Introduction

Concern for the well-being of children growing up in conditions of armed conflict and political violence is not new. Since the mid-1990s scholars, academics, and mental health practitioners have explored and investigated the impact of war and political violence on the mental health and well-being of youth populations living in conflict-affected areas (Ager, 2002; Gilligan, 2009). Due to the ongoing dramatic raise of armed conflicts across the world, over the last 30 years an increasing number of researches have been done to identify and describe the impact of violence on the lives of young people (De Jong et al., 2003; Dubow et al., 2010). Indeed, a considerable body of literature has been developed to investigate the risks and challenges faced by those children and develop more effective intervention techniques to help them both cope and survive in their environment (Betancourt, Meyers-Ohki, et al., 2013; Betancourt, Newnham, et al., 2013; Cummings et al., 2017b).

If we delve into the literature on the mental health and well-being of children in contexts of warfare and armed conflict, what we find is a schism between those who follow and promote a strictly psychiatric and biomedical model and those who seek to examine the whole issues from a more holistic and broader socio-ecological and socio-historical perspective (Shalhoub-Kevorkian, 2006). On the one hand, researchers and academics in the first camp have long concentrated their efforts on understanding and evaluating how exposure to such violence contributes to increasing mental health distress, even leading to the development of longer-term psychopathology (Laor & Wolmer, 2003). Scholars in this field have extensively documented how high levels of military and political violence experienced during childhood development leads to the emergence of a wide range of negative outcomes in terms of mental health (psychological stress, behavioural problems, post-traumatic stress syndromes) (Attanayake et al., 2009; Betancourt, Meyers-Ohki et al., 2013; Betancourt, Newnham, et al., 2013; Slone & Mann, 2016). Moreover, the persistently stressful conditions associated with protracted conflicts (e.g., poverty, unsafe housing, parental distress, marginalization) has been linked to a rise in posttraumatic stress disorder (PTSD) symptoms among children in Afghanistan (Panter-Brick et al., 2014), Uganda, and Sri Lanka (Fernando et al., 2010; Olema, Catani, Erti, Saile, & Neuner, 2014).

On the other hand, an increasing number of alternative approaches to mental health have started to not solely rely on medical symptoms, but also link mental health to indicators of social and personal well-being and quality of life (Giacaman, Rabaya, Nguyen-Gillham, Batniji, Punamaki, & Summerfield, 2011). Studies have started to emphasize how most children, even when living in highly traumatic and violent contexts, are able to maintain positive psychological functioning (Barber, 2008; Barry, 2013; Miller et al., 2006; Tol, Jordans, Kohrt, Betancourt, & Komproe, 2013a, 2013b; among the others). Within this second current, the attention has started to shift from the evaluation of trauma symptoms in exposed children to the observation of their well-being, the behaviours enacted, and the resources employed in order to preserve it. One well-known example is the birth and development of the concept of resilience (Betancourt & Khan, 2008; Masten, 2014). Indeed, in order to identify and observe a ‘resilient outcome’, it is necessary to pay specific attention to all those protective processes and resources that lead to positive adjustment, and hence promote positive functioning (Atallah, 2017; Werner, 2012).

Socio-Ecological Perspectives on Children’s Well-Being Amid Political Violence

Examining this important debate revealed the presence of a considerable numerical discrepancy, showing that studies dealing with risk factors and the subsequent psychopathology are far more numerous that the ones exploring the variables and processes associated with positive outcomes (Attanayake et al., 2009; Betancourt & Khan, 2008; Slone & Mann, 2016). Unquestionably, armed conflict and political violence are among the most destructive known forces (Boyden, 2003), thereby putting children at risk of being emotionally, psychologically, and physically overwhelmed by such exposure. However, this narrow outlook might lead scholars to overlook how children and youth are able to cope with and manage their own challenging surroundings.

To address this oversight, researchers have begun adopting an ecological perspective to the study of children’s health and well-being in conflict-affected areas (Cummings et al., 2017b; Dubow et al., 2009), which is rooted in the seminal work of Bronfenbrenner (1979) and offers a more comprehensive picture of the many factors that influence the child’s development. Indeed, considering that children develop within multiple nested contexts (with at the centre the child, encircled by family, community, societal and internationals levels), it enables a more multifaceted understanding of the life and the health of children affected by armed conflict (Akesson, 2017; Kent, 2012). Extreme violence has many simultaneous ecological consequences, which include increasing poverty and marginalization, fomenting social and institutional distrust, and causing the disruption of social networks that thereby prevent children from accessing support and protection (Betancourt, Meyers-Ohki, et al., 2013; Betancourt, Newnham, et al., 2013). These are all sources of suffering and distress for war-affected children (Wessells & Kostelny, 2012). Therefore, by incorporating multiple levels of the social ecology into our analysis, a more nuanced understanding of the impact of exposure to political violence on children’s development can be achieved (Cummings, et al., 2009; Dubow et al., 2009). Thus, a socio-ecological lens allows us to consider well-being and health as dependent upon all the constituent elements of the child and their context, such as gender, cognitive competencies, age, family, neighbourhood, society, and culture.

Following this path, researchers have highlighted several different factors—such as intelligence, self-regulation, hope, beliefs, self-efficacy, self-esteem, supportive relationships, spirituality, and community belonging—that are implicated in children’s well-being and their ability to positively adjust to adversity (Betancourt & Khan, 2008; Masten, 2014; Veronese & Castiglioni, 2015). Moreover, parents’ mental health and positive interactions between the child and parent have been identified as potential moderators of children’s well-being in contexts of political violence (Cummings, Merrilees, Taylor & Mondi, 2017a, 2017b; Dubow et al., 2009). Similarly, high levels of social support and emotional security within the community have been identified as attenuators on children’s ability to adjust to experiences related to political violence (Betancourt et al., 2010; Cummings et al., 2011).

Despite these scholarly interventions, there remains a strong emphasis on both individual maladaptive conditions and the psychopathological effects of war and violence, with still very little attention dedicated to the role of children’s relationships, families, neighbourhoods, and communities as protective resources. As a consequence, many studies still proceed as though political violence occurs in a vacuum (Dawes & Cairns, 1998), leaving us with little knowledge about the factors, resources and processes by which children are able to endure their traumatic living contexts (Jones & Sumner, 2009; Rosenbaum & Ronen, 2013; Streuli, Whoodhead, & Camfield, 2009). Yet, considering health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 2010), promoting well-being is a fundamental part of improving the overall health of a population, especially the health of children.

Thus, the purpose of this work is to provide a scoping review of published peer-reviewed studies that have assessed and investigated the well-being of children living in contexts affected by military and political violence. The first aim is to provide a comprehensive review of the relevant research examining the strategies and resources that children possess, display, or to which they access to cope with their highly stressful environments, as well as the implication for clinical practice and policy recommendations. We believe that a clear and concise review of the literature regarding how young people are able to endure and negotiate with hardships might be important to both scholars and practitioners. In addition, it might provide critical information for policy makers, thus inform and provide direction for projects aimed at protecting the health and development of children living in contexts characterized by extreme instability and violence.

Method

In the present work, we explored the peer-reviewed literature that focuses on the well-being and life satisfaction of children living in circumstances affected by military and political violence in the last 10 years. In our review, we adopted a socio-ecological lens to examine and organize the literature, which enabled us to explore children’s well-being and life satisfaction while considering the protective factors and processes at different levels that contribute to fostering healthy childhood development (family, social, economic, political). As stated above, a socio-ecological framework is needed to consider children’s resources, well-being, and life satisfaction within the multiple areas of their lives—family, peer, school, and the wider community. Moreover, this framework plays a crucial role in conceptualizing and suggesting multi-level interventions aimed at fostering long-term mental health and well-being among the populations currently suffering from political violence.

Selected articles were analyzed and reviewed narratively. Since there are no shared guidelines for narrative reviews, (Ferrari, 2015; Omaleki & Reed, 2019) in the present work the quality of the review was improved by adopting criteria from systematic reviews (Cavazzoni, Fiorini & Veronese, 2020). Indeed, following some of the PRISMA criteria (Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria) helped us in the search strategy, reducing bias in the selection of articles (Ferrari, 2015; Marriott et al., 2014; Omaleki & Reed, 2019).

Information Sources and Search Strategy

We searched PsycARTICLES, PsycINFO, EMBASE, PUBMED, and Google Scholar databases for all peer-reviewed publications dating from 2008 to 2019 (April) that pertain to the well-being and the life satisfaction of children living in conflict-affected areas. Manual searches of reference lists of articles identified in the initial searches were also conducted. The search results were limited to those that contained keywords within a matrix of relevant terminology identified in either the study title or abstract. Therefore, we employed the resulting combination of keywords to guide the search: (1) child(ren), childhood in combination with (2) armed conflict, political violence, military violence, and (3) well-being, psychological/subjective well-being, and life satisfaction. The studies were included in the review according to the criteria underlined below.

Eligibility Criteria

In order to provide a comprehensive exploration of the most recent advancements in the literature related to the well-being and life satisfaction of children living in contexts of military and political violence, the review included only articles published from 2008 to 2019. Quantitative, mixed method, and qualitative studies were included. In contrast, case studies, case reports, as well as narrative and systematic reviews were excluded. Furthermore, articles subjected to full review were those that followed to the subsequent criteria: (1) the publication must address children’s overall well-being or life satisfaction (well-being, factors that promote well-being, life satisfaction); (2) publications related to psychosocial interventions must be aimed at strengthening children’s well-being and psychological functioning (thus excluding intervention aimed at lessening the symptoms of trauma and PTSD); (3) the article must address children (6–17 years old); (4) the studies took place in a post-conflict setting or a setting with protracted political violence; and (5) the studies were peer-reviewed, published, and available in English. Articles were excluded if they came from conference proceedings or conference abstracts, book chapters, workshops, or dissertations. Studies were also excluded if target populations were asylum seekers or refugees and were therefore living in countries where there is a certain level of perceived safety.

Records identified through databases were exported into Endnote software version X7, and duplicate papers were identified and excluded. Two team members working independently screened each of the abstracts for relevance and excluded those not meeting established criteria. All discrepancies were discussed and resolved between the two reviewers or, when required, with the inclusion of the third reviewer.

Results

The search strategy resulted in a total of 1218 unique studies. Abstracts were screened for relevance and those not meeting the inclusion criteria were eliminated. In addition, three records were identified through bibliography mining. Editorials, opinion pieces, reviews, and special issues were excluded. Finally, 70 full-text articles were further assessed for eligibility, of which 48 were excluded for failing to meet the study criteria (Fig. 1). After the final screening process, a total of 22 studies met the established criteria, and they were reviewed and summarized in Table 1.

Fig. 1
figure 1

Flow of information through the different phases of the review

Table 1 Summary of studies: authors, locations, sample description, study method and dimension explored
Table 2 Critical findings
Table 3 Implications for practices, policy and research

The 12 quantitative studies, seven qualitative studies, and the three mixed method studies that were reviewed included a total of 34,043 children and youth. Fourteen articles (63.6%) focused on children exposed to the Israeli-Palestinian conflict, ten of them conducted within the solely Palestinian population, one conducted with the Jewish Israeli population, and one conducted in Israel with both Jewish and Arab–Israeli populations. Another two were conducted with both Palestinian and Israeli populations. Two additional studies investigated the well-being of children living in the Ampara district of Sri-Lanka—affected both by civil war and the tsunami of 2004, one study focused on South Sudan, another in Northern Ireland, one in Rwanda, and one with child victims of armed conflicts living in Kalamansig, Philippines. One final study jointly examined children living in Jordan, Lebanon, the Philippines, and Syrian refugees living in Iraq, while another focused on school-aged children living in Afghanistan, Eritrean refugees in Ethiopia, and Liberian refugees living in Sierra Leone. In Table 1 we present more information about the methods adopted within the included studies (e.g., qualitative, mixed methods), details of the study locations, and the descriptions of the sample.

The studies investigated a range of domains and dimensions that mutually interact to enhance (or diminish) children’s well-being and life satisfaction. Four studies explicitly focused on assessing the effectiveness of interventions aimed at promoting and assessing children’s well-being and health. Overall, the selected studies present diverse contributions to what constitutes well-being and life satisfaction for children exposed to armed conflicts and political violence across diverse socio-cultural settings. Within these studies, which occurred across thirteen different countries, researchers were able to identify several dimensions that were contributing to the children’s well-being in situations of significant adversity. In the process, the concept of well-being emerged as a combination of personal resources and supportive contexts—such as family, peers, and community—that vary over time and across contexts.

In the next section, we summarize the identified interlocked factors characterizing both micro- and macro-systems, that contribute to protecting children exposed to potentially traumatic events in contexts of war and extreme violence. We will also provide a narrative synthesis of the studies reviewed categorizing the hypotheses tested in such researches. The findings are grouped according to each ecological level’s focus and summarized in Table 2.

Finally, the policy implications, as well as literature gaps and recommendations aimed at informing the practice of future research and interventions, are highlighted in the conclusion section and reported in Table 3.

Discussion

The purpose of this work was to provide a review of studies that have investigated the well-being of children living in contexts affected by military and political violence. Overall, the selected studies provided us a comprehensive picture of children’s well-being and positive functioning across diverse sociocultural settings. We grouped children’s resources into three different categories: individual characteristics and resources promoting children’s well-being (i.e., gender; agency and coping strategies; self-complexity; life satisfaction and positive emotions; education; spirituality; political activity); family-level and social-level resources: the web of supportive relationships (i.e., familial and social support); and community and contextual resources (i.e., community values and practices; safety and security; accessibility to resources) (see Fig. 2).

Fig. 2
figure 2

Ecological well-being framework for children affected by war

Individual Characteristics and Individual-level Resources Promoting Children’s Well-being

Several personal resources able to enhance and improve the well-being of children living in conflict-affected areas emerged from these studies. These include demographic characteristics, agency and coping strategies, self-complexity, emotional orientations (i.e. life satisfaction, positive emotion), education, as well as religious beliefs.

Gender. Girls were sampled in 21 of the 22 studies reviewed. Female gender comprised 51% of the total research participants (four of the studies did not specify gender distribution). Evidence was mixed regarding the role of gender and well-being. On the one hand, the majority of studies evidenced that girls reported a greater severity of psycho-social problems compared to males and lower levels of well-being (Cummings et al., 2017c; Harel-Fisch et al., 2010; Nguyen-Gillham et al., 2008; Slone & Roziner, 2013; Veronese et al., 2018). This result might be related to the fact that patriarchal societies manifest severe gender inequities, with a disproportionate allocation of resources and opportunities resulting in different effects on the life chances and well-being of boys and girls (Cavazzoni, Fiorini, Shoman, Diab & Veronese, 2021; Nguyen-Gillham et al., 2008). For instance, within the Palestinian context, although boys seem to be more exposed to violence than girls, they displayed fewer traumatic symptoms and experienced more significant support in terms of participation in community activities, thereby perceiving the context to be more protective (Veronese et al., 2017a). On the other hand, girls emerged as better able to employ both social relationships (e.g. peers and family support) and personal resources (e.g. optimism, self-esteem) when compared to boys, exhibiting higher levels of life satisfaction and greater feelings of protection from families and community members (Diab et al., 2014; Veronese & Barola, 2018; Veronese & Castiglioni, 2015). These disparities are representative of the ongoing debates among scholars on the role that gender plays in the way children cope with and face the violence they are exposed to.

Agency and coping strategies. Within studies devoted to the well-being and mental health of children living in war zones, the crucial role played by agency in protecting them from their traumatic contexts has been widely highlighted. Indeed, agency and coping strategies were mentioned and assessed as protective factors when it came to a child’s ability to adjust to adverse life-contexts, enabling them to find creative solutions in unpredictable contexts. Agency—within the studies reviewed—is intended as the power of individuals to make choices and establish an active role within their daily lives. Indeed, children were depicted as capable of mobilizing and deploying resources as a means of coping with violent and challenging contexts, within families, social structures, and the broader social environment (Nguyen-Gillham, et al., 2008; Pells, 2011; Veronese & Barola, 2018; Veronese et al., 2017b, 2018; Winthrop & Kirk, 2008). For instance, within the Palestinian context, agency and the ability to endure and overcome their harsh realities were connected to the capacity to make life as normal as possible (Nguyen-Gillham et al., 2008). Being able to maintain the activities of an ordinary life, such as playtime, the enjoyment of places, and attending school, helped promote children’s sense of wellness. Moreover, agency emerged as strongly connected to children’s formal and informal education, as a way to increase knowledge, gain confidence, and learn strategies to cope with the environment to protect their own life satisfaction and happiness (Veronese et al., 2018). Similarly, in Pell’s study (2011) in Rwanda, children’s agency was exhibited through future aspirations, informed by a strong desire to make their lives meaningful. Children were determined to make sense of personal suffering in order to negotiate with survival and ‘make the world a better place’ for themselves and for others (Pell, 2011, p. 602).

Self-complexity. The construct of self-complexity—defined in terms of ‘the number of non-overlapping attributes underlying the self-concept’ (Slone & Roziner, 2013, p. 659)—emerged only in one study. Working with 580 Israeli and Arab–Israeli adolescents, Slone and Roziner pointed out the powerful influence of self-complexity in moderating the negative impact of the children’s exposure to violence and, thus, to improving personal well-being. They explore the variability amongst youth affected by the same amount of violence by introducing the concept of self-complexity, associating this variability to “differences in cognitive representations of the self, and more specifically, to differences in the complexity of self-representation” (Slone & Roziner, 2013, p. 660). Within their findings, Jews adolescents were reporting a higher level of well-being than their Arab peers. By assessing the levels of self-complexity amongst their sample, they found that those adolescents with higher levels of complexity were also demonstrating greater well-being and fewer symptoms of psychopathology. Thus, the authors attest to the importance of self-complexity as a crucial variable that facilitates adolescents’ successful negotiation of a crisis, enabling them to preserve their own well-being.

Life satisfaction and positive emotions. Feelings indicating high levels of positive emotions and happiness were found to be critical factors in children’s well-being across many of the reviewed studies (Harel-Fisch et al., 2010; Thomas et al., 2016; Veronese et al., 2017a, 2017b; Veronese et al., 2012a, 2012b). Positive affects played a significant role in reducing traumatic symptoms (Veronese et al., 2017a, 2017b; Veronese et al., 2012a, 2012b). These findings are in line with Denier’s conceptualization of well-being, which is defined by people’s evaluation of their lives and is composed of several distinct but interrelated components: positive affect, negative affect, and general life satisfaction (Diener, 2009). In their studies with school-aged children in Palestine—from both the West Bank and the Gaza Strip—Veronese and colleagues found that feelings of life satisfaction enable children to experience and activate positive emotions which, in turn, mitigate the impact of traumatic events (Veronese et al., 2017a, 2012a, 2017b). These findings confirmed the fact that positive emotions in children have a crucial role in controlling traumatic reactions caused by political violence and armed conflicts, contributing to positive adjustment and well-being.

Similarly, it was evidenced that negative emotions such as fear, sadness, and a sense of hopelessness caused by armed conflicts are strongly linked to higher levels of psychological distress and PTSD (Harel-Fisch et al., 2010; Thomas et al., 2016). For instance, in Harel-Fisch and colleagues’ comparative study (2010) of Jewish Israeli youth, Arab Israeli youth and Palestinian children (from both the Gaza Strip and the West Bank), they found that as a result of their increased exposure to high levels of armed conflict, Palestinians showed an elevated degree of negative emotions and lower levels of well-being when compared to their Israeli peers. More specifically, while all four populations were exposed to significant levels of armed conflict and violence, their findings showed that Palestinian children in the West Bank and especially those in the Gaza Strip, are growing up amongst armed conflict that are causing higher levels of fear, which is negatively impacting their well-being. Likewise, the children perceived negative emotions as a threat to their psychological integrity and happiness both in Palestine and Sri Lanka (Thomas et al., 2016; Veronese et al., 2017b).

Education. Most studies observed that having educational opportunities was significant for children’s well-being. School attendance widely emerged as a source of vital importance in supporting children’s lives, mental health, and well-being within the studies reviewed (Eilinig et al., 2014; Nguyen-Gillham et al., 2008; Veronese et al., 2017b; Winthrop & Kirk, 2008). School has been identified as essential in helping children who are living in contexts affected by political violence to achieve a sense of safety and normality in their daily lives. Moreover, regular school attendance was associated with higher levels of self-esteem, confidence, and pro-social behaviours among children. For example, in Nguyen-Gillham and colleagues’ study (2008), school was highlighted as a crucial element since it provides a primary structure and routine amid the chaotic and complex environment that surrounds Palestinian children. Similarly, in South Sudan, being able to achieve good results in school was strongly connected to greater satisfaction with life and, thus, positive adjustments and a greater sense of well-being (Eilinig et al., 2014). In addition, the school also symbolized a safe place where children could boost their future prospects, aspirations, and opportunities while engaging in learning, playing, and socializing activities (Veronese et al., 2017b; Winthrop & Kirk, 2008). In the comparative research that included Ethiopia, Afghanistan, and Sierra Leone, the acquisition of specific skills (e.g., Islamic studies, languages, mathematics) emerged as the primary way in which school supported children’s well-being (Winthrop & Kirk, 2008). Education was depicted as the way to construct pathways towards a brighter future in order to achieve greater happiness and satisfaction (Winthrop & Kirk, 2008). Evoking the words of a Kunama refugee boy attending the fifth grade in Ethiopia, “my desire is to know and be able to identify what is good and bad in my daily life and how I might act in prevention if something happens in my life. Because of this, I have more interest and desire in education.” (Winthrop & Kirk, 2008, p. 650).

Spirituality. Religious beliefs have also been assessed as crucial factors for children’s well-being. Religiosity was widely connected with higher levels of optimism and positive emotions, as well as reduced levels of distress symptoms, thereby providing evidence that strong religious convictions are often a fundamental component in children and youth’s life when exposed to armed conflicts and political violence (Itzhaki et al., 2020; Noguera, 2013; Thomas et al., 2016; Veronese et al., 2017b). In Sri-Lankan children, spirituality was uncovered as a factor that facilitated coping (Thomas et al., 2016) and its presence in Palestine helped children deal with the ongoing violence that they faced, introducing “narratives of redemption and freedom rather than revenge and violence” (Veronese et al., 2017b, p.372). Being religious was also connected to optimism and a sense of power and hope for the future: God could respond to their needs (Noguera, 2013). The interesting study carried out by Itzhaki and colleagues (2020) with ultraorthodox Jews in Israel evidenced how becoming less religious was correlated with a lower level of social support and a reduced sense of community: both factors that were mentioned as important to youth’s overall life satisfaction. What was surprising in that sample was that the youth who abandoned their religion reported that their well-being was primarily affected by being rejected by the surrounding religious community. Despite religion’s ostensibly elevated importance in their lives, the low levels of well-being that they experienced seems largely related to the repercussions of being excluded from religious communities. “Youth seemed to feel that community members’ love for them was conditioned by their adherence to communal norms, and when they did not comply with these norms, they experienced a reduction in this love” (Itzhaki et al., 2020, p. 51). This finding highlights that religion was perceived as a significant resource for youth’s wellness mainly due to its attendant social network, which brings us to the second group of well-being resources, which is the importance of social networks.

Political activity. Political activity, including both civic and political involvement, also emerged as a protective factor amongst participants who found themselves in situations of conflict, while also being vital to restoring a sense of their own identity. The reviewed research suggests that political activity helps children develop feelings of empowerment, dignity, and hope for the future—all factors which offer protection from the effects of violence (Nguyen-Gillham et al., 2008; Veronese et al., 2017b). Civic and political commitment allows children to develop interpretations and meaning about what is happening around them. For example, in the studies related to the Palestinian territories, engagement in political activities, which manifests itself in the struggle against the Israeli occupation, showed widespread protective effects on children’s exposure to political violence. Nguyen-Gillham and colleagues (2008) conducted research in the occupied Palestinian territories that identified ideology, a connection to the land, and the struggle against the occupation as the crucial factors in children’s well-being. “To be passive politically is humiliating while even a minor political gesture restores a modicum of dignity” (Nguyen-Gillham et al., 2008, p. 296). Similarly, Veronese and colleagues (2017b) observed how Palestinian children in Gaza appeared to react to the imposed limitations on their movement and the everyday threat of losing their treasured spaces (i.e. home, school) caused by the Israeli military occupation by developing a strong sense of attachment to them. The research conducted in refugee camps revealed similar findings since refugees expressed a strong degree of identification with the places that they come from. In this sense, their home villages function as a constitutive element within a collective protective memory (Veronese et al., 2017b).

Family-Level and Social-Level Resources: The Web of Supportive Relationships

Findings indicate that familial and social support were also key dimensions in promoting individual’s well-being and greater life satisfaction (Diab et al., 2014; Eiling et al., 2014; Harel-Fisch et al., 2010; Nguyen-Gillham et al., 2008; Noguera, 2013; Thomas et al., 2016; Veronese et al., 2014, 2017b). The social dimension seems to be crucial in ensuring connectedness within a fragmented society, thereby helping children to cope with feelings of isolation (Veronese et al., 2017b). Cohesive social networks have been found to be crucial in providing the basic socio-emotional needs to enhance self-competence and feelings of belonging, which increases the children’s well-being and life satisfaction (Harel-Fisch et al., 2010; Thomas et al., 2016; Veronese et al., 2014).

In fact, higher levels of perceived social support have been linked to increased adaptive behaviours and overall greater satisfaction with life. The value of supportive relationships, such as family and friends, was transversal in almost all of the selected articles. A variety of family-level predictors of life satisfaction and well-being emerged from the studies. The family was depicted as a vital source of protection from the negative impacts of being exposed to traumatic events and high levels of perceived family support was associated with increased levels of well-being and life satisfaction (Harel-Fisch et al., 2010; Thomas et al., 2016; Veronese et al., 2014). Similarly, higher levels of family support were linked to lower levels of emotional distress and post-traumatic symptoms amongst participants. For example, amongst Filipino children the family emerged as a significant source of strength, practical life learning, confidence, and courage (Noguera, 2013). The children depicted their family as the place where they can receive help, when needed, and be both nurtured and protected (Noguera, 2013). Similarly, parental support was associated with positive perceptions of life and health in the large study of Harel-Fisch and colleagues, which they conducted in the occupied Palestinian territories (2010). In their study, the authors underlined the role that parental support plays in children’s well-being and positive functioning, “buffering” the effects of exposure to military and political violence. Analogously, a family’s improved quality of life has been found to positively correlate both children’s well-being and their ability to cope with traumatic experiences (Veronese et al., 2014). On the contrary, when the family structure is compromised as a consequence of the ongoing conflicts, it represents one of the largest factors that negatively impacts children’s well-being (Thomas et al., 2016). Difficulties and suffering within the family itself risk undermining children’s resourcefulness and their ability to adjust to trauma. “The child’s satisfaction with its family, and how the family is satisfied with its child, may activate a process enabling children to interpret their lives positively, making them optimistic and satisfied with their lives” (Veronese et al., 2014, p.566).

Likewise, positive relationships with friends and peers are central to children’s perceptions of happiness and well-being (Nguyen-Gillham et al., 2008). Being friendly and sociable is correlated to a higher level of well-being in school-age children from South Sudan (Eiling et al., 2014) and it was also described as a vital source of joy by children in the Philippines (Noguera, 2013). Similarly, Diab and colleagues (2014) identified the protective and beneficial effects of positive peer and sibling relations throughout childhood and early adolescence, which provides children with a sense of safety and closeness that enables the possibility of sharing experiences. Moreover, friends and family, as well as other significant adult members of a given community, were also described as the ones who fed, consoled, and protected them. As such, they represent real sources of security and protection for the children (Noguera, 2013).

Community and Contextual Resources

Growing up with the sense of belonging to a community is a well-known and critical aspect in a child’s life and overall well-being. The provenance community can be a source of strength, values, and resources for children. Research has indicated that community acceptance promotes an optimistic outlook on life and an overall greater satisfaction and perceived well-being. Moreover, being satisfied with their own living contexts, and with the opportunities offered by those contexts (i.e. feeling safe, accessibility to resources, etc.), is another crucial component of people’s overall life satisfaction.

Community characteristics and values. Community values, identity, and practices have been identified as critical to providing protection for children living amidst political violence, also in promoting their well-being and life satisfaction within a collective sense of belonging and empowerment. The majority of the studies reviewed show how communities provide essential protection for children, enabling them to attribute some social meaning to the vast number of uncontrollable events that they are made to endure (Cummings et al., 2017c; Itzhaki et al., 2020; Veronese et al., 2012a, 2012b). On the contrary, being unable to perceive themselves as part of a bigger community and the consequent inability to access and recognize shared values strongly increased youth vulnerability, while also diminishing their well-being and life satisfaction (Harel-Fisch et al., 2010). For instance, in their study, Harel-Fisch and colleagues (2010) have attempted to understand the different levels of well-being and positive perceptions amongst Jewish and Arab children—both of whom were living in Israel. As the authors explained,

Israeli Arab children are living in a predominantly Jewish country built on Western democratic values and may aspire to many of the values of the society they are growing up in, thus causing a perception of social inequality and a sense of personal - environment misfit. The Arab Israeli society has a strong connection to Arab culture and heritage. The conflicts in values, culture, and tradition between Western and Arab culture may leave them in a particularly vulnerable position for mental health issues and risk behaviours” (Harel-Fisch et al., 2010, p. 635).

Therefore, the studies agreed upon the importance of being able to access and perceive a shared cultural identity in order to feel protected, to attribute meaning to the extreme events that they faced, and thus, to preserve and improve their well-being (Cummings et al., 2017c; Harel-Fisch et al., 2010; Itzhaki et al., 2020; Veronese et al., 2012a, 2012b).

Safety and security. Amongst social science scholars, it is widely acknowledged that security and safety have a substantial influence on a child’s quality of life and well-being. Armed conflict and political violence challenge the children’s belief of the world as a safe place, and actively compromises their psychological and physical well-being (Laor & Wolmer, 2003). Within the studies reviewed, children widely reported the need to have their own safe spaces. Children’s ability to move within surroundings is related to their well-being and happiness in life, which is crucial in helping them display optimism needed to cope with extreme trauma (Eiling et al., 2014; Veronese et al., 2012a, 2012b). For instance, children coming from a Palestinian city—destroyed by military incursions, home invasions, imprisonment, and targeted murders—reported lower levels of life satisfaction and happiness than the children from other rural areas (Veronese et al., 2012a, 2012b). Moreover, an insecure environment enhances feelings of fear, sadness, and distress, which has a negative impact on children’s positive growth and psychosocial well-being (Constandinides et al., 2011; Veronese et al., 2018). Indeed, being able to feel secure about their own environment as well as their own community emerged as a crucial factor in children’s ability to adjust to contexts characterized by political violence (Cummings et al., 2017c; Veronese et al., 2014, 2017b).

Accessibility to resources. Children’s perception of their own well-being was strongly related to the ability to access resources. For example, not being able to access health or educational opportunities strongly contributed to reduced levels of well-being in the studies reviewed (Berger et al., 2009; Veronese et al., 2017b). In the specific case of Palestinian children, they often complained of a lack of services and resources related to the health system, which meant that they were not able to provide adequate health protection for their families (Veronese et al., 2017b). Similarly, in the eastern district of Ampara, in Sri Lanka, Berger and colleagues (2009) underlined the fact that children’s inability to access play-spaces or to attend school was threatening their everyday life and well-being. Indeed, there is a significant body of literature evidencing the essential influence of leisure activities in positive child development and well-being (Leversen, Danielsen, Birkeland, & Samdal, 2012). Being able to engage in these activities satisfies one of the basic needs for the child, since it promotes happiness, social interactions, thus, life satisfaction (Veronese et al., 2018, 2012a, 2012b). Therefore, the lack of access to resources and the lack of play-dedicated areas emerged as a negative factor for children’s well-being, limiting the capacity to engage in activities in their own ways (Berger et al., 2009; Veronese et al., 2017b).

Conclusion, Limitations and Implication for Practices

The aim of this article was to offer a cross-section of the existing literature regarding the well-being and life satisfaction of children living in contexts characterized by armed conflict and political violence. Overall, the concept of well-being emerged as a combination of personal resources and supportive relational contexts—such as family, peers, and community—that vary over time and across contexts. Moreover, all the reviewed authors agreed on the need to move beyond the dominant medical paradigm that tends to pathologize children's suffering and to prioritize the exploration of both well-being and life satisfaction in children exposed to armed conflict and political violence. Finally, the selected studies presented different contributions that could be useful in developing direct interventions aimed at enhancing the well-being of children impacted by armed conflicts (summarized in Table 3).

Firstly, the authors underlined an urgent need to foster knowledge on the well-being of children who had been exposed to political violence in order to inspire interventions and improved child-care treatments. Accordingly, the role of agency, self-complexity, education, and spirituality needed to be explored and understood within a socio-ecological framework (Bronfenbrenner, 1979). Moreover, scholars now place much more emphasis on the role of positive emotions as a crucial resource towards ensuring children’s well-being and, above all, uncovering new ways of activating them (Thomas et al., 2016; Veronese et al., 2017a, 2017b; Veronese et al., 2012a, 2012b). A second point concerns the critical role of both local knowledge and culture when examining children living in contexts of political violence. Scholars affirm the need for more sophisticated and culturally sensitive measures and pre-intervention assessments in order to identify the local resources available within a community (Thomas et al., 2016). Lastly, the authors highlight the importance of maintaining a politically-informed focus (Nguyen-Gillham et al., 2008; Veronese & Barola, 2018). In evaluating the well-being and mental health of children involved in protracted conflicts, armed violence, and oppression, there are unavoidable political implications. It is indeed mandatory to take into consideration the political and social nature of the conflict that affects the populations in order to be able to address children’s suffering and their process of self-recovery (Veronese & Barola, 2018).

Therefore, scholars jointly advocated for multi-level clinical interventions that simultaneously consider personal, family, and community resources, as well as environmental factors. In order to address and promote children’s well-being and life satisfaction in their ecological conceptualization, interventions need to emphasize and focus on enhancing social support across all the dimensions of the children’s lives (Harel-Fisch et al., 2010). The evidence demonstrated that sustained attention must be given to interventions aimed at supporting families, networks of friends, and communities in order to promote and re-activate all of the resources associated with positive functioning and adaptation (Constandinides et al., 2011). Scholars outlined the need to develop new clinical interventions aimed at strengthening aspects of positive functioning and promoting children’s well-being, thereby reinforcing related individual and contextual factors (Veronese et al., 2012a, 2012b). Furthermore, greater attention should be assigned to perceptions of well-being. As outlined, local conceptualizations of well-being and the available resources in the environment should guide any intervention (Thomas et al., 2016), together with an awareness of children’s competencies, personal resources, and priorities (Pells, 2011). As Boyden expressed, “if children are to be helped to overcome highly stressful experiences, their views and perspectives need to be treated as a source of learning and strength, not weakness” (Boyden, 2003, p.15). Engaging children in the development of projects and interventions might help restore and enhance their sense of agency, which, as discussed, is an important first step in promoting their well-being.

Some limitations need to be acknowledged and discussed. Firstly, diverse social and psychological constructs, such as ‘post traumatic growth’ or ‘resilience,’ have been studied interchangeably with the construct of well-being (Chan et al., 2016). Within this work, we included articles that explicitly referenced the terms ‘well-being’ or ‘life-satisfaction’, therefore, omitting ones that refer to the same construct using alternative terms. This choice was also made to facilitate the literature review process (the same concept of resilience has been defined in a multitude of different ways, Herrman et al., 2011) and to not overlap with the already existing literature reviews on the concept of resilience (Herrman et al., 2011; Martin-Breen & Anderies, 2011; Tusaie & Dyer, 2004). Furthermore, the Israeli-Palestinian context is over-represented in the studies analysed in the present literature. As a result, we are prevented from developing further reflections driven by diverse contextual, cultural, or societal factors. In addition, we acknowledge the fact that the same author led multiple studies within the Palestinian context. However, they were all different studies and not part of one single research project. Nevertheless, to our knowledge, in the recent scientific literature no other contexts were explored with the specific aim to study personal well-being and satisfaction with life in war-affected children. Furthermore, most of the studies reviewed did not discuss aspects related to the age of the participants, preventing us from drawing more consistent considerations with respect to the diverse relevance of the constructs investigated in the different developmental stages of children. A lack of longitudinal studies on the discussed topic, which could help deepen our analysis, is also evident. Indeed, the need for future studies and research exploring well-being and mental health in children living in armed conflict contexts in a longitudinal manner is emphasized. Moreover, including only English studies meant the exclusion of studies despite their titles and abstract could be relevant. Finally, we did not search for studies prior to 2008 and we have concluded our search in April 2019, so it is possible that new studies meeting the inclusion criteria have been published since then.

In sum, our review emphasizes the several dimensions of children’s well-being and suggests interventions and treatments that might focus on the children’s ability to activate resources (individual, social, and environmental) in order to cope with realities affected by war and violence. Indeed, besides community-based interventions, scholars argued that humanitarian aid for children often disregarded or overlooked children’s perspectives, resources, and agency (Winthrop & Kirk, 2008), which suggests that there is an urgent need for alternative perspectives. Engaging children in the development of interventions and programs may help restore a sense of agency amongst them, which will go far in terms of preventing the development of traumatic reactions (Nguyen-Gillham et al., 2008; Veronese & Barola, 2018). In conclusion, the authors highlight the importance of taking a politically informed focus into consideration while designing interventions targeting children living in areas of chronic military and political violence. In other words, political considerations and implications in mental health disciplines have to be taken into account when populations are involved in protracted conflicts.