Psychosocial effects of war experiences among displaced children in southern Darfur
Author: Morgos D, Worden JW, Gupta L.
Source:
OMEGA-Journal of Death and Dying, 56(3), 229-253.
This study focused on assessing the psychosocial effects of the long standing,
high intensity, and guerrilla-style of warfare among displaced children in
Southern Darfur. The goal was to better understand the etiology, prognosis, and
treatment implications for traumatic reactions, depression, and grief symptoms in
this population. Three hundred thirty-one children aged 6-17 from three IDP Camps
were selected using a quota sampling approach and were administered a Demographic
Questionnaire, Child Post Traumatic Stress Reaction Index, Child Depression
Inventory, and the Expanded Grief Inventory. Forty-three percent were girls and
57% were boys. The mean age of the children was 12 years. Results found that
children were exposed to a very large number of war experiences with no
significant differences between genders for types of exposure, including rape,
but with older children (13-17 years) facing a larger number of exposures than
younger children (6-12 years). Out of the 16 possible war experiences, the mean
number was 8.94 (SD = 3.27). Seventy-five percent of the children met the DSM-IV
criteria for PTSD, and 38% exhibited clinical symptoms of depression. The
percentage of children endorsing significant levels of grief symptoms was 20%.
Increased exposure to war experiences led to higher levels of: (1) traumatic
reactions; (2) depression; and (3) grief symptoms. Of the 16 war experiences,
abduction, hiding to protect oneself, being raped, and being forced to kill or
hurt family members were most predictive of traumatic reactions. Being raped,
seeing others raped, the death of a parent/s, being forced to fight, and having
to hide to protect oneself were the strongest predictors of depressive symptoms.
War experiences such as abduction, death of one's parent/s, being forced to
fight, and having to hide to protect oneself were the most associated with the
child's experience of grief. In addition to Total Grief, Traumatic Grief,
Existential Grief, and Continuing Bonds were measured in these children. Although
trauma, depression, and grief often exist as co-morbid disorders, the mechanisms
and pathways of these is less understood. In this study we used Structural
Equation Modeling to better understand the complex interaction and trajectories
of these three symptoms evolving from war exposure and loss. This study is the
first of its kind to assess the psychosocial effects of war experiences among
children currently living in war zone areas within Sudan. It identifies some of
the most prevalent war-related atrocities and their varying impact on the
children's psychological well-being and overall adjustment. Implications for
planning mental health interventions are discussed.