Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-27T13:31:37.842Z Has data issue: false hasContentIssue false

Children and war: Risk, resilience, and recovery

Published online by Cambridge University Press:  17 April 2012

Emmy E. Werner*
Affiliation:
University of California, Davis
*
Address correspondence and reprint requests to: Emmy E. Werner, University of California, Davis, 1307 Henry Street, Berkeley, CA 94709-1928; E-mail: [email protected].

Abstract

This article reviews and reflects on studies that have explored the effects of war on children around the world. Most are cross-sectional and based on self-reports. They describe a range of mental health problems, related to dose effects and to the negative impact of being a victim or witness of violent acts, threats to and loss of loved ones, prolonged parental absence, and forced displacement. The more recent the exposure to war, and the older the child, the higher was the likelihood of reported posttraumatic stress disorder symptoms. Especially vulnerable to long-term emotional distress were child soldiers, children who were raped, and children who had been forcibly displaced. In adulthood, war-traumatized children displayed significantly increased risks for a wide range of medical conditions, especially cardiovascular diseases. Among protective factors that moderated the impact of war-related adversities in children were a strong bond between the primary caregiver and the child, the social support of teachers and peers, and a shared sense of values. Among the few documented intervention studies for children of war, school-based interventions, implemented by teachers or locally trained paraprofessionals, proved to be a feasible and low-cost alternative to individual or group therapy. More longitudinal research with multiple informants is needed to document the trajectories of risk and resilience in war-affected children, to assess their long-term development and mental health, and to identify effective treatment approaches.

Type
Special Section Articles
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychological Association. (2010). Resilience and recovery after war: Refugee children and families in the United States. Washington, DC: Author. Retrieved from http://www.apa.org/pi/families/refugees.aspxGoogle Scholar
Attanayake, V., McKay, R., Jeffres, M., Singh, S., Burkle, F. Jr., & Mills, E. (2009). Prevalence of mental disorders among children exposed to war: A systematic review of 7,920 children. Medicine, Conflict and Survival, 25, 419.CrossRefGoogle Scholar
Barenbaum, J., Ruchkin, V., & Schwab-Stone, M. C. (2004). The psychosocial aspects of children exposed to war: Practice and policy initiatives. Journal of Child Psychology and Psychiatry, 45, 4162.CrossRefGoogle ScholarPubMed
Betancourt, T. S. (2011). Attending to the mental health of war-affected children: The need for longitudinal and developmental perspectives. Journal of the American Academy of Child & Adolescent Psychiatry, 50, 323325.CrossRefGoogle Scholar
Betancourt, T. S., Borisova, I. I., Williams, T. P., Brennan, R. T., Whitfield, T. H., Soudiere, M., et al. (2010). Sierra Leone's former child soldiers: A follow-up study of psychosocial adjustment and community reintegration. Child Development, 81, 10771095.CrossRefGoogle ScholarPubMed
Betancourt, T. S., & Khan, K. T. (2008). The mental health of children affected by armed conflict: Protective processes and pathways to resilience. International Review of Psychiatry, 20, 317328.CrossRefGoogle ScholarPubMed
Boothby, N., Crawford, J., & Halperin, J. (2006). Mozambican child soldier life outcome study. Global Public Health, 1, 87107.CrossRefGoogle ScholarPubMed
Chandra, A., Lara-Cinisomo, S., Jaycox, L., Tanielian, T., Burns, R. M., Ruder, T., et al. (2010). Children on the homefront: The experience of children from military families. Pediatrics, 125, 1625.CrossRefGoogle ScholarPubMed
Cicchetti, D. (2010). Resilience under conditions of extreme stress: A multi-level perspective. World Psychiatry, 9, 145154.CrossRefGoogle Scholar
Duraković-Belko, E., Kulenović, A., & Dapić, R. (2003). Determinants of post-traumatic adjustment in adolescents from Serajevo who experienced war. Journal of Child Psychology, 59, 2740.Google Scholar
Forstmeier, S., Kuwert, P., Spitzer, C., Freyberger, H. J., & Maerckler, A., (2009). Postraumatic growth, social acknowledgment as survivors, and a sense of coherence in former German child soldiers of World War II. American Journal of Geriatric Psychiatry, 17, 10301038.CrossRefGoogle Scholar
Franz, M. (2006). Die biografische Langzeitbewirkung kriegsbedingter Vaterlosigkeit [The long-term consequences of father absence during the war]. In Janus, L. (Ed.), Geboren im Krieg: Kindheitserfahrungen im 2. Weltkrieg und ihre Auswirkungen (pp. 6983). Giessen, Germany: Psychosozial Verlag.Google Scholar
Garmezy, N. (1983). Stressors of childhood. In Garmezy, N. & Rutter, M. (Eds.), Stress, coping and development in children (pp. 4384). Baltimore, MD: Johns Hopkins University Press.Google Scholar
Gavranidou, M. (2007). Folgen der Jugoslawien—Nachfolgekriege und Resilienzfaktoren der betroffenen Kinder [Consequences of the Yugoslavian civil war and resiliency factors in the children]. In Fooken, I. & Zinnecker, J. (Eds.), Trauma und Resilienz (pp. 169181). Munich: Juventa Verlag.Google Scholar
Glaesmer, H., Brähler, E., Gündel, H., & Riedel-Heller, S. (2011). The association of traumatic experiences and posttrautmatic stress disorder with physical morbidity in old age: A German population based study. Psychosomatic Medicine, 73, 359.CrossRefGoogle Scholar
Jordans, M. J. D., Tol, W. A., Komproe, I. H., & de Jong, J. V. T. M. (2009). Systematic review of evidence and treatment approaches: Psychsocial and mental health care for children in war. Child and Adolescent Mental Health, 14, 214.CrossRefGoogle Scholar
Klasen, F., Oettingen, G., Daniels, J.Post, M., Hoyer, C., & Adam, H. (2010). Posttraumatic resilience in former Ugandan child soldiers. Child Development, 81, 10961113.CrossRefGoogle ScholarPubMed
Kuterovac-Jagodić, G. (2003). Posttraumatic stress symptoms in Croatian children exposed to war. Journal of Clinical Psychology, 59, 925.CrossRefGoogle ScholarPubMed
Kuwert, P., Brähler, E., Glaesmer, H., Freyberger, H. J., & Decker, O. (2009). Impact of forced displacement during World War II on the present day mental health of the elderly: A population-based study. International Psychogeriatrics, 21, 748753.CrossRefGoogle ScholarPubMed
Kuwert, P., Klausner, T., Eichhorn, S., Grundke, E., Dudeck, M., Schomerus, G., et al. (2010). Trauma and current post-traumatic stress symptoms in elderly German women who experienced wartime rapes in 1945. Journal of Nervous and Mental Disease, 198, 450451.CrossRefGoogle ScholarPubMed
Kuwert, P., Spitzer, C., Dudeck, M., Vogel, M., Freyberger, H. J., & Ermann, H. (2008). Psychological complaints, interpersonal problems, quality of life and sense of coherence in former German war children. Psychotherapie, Psychosomatik und Medizinische Psychologie, 58, 257263.CrossRefGoogle Scholar
Layne, C. M., Olsen, J. A., Baker, A., Legerski, J. P., Isakson, B., Pasalic, A., et al. (2010). Unpacking trauma exposure risk factors and differential pathways of influence: Predicting postwar mental distress in Bosnian adolescents. Child Development, 81, 10531076.CrossRefGoogle ScholarPubMed
Lester, P., Peterson, K., Reeves, J., Knauss, L., Glover, D., Mogil, C., et al. (2010). The long war and parental combat deployment: Effects on military children and at-home spouses. Journal of the American Academy of Child & Adolescent Psychiatry, 19, 310320.Google Scholar
Macksoud, M. (2000). Helping children cope with the stresses of war: A manual for parents and teachers. New York: UNICEF.Google Scholar
Macksoud, M., & Aber, L. (1996). The war experiences and psychosocial development of children in Lebanon. Child Development, 67, 7088.CrossRefGoogle ScholarPubMed
Masten, A. S., & Narayan, A. J. (2012). Child development in the context of disaster, war, and terrorism: Pathways of risk and resilience. Annual Review of Psychology, 63, 131.CrossRefGoogle ScholarPubMed
Muhtz, C., von Alm, C., Godemann, K., Wittekind, C., Jelinek, L., Yassouridis, A., et al. (2011). Long-term consequences of flight and expulsion in former refugee children. Psychotherapie, Psychosomatik und Medizinische Psychologie, 61, 233238.CrossRefGoogle ScholarPubMed
Park, N. (2011). Military children and families. American Psychologist, 66, 6572.CrossRefGoogle ScholarPubMed
Persson, T. J., & Rousseau, C. (2009). School-based interventions for minors in war-exposed countries: A review of targeted and general programmes. Torture, 19, 88101.Google ScholarPubMed
Sack, W. H., Him, C., & Dickson, D. (1999). Twelve-year follow-up study of Khmer youths who suffered massive war trauma as children. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 11731179.CrossRefGoogle ScholarPubMed
Saltzman, W. R., Lester, P., Beardslee, W. R., Layne, C. M., Woodward, K., & Nash, W. P. (2011). Mechanisms of risk and resilience in military families: Theoretical and empirical basis of a family-focused resilience enhancement program. Clinical, Child and Family Psychology Review, 14, 213230.CrossRefGoogle ScholarPubMed
Santacruz, M., & Arana, R. (2002). Experiences and psychosocial impact of the El Salvador civil war on child soldiers. Biomedica, 22(Suppl. 2).Google Scholar
Schmitt, M. (2007). Interdisziplinäre Längsschnittstudie des Erwachsenenalters: Folgen kollektiver Kriegstraumata im Erwachsenenalter [Interdisciplinary longitudinal study of adulthood: Consequences of collective war trauma in adulthood]. In Fooken, I. & Zinnecker, J. (Eds.), Trauma und Resilienz (pp. 109120). Munich: Juventa Verlag.Google Scholar
Strauss, K., Dapp, U., Anders, J., von Rentel-Kruse, W., & Schmidt, S., (2011). Range and specificity of war-related trauma to posttraumatic stress, depression and general health perception: Displaced former World War II children in later life. Journal of Affective Disorders, 128, 267276.CrossRefGoogle Scholar
Von Münch, I. (2009). “Frau Komm!” Die Massenvergewaltigungen deutscher Frauen und Mädchen 1944/45 [“Woman come!” The mass rapes of German women and girls 1944/45]. Graz, Austria: Aries Verlag.Google Scholar
United Nations. (2009). Machel study 10-year strategic review: Children and conflict in a changing world. New York: Office of the Special Representative of the Secretary-General for Children and Armed Conflict.Google Scholar
Wadsworth, S. M., & Riggs, D. (Eds.). (2011). Risk and resilience in U.S. military families (pp. 180184). New York: Springer.CrossRefGoogle Scholar
Werner, E. E. (2000). Through the eyes of innocents: Children witness World War II. Boulder, CO: Westview Press.Google Scholar
Werner, E. E. (2007). Resilience and protective factors in the lives of individuals who were children and youths in World War II. In Fooken, I. & Zinnecker, J. (Eds.), Trauma und Resilienz (pp. 4755). Munich: Juventa Verlag.Google Scholar
Wessels, M. (2006). Child Soldiers: From violence to protection. Cambridge, MA: Harvard University Press.Google Scholar
Wolmer, L., Hamiel, D., & Laar, N. (2011). Preventing children's post-traumatic stress after disaster with teacher-based intervention: A controlled study. Journal of the American Academy of Child & Adolescent Psychiatry, 50, 340348.CrossRefGoogle ScholarPubMed
Yehuda, R., Flory, J. D., Pratchett, L. R., Buxbaum, J., Ising, M., & Hubbert, F. (2010). Putative biological mechanism for the association between early life adversity and the subsequent development of PTSD. Psychopharmacology, 212, 405417.CrossRefGoogle ScholarPubMed