Journal of the American Academy of Child and Adolescent Psychiatry
Volume 36, Issue 8, 1997, Pages 1098-1106

Effects of war trauma on Cambodian refugee adolescents' functional health and mental health status (Article)

Mollica R.F.* , Poole C. , Son L. , Murray C.C. , Tor S.
  • a Harvard Program in Refugee Trauma, Harvard School of Public Health, Cambridge, MA, United States, Harvard Program in Refugee Trauma, 8 Story Street, Cambridge, MA 02138, United States
  • b Harvard Program in Refugee Trauma, Harvard School of Public Health, Cambridge, MA, United States
  • c Harvard Program in Refugee Trauma, Harvard School of Public Health, Cambridge, MA, United States
  • d Harvard Program in Refugee Trauma, Harvard School of Public Health, Cambridge, MA, United States
  • e Harvard Program in Refugee Trauma, Harvard School of Public Health, Cambridge, MA, United States

Abstract

Objective: To measure the effect of war trauma on the functional health and mental health status of Cambodian adolescents living in a refugee camp on the Thai-Cambodian border. Method: A multistage probability sample identified 1,000 households in the camp known as Site Two. Interviews were conducted in each household with randomly selected adults 18 years of age and older. All adolescents aged 12 and 13 years old, along with one parent, were interviewed. One hundred eighty-two adolescents (94 girls, 88 boys) and their parents participated. Culturally sensitive instruments were used, including Cambodian versions of the Child Behavior Checklist (CBCL) and the Youth Self- Report (YSR). Results: Parents and adolescents reported the latter having experienced high levels of cumulative trauma, especially lack of food, water, and shelter. Mean Total Problem scores were in ranges similar to those of adolescents receiving clinical care in the United States, Netherlands, and Israel. Nearly 54% (53.8%) had Total Problem scores in the clinical range by parent report on the CBCL and 26.4% by adolescent report on the YSR. The most commonly reported symptoms were somatic complaints, social withdrawal, attention problems, anxiety, and depression. The dose-effect relationship between cumulative trauma and symptoms was strong for parent reporting on the CBCL; the subscales on both the YSR end CBCL for Anxious/Depressed and Attention Problems revealed dose-effect associations. Dose-effect relationships between cumulative trauma and social functioning or health status were lacking. Conclusion: The high levels of emotional distress in this population of Cambodian adolescents and corresponding dose-effect relationships reveal the important negative psychosocial impact of violence on Cambodian adolescents. Lack of findings related to physical health status and the presence of positive social functioning of many youths should not deter health care providers and public health officials from diagnosing and treating underlying high levels of psychological distress.

Author Keywords

Children posttraumatic stress disorder Adolescents Cambodian refugees trauma

Index Keywords

battle injury refugee Cambodia mental health human Self Report priority journal health status social interaction child behavior mental health care Adolescent male female emotional stress Article child psychiatry social adaptation major clinical study posttraumatic stress disorder distress syndrome child health care Child

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0030876798&doi=10.1097%2f00004583-199708000-00017&partnerID=40&md5=29ea2b0e45416b98b6e51371f2e9917d

DOI: 10.1097/00004583-199708000-00017
ISSN: 08908567
Cited by: 162
Original Language: English