Abstract
BackgroundThe consequences of war violence and natural disasters on the mental health of children as well as on family dynamics remain poorly understood. Aim of the present investigation was to establish the prevalence and predictors of traumatic stress related to war, family violence and the recent Tsunami experience in children living in a region affected by a long-lasting violent conflict. In addition, the study looked at whether higher levels of war violence would be related to higher levels of violence within the family and whether this would result in higher rates of psychological problems in the affected children.Methods296 Tamil school children in Sri Lanka's North-Eastern provinces were randomly selected for the survey. Diagnostic interviews were carried out by extensively trained local Master level counselors. PTSD symptoms were established by means of a validated Tamil version of the UCLA PTSD Index. Additionally, participants completed a detailed checklist of event types related to organized and family violence.Results82.4% of the children had experienced at least one war-related event. 95.6% reported at least one aversive experience out of the family violence spectrum. The consequences are reflected in a 30.4% PTSD and a 19.6% Major Depression prevalence. Linear regression analyses showed that fathers' alcohol intake and previous exposure to war were significantly linked to the amount of maltreatment reported by the child. A clear dose-effect relationship between exposure to various stressful experiences and PTSD was found in the examined children.ConclusionData argue for a relationship between war violence and violent behavior inflicted on children in their families. Both of these factors, together with the experience of the recent Tsunami, resulted as significant predictors of PTSD in children, thus highlighting the detrimental effect that the experience of cumulative stress can have on children's mental health.
Highlights
The consequences of war violence and natural disasters on the mental health of children as well as on family dynamics remain poorly understood
Some sporadic findings have been published by several organizations and agencies working in refugee camps. These findings suggest that war violence translates into family violence, as evidenced by high levels of spousal beatings in refugee and resettlement communities [19]
Drug use in parents and children Drug use by fathers appeared to be very prevalent in Sri Lanka, with 46.9 % of the children reporting that their fathers used alcohol and 69.6 % reporting use of other types of drugs
Summary
The consequences of war violence and natural disasters on the mental health of children as well as on family dynamics remain poorly understood. Aim of the present investigation was to establish the prevalence and predictors of traumatic stress related to war, family violence and the recent Tsunami experience in children living in a region affected by a long-lasting violent conflict. Thousands of people have been killed and many more have been displaced as a result of conflict and violence in the country. A giant tidal wave destroyed widespread coastal areas throughout Sri Lanka including the North-Eastern provinces. It caused more than 30,000 casualities in Sri Lanka, and hundreds of thousands of inhabitants had to be relocated to relatives' homes and provisional camps. Tensions between conflict parties grew and eventually the civil war broke out again, costing the lives of nearly 3,000 people in a year alone [1]
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