Abstract
Aim: This study aimed to explore the effects of war traumatic exposure on emotional and behavioral problems in a sample of Kosovar war veterans and the wives of veterans 16 years after the 1998–1999 war, as well as whether the level of education, income, well-being, and substance use are predictors for emotional and behavioral problems. Methods: Self-report data were obtained from 373 adults, 247 male war veterans (66.2% of the sample) and 126 wives of other male war veterans (33.8% of the sample). The sample was recruited from a list of war veterans provided by the Kosovar National Association of War Veterans. The mean age of participants was 45.42 [standard deviation (SD), 7.64] years. Measurements comprised a sociodemographic brief structured interview, the Well-Being Index (WHO-5), the Harvard Trauma Questionnaire, and the Adult Self Report (ASR). Logistic regression analysis was conducted to explore if the demographic variables were predictors for ASR general scales and subscales. Multivariate analysis of covariance was performed by adding as covariates the continuous variables pointed out in the logistic regression analysis as discriminating factors between the groups. Post hoc analyses were corrected, and we estimated partial η2 to measure the effect size. Results: The higher traumatic exposure during the war, the greater the tendency to have emotional problems and behavioral problems for both kinds of participants. The result showed that there were no differences on the prevalence of emotional and behavioral problems between the two groups, and both veterans and wives of veterans had no differences on seeking professional help for their emotional and behavioral problems. Wives of veterans living in rural areas showed higher scores on almost all ASR scales compared with those living in urban areas or even with those of veterans from urban and rural areas. Veterans with elementary education level had the highest scores compared with other groups. Veterans with poor well-being had the highest scores compared with other groups. Using Internalizing, Externalizing, and Total Problems as outcome variables and trauma exposure, smoking, drinking alcohol, and well-being as predictors, we found that the model was a significant predictor for both male and female participants on these three scales. Conclusion: The relationship found between the level of exposure to traumatic events and emotional and behavior problems, as well as the factors that moderated such relations, in war veterans and their wives, should help global mental health researchers address the contextual dimensions of this relationship and identify better ways to prevent and treat those problems.
Highlights
War and its consequences remain a challenge for mental health professionals because of specific dynamics that accompany individuals who were either witnesses and/or active participants in it
The war was fought by the Kosovo Liberation Army (KLA), which had been created to respond to Serbian repression against the Albanian population such as the massacre of 53 members of one family [21]
Means and SDs for male veterans and wives of veterans on all Adult Self-Report (ASR) problem scales are presented in Table 2, with gender differences tested using independent-sample t tests
Summary
War and its consequences remain a challenge for mental health professionals because of specific dynamics that accompany individuals who were either witnesses and/or active participants in it. The war of 1998– 1999 in Kosovo involved 36,000 people in combat, most of whom were not trained as professional soldiers. A 2016 study in Kosovo [2] found a posttraumatic stress disorder (PTSD) prevalence of 11.2% in Kosovar war veterans 8 years after the conflict. Another study [3], which investigated longterm mental health outcome in Kosovo 8 years after the Balkans war, found a prevalence of 33% for PTSD or major depressive episode in a community sample. A large epidemiological survey conducted in the Balkans found prevalence for mood and anxious/depressed disorders of 47.6% and 41.8%, respectively, in 648 Kosovar adults [4]
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