-Censor, E., Makarov, M., \u0026amp; Shai, A. (2025). The impact of adverse childhood experiences on pain and subjective cognitive decline in patients treated for localized breast cancer: The mediating role of sense of coherence, sense of danger and psychosocial distress and danger. \u003cem\u003eThe Breast\u003c/em\u003e, 103884. https://doi.org/10.1016/j.breast.2025.103884\u003c/li\u003e\n \u003cli\u003eSher‐Censor, E., \u0026amp; Mizrachi‐Zinman, A. (2021). Mothers\u0026rsquo; narratives on their immigration experiences: Associations with maternal relatedness and adolescent adjustment. \u003cem\u003eJournal of Research on Adolescence\u003c/em\u003e, \u003cem\u003e31\u003c/em\u003e(2), 351-367. https://doi.org/10.1111/jora.12601\u003c/li\u003e\n \u003cli\u003eSolantaus, T., Leinonen, J., \u0026amp; Punam\u0026auml;ki, R. L. (2004). Children\u0026apos;s mental health in times of economic recession: replication and extension of the family economic stress model in Finland. \u003cem\u003eDevelopmental psychology\u003c/em\u003e, \u003cem\u003e40\u003c/em\u003e(3), 412. https://doi.org/10.1037/0012-1649.40.3.412\u003c/li\u003e\n \u003cli\u003eSolomon, Z., Mikulincer, M., \u0026amp; Benbenishty, R. (1989). Locus of control and combat‐related post‐traumatic stress disorder: The intervening role of battle intensity, threat appraisal and coping. \u003cem\u003eBritish Journal of Clinical Psychology\u003c/em\u003e, \u003cem\u003e28\u003c/em\u003e(2), 131-144. https://doi.org/10.1111/j.2044-8260.1989.tb00823.x\u003c/li\u003e\n \u003cli\u003eSolomon, Z., \u0026amp; Prager, E. (1992). Elderly Israeli holocaust survivors during the Persian Gulf war. \u003cem\u003eAmerican Journal of Psychiatry\u003c/em\u003e, \u003cem\u003e149\u003c/em\u003e(12), 1707-1710.\u003c/li\u003e\n \u003cli\u003eSung, S., Simpson, J. A., Griskevicius, V., Kuo, S. I., Schlomer, G. L., \u0026amp; Belsky, J. (2016). Secure infant-mother attachment buffers the effect of early-life stress on age of menarche. \u003cem\u003ePsychological Science\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(5), 667\u0026ndash;674. https://doi.org/10.1177/0956797616631958\u003c/li\u003e\n \u003cli\u003eThe Israel Democracy Institute (2024). https://www.idi.org.il/articles/56248 The National Security Agency(2024). https://www.btl.gov.il/About/newspapers/Pages/NtonimSHANA.aspx\u003c/li\u003e\n \u003cli\u003eTraino, K. A., Espeleta, H. C., Dattilo, T. M., Fisher, R. S., \u0026amp; Mullins, L. L. (2023). Childhood adversity and illness appraisals as predictors of health anxiety in emerging adults with a chronic illness. \u003cem\u003eJournal of Clinical Psychology in Medical Settings\u003c/em\u003e, \u003cem\u003e30\u003c/em\u003e(1), 143-152.https://doi.org/10.1007/s10880-022-09870-z\u003c/li\u003e\n \u003cli\u003eVliegen, N., Luyten, P., \u0026amp; Biringen, Z. (2009). A multimethod perspective on emotional availability in the postpartum period. \u003cem\u003eParenting: Science and Practice\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(3-4), 228-243. https://doi.org/10.1080/15295190902844514\u003c/li\u003e\n \u003cli\u003eWilson-Genderson, M., Heid, A. R., Cartwright, F., \u0026amp; Pruchno, R. (2021). Adverse childhood experiences, adult trauma, and depressive symptom trajectories. Aging \u0026amp; Mental Health, 26(11), 2170\u0026ndash;2178. https://doi.org/10.1080/13607863.2021.1978926\u003c/li\u003e\n \u003cli\u003eYirmiya, K., Motsan, S., Zagoory-Sharon, O., Schonblum, A., Koren, L., \u0026amp; Feldman, R. Continuity of psychopathology v. resilience across the transition to adolescence: role of hair cortisol and sensitive caregiving. \u003cem\u003ePsychological Medicine\u003c/em\u003e, \u003cem\u003e53\u003c/em\u003e(10), 4487-4498. https://doi.org/ 10.1017/S0033291722001350\u003c/li\u003e\n \u003cli\u003eZhang, X., Krishnakumar, A., \u0026amp; Narine, L. (2020). Family economic hardship and child outcomes: Test of family stress model in the Chinese context.\u003cem\u003eJournal of Family Psychology, 34\u003c/em\u003e(8), 960\u0026ndash;968. https://doi.org/10.1037/fam0000670\u003c/li\u003e\n \u003cli\u003eZhang, L., Mersky, J. P., \u0026amp; Lee, C. P. (2023). Intergenerational pathways linking mothers\u0026rsquo; adverse childhood experiences and children\u0026rsquo;s social-emotional problems. \u003cem\u003eChild Maltreatment\u003c/em\u003e, \u003cem\u003e28\u003c/em\u003e(1), 107-118. https://doi.org/10.1177/10775595211067212\u003c/li\u003e\n \u003cli\u003eZiv, Y., \u0026amp; Arbel, R. (2021). Parenting practices, aggressive response evaluation and decision, and social difficulties in kindergarten children: The role of fathers. \u003cem\u003eAggressive Behavior\u003c/em\u003e, \u003cem\u003e47\u003c/em\u003e(2), 148-160.https://doi.org/10.1002/ab.21932\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv dir=\"RTL\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e\u003cem\u003eFamilies\u0026rsquo; Demographic Characteristics\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cdiv align=\"left\" dir=\"ltr\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSample 1: Mothers of children aged 3-18 years\u0026nbsp;\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e(\u003cem\u003eN\u003c/em\u003e = 877)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSample 2: Mother of infants/toddlers\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e(\u003cem\u003eN\u003c/em\u003e = 291)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eMean/n\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eSD/%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eRange\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eMean/n\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eSD/%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eRange\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003ePlace of residence\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;In a war zone \u003csup\u003ea\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e14.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e13.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;Outside the war zones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e748\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e85.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e251\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e86.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003eEthnocultural group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp; Jewish\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e743\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e84.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e85.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp; Arab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e15.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e14.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMothers\u0026rsquo; age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e6.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e24-64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e33.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e22-50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMothers\u0026rsquo; years of education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e16.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e12-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e16.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e8-25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003eMarital status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Married/cohabiting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e95.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e99.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;Not married/cohabiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003eChild gender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e443\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e50.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e56.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e433\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e49.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e43.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003eChild age \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e8.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e3.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e3-18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e6.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003eChild birth order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;First-born\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e406\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e46.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e35.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;Later-born\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e471\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e53.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e64.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eNote.\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003csup\u003ea\u0026nbsp;\u003c/sup\u003eBy the time mothers completed the survey, all families were displaced to areas outside the war zones. \u003csup\u003eb\u0026nbsp;\u003c/sup\u003eChild age in Sample 1 refers to the age in years; Child age in the Sample 2 refers to the age in months.\u0026nbsp;\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003e\u003cem\u003eDescriptive Statistics of Study Variables\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cdiv align=\"left\" dir=\"ltr\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 34px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSample 1: Mothers of children aged 3-18 years\u0026nbsp;\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e(\u003cem\u003eN\u003c/em\u003e = 877)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp dir=\"LTR\"\u003eSample 2: Mother of infants/toddlers\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e(\u003cem\u003eN\u003c/em\u003e = 291)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eMean/n\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eSD/%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eRange\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eMean/n\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eSD/%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eRange\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM number of ACEs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM childhood exposure to war/terror\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e21.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e18.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp;No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e686\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e78.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e81.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM current war exposure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM sense of danger\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM depression symptoms\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e6.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM anxiety symptoms\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e3.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e3.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM co-parenting support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM parental burnout\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-4.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM avoidant \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;communication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eM hostility\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-4.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp dir=\"LTR\"\u003eChild symptoms \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e15.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e7.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1-42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp dir=\"LTR\"\u003e7.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp dir=\"LTR\"\u003e5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp dir=\"LTR\"\u003e0-27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eNote.\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eM = mothers\u003cem\u003e.\u0026nbsp;\u003c/em\u003e\u003csup\u003ea\u0026nbsp;\u003c/sup\u003eMothers in Sample 1 reported their children\u0026rsquo;s symptoms using an adapted 24-item version of the SDQ (Goodman, 1997); Mothers in Sample 2 reported their children\u0026rsquo;s symptoms using an adapted 16-item version of the BPSC (Sheldrick et al., 2013).\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv dir=\"RTL\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003e\u003cem\u003eBivariate Correlations Between Study Variables\u003c/em\u003e\u003c/p\u003e\n \u003cdiv align=\"left\" dir=\"ltr\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"926\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e1. M number of ACEs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.09\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.13***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.10**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.14***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.20***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.09**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.17***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.21***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e2. M childhood exposure to war/terror \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.18***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.15***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.09**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.17***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.11**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.07*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.14***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e3. M current war exposure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.12*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.28***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.15***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.10**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.16***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.08*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.08*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.07*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.22***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e4. M sense of danger\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.23***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.24***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.42**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.42***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.31***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.11***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.24***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.27**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e5. M depression symptoms\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.29***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.14*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.34***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.55***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.51***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.22***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.19***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.34***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e6. M anxiety symptoms\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.43***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.15*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.32***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.64***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.35***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.22***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.31***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e7. M co-parenting support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.21***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.23***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.62***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.43***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.245***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.30***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.45***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e8. M parental burnout\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.24***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.19**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.12*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.34***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.33***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.38***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.22***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e9. M avoidant communication / hostility\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.34***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.20***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.46***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.15**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.20***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp dir=\"LTR\"\u003e10. Children\u0026rsquo;s psychological symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.14*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.12*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.23***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.30***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.31***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e-.26***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e. 26***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eNote.\u0026nbsp;\u003c/em\u003eM = mothers\u003cem\u003e.\u0026nbsp;\u003c/em\u003e\u003csup\u003ea\u0026nbsp;\u003c/sup\u003eno exposure = 0, exposure = 1.\u0026nbsp;Correlations for Sample 1 are presented above the diagonal. Correlations for Sample 2 are presented below the diagonal\u003cem\u003e.\u0026nbsp;\u003c/em\u003e* \u003cem\u003ep\u003c/em\u003e \u0026lt; .05. **\u003cem\u003e\u0026nbsp;p\u003c/em\u003e \u0026lt; .01. ***\u003cem\u003e\u0026nbsp;p\u003c/em\u003e \u0026lt; .001.\u003cstrong\u003e\u003cbr clear=\"all\"\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv dir=\"RTL\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eTable 4\u0026nbsp;\u003c/strong\u003e\u003cem\u003eStandardized Indirect Effects\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003cdiv align=\"left\" dir=\"ltr\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" summary=\"User-defined estimands: (Group number 1 - Default model)\" width=\"614\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eParameter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003eEstimate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003eLower CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003eUpper\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003eCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSample 1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; coparenting\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; burnout\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; avoidant comm\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; coparenting\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; burnout\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.030\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; avoidant comm\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eWar/terror ACE \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; coparenting\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eWar/terror ACE \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; burnout\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eWar/terror ACE \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; avoidant comm\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eWar/terror ACE \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; coparenting\u0026ndash;\u0026gt;c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eWar/terror ACE \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; burnout\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.033\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eWar/terror ACE \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; avoidant comm\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war\u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; coparenting\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; burnout\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; avoidant comm\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; coparenting\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; burnout\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.040\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; anx \u0026ndash;\u0026gt; avoidant comm\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eSample 2\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; coparenting\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; burnout\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eACEs \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; hostility\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; coparenting\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.00\u003cspan dir=\"RTL\"\u003e0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.0\u003cspan dir=\"RTL\"\u003e2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.027\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; burnout\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.0\u003cspan dir=\"RTL\"\u003e2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.00\u003cspan dir=\"RTL\"\u003e4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.0\u003cspan dir=\"RTL\"\u003e5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 406px;\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent war \u0026ndash;\u0026gt; danger \u0026ndash;\u0026gt; dep \u0026ndash;\u0026gt; hostility\u0026ndash;\u0026gt; c symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.0\u003cspan dir=\"RTL\"\u003e3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp dir=\"LTR\"\u003e.01\u003cspan dir=\"RTL\"\u003e0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp dir=\"LTR\"\u003e\u003cem\u003eNote.\u0026nbsp;\u003c/em\u003eWar/terror ACE = mothers\u0026rsquo; exposure to war/terror in childhood; Current war = mothers\u0026rsquo; current war exposure; dep\u0026nbsp;=\u003cem\u003e\u0026nbsp;\u003c/em\u003emothers\u0026rsquo; depression symptoms;\u0026nbsp;anx\u0026nbsp;= mothers\u0026rsquo; anxiety symptoms;\u0026nbsp;coparenting = mothers\u0026rsquo; perception of co-parenting support; avoidant comm = mothers\u0026rsquo; avoidant communication; C = child.\u003cstrong\u003e\u003cbr clear=\"all\"\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"War, Family Stress Model, ACE, mother-child relationship","lastPublishedDoi":"10.21203/rs.3.rs-9459838/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9459838/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eWe examined how war impacts mothers and children by applying the Family Stress Model (FSM) and Early Childhood Adversity (ACE) model. 877 Israeli mothers of children aged 3\u0026ndash;18 years (Sample 1) and 291 Israeli mothers of infants and toddlers (birth\u0026ndash;36 months; Sample 2) completed self-reports. Structural Equation Modeling analyses supported the FSM and the ACE model. In Sample 1, maternal ACEs, including childhood exposure to war/terror, and mothers\u0026rsquo; current war-related adversities, were associated with children\u0026rsquo;s psychological symptoms. In line with the FSM, these effects were sequentially mediated by mothers\u0026rsquo; heightened sense of danger, followed by their depression and anxiety symptoms, followed by poorer co-parenting and parenting. Similar patterns were found in Sample 2, yet childhood war/terror exposure and maternal anxiety symptoms were not linked to child symptoms. The study reveals the contribution of the FSM and ACE models for understanding how past and current parental adversities impact mothers and children. It demonstrates the detrimental effect of war on families and illuminates potential mechanisms for intervention. Furthermore, it highlights that mothers with more ACEs may be particularly vulnerable in their ability to cope with war-related stress, increasing their risk for psychological distress and subsequent parenting difficulties.\u003c/p\u003e","manuscriptTitle":"Understanding the Impact of War on Mothers and Children Through the Family Stress Model and Adverse Childhood Experiences Framework","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-08 12:58:39","doi":"10.21203/rs.3.rs-9459838/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"22ae4774-4a9e-40c5-b744-91a616d52a7e","owner":[],"postedDate":"May 8th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"188766891902603543460352175927638183408","date":"2026-05-15T17:48:05+00:00","index":14,"fulltext":""},{"type":"reviewerAgreed","content":"114945042869926121260844648809537287381","date":"2026-04-29T15:36:02+00:00","index":9,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-08T12:58:39+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-08 12:58:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9459838","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9459838","identity":"rs-9459838","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}