Abstract

BackgroundResearch in war-torn regions has mainly focused on the impact of traumatic experiences on individual mental health and has found high prevalence rates of psychiatric disorders in affected adults and children. However, little is known about the possible protective factors occurring in children’s environments in the aftermath of mass trauma. Therefore, we conducted a cross-sectional study with families in Northern Sri Lanka, a region that had been shattered by a long-lasting civil war and devastated by the Asian tsunami in 2004.MethodsSchoolchildren aged 7 to 11 (N = 359) were interviewed on the basis of standardized measures to assess children's exposure to traumatic events, mental health symptoms, and parenting behavior as perceived by children. All interviews were carried out by local senior counselors.ResultsLinear regression analyses identified exposure to mass trauma and family violence as significant risk factors of child mental health whereas parental care emerged as a significant factor associated with fewer behavior problems. In addition, parental care significantly moderated the relationship between mass trauma and internalizing behavior problems.ConclusionsFamily characteristics seem to be strongly associated with children’s mental health even in regions severely affected by mass trauma. This finding is particularly relevant for the development of targeted psychosocial interventions for children and families living in war torn areas.

Highlights

  • Research in war-torn regions has mainly focused on the impact of traumatic experiences on individual mental health and has found high prevalence rates of psychiatric disorders in affected adults and children

  • We purposely selected three clusters with varying levels of exposure to the civil war and to the Tsunami: Valikamam West, which is located near Jaffna downtown and was not affected by the recent war or by the Tsunami; Valikamam North, which was not affected by the Tsunami but was affected by earlier stages of the war, and Vadamaradchi, which was severely affected by both the Tsunami as well as the civil war

  • The current study focused on specific aspects of child mental health, namely Posttraumatic Stress Disorder (PTSD) and depression, as well as emotional and behavioral problems measured by the Strengths and Difficulties Questionnaire (SDQ)

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Summary

Introduction

Research in war-torn regions has mainly focused on the impact of traumatic experiences on individual mental health and has found high prevalence rates of psychiatric disorders in affected adults and children. We conducted a cross-sectional study with families in Northern Sri Lanka, a region that had been shattered by a long-lasting civil war and devastated by the Asian tsunami in 2004. Thousands of people worldwide are affected by mass trauma, including war and other forms of armed conflicts [1], and to a lesser extent, natural disasters such as floods, hurricanes and Tsunamis [2]. After the Asian Tsunami in 2004, studies with affected children in Thailand and in Sri Lanka reported high prevalence rates of posttraumatic stress disorder, major depression, and suicidal ideation [7,8,9,10].

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