British Journal of Psychiatry
Volume 214, Issue 6, 2019, Pages 354-360

Role of childhood adversities and environmental sensitivity in the development of post-traumatic stress disorder in war-exposed Syrian refugee children and adolescents (Article)

Karam E.G.* , Fayyad J.A. , Farhat C. , Pluess M. , Haddad Y.C. , Tabet C.C. , Farah L. , Kessler R.C.
  • a Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Youssef Soursok Street, Beirut Achrafieh Beirut, 1100-2807, Lebanon
  • b Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Youssef Soursok Street, Beirut Achrafieh Beirut, 1100-2807, Lebanon
  • c Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Youssef Soursok Street, Beirut Achrafieh Beirut, 1100-2807, Lebanon
  • d Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, United Kingdom
  • e Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Youssef Soursok Street, Beirut Achrafieh Beirut, 1100-2807, Lebanon
  • f Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Youssef Soursok Street, Beirut Achrafieh Beirut, 1100-2807, Lebanon
  • g Department of Social Services, St Joseph University, Lebanon
  • h Department of Health Care Policy, Harvard Medical School, United States

Abstract

Background Increased post-traumatic stress disorder (PTSD) rates have been documented in children exposed to war. However, the contribution of childhood adversities and environmental sensitivity to children's responses to adversities and trauma are still far from settled.Aims To evaluate the relative roles of war, childhood adversities and sensitivity in the genesis of PTSD.Method Data on childhood adversities and sensitivity was collected from 549 Syrian refugee children in Lebanon. PTSD symptoms were assessed using the PTSD Reaction Index.Results Although childhood adversities, war events and sensitivity were all significantly related to PTSD in bivariate analyses, multivariate analyses showed that childhood adversities were the most important variable in predicting PTSD. The effect of war on PTSD was found to be dependent on the interplay between childhood adversities and sensitivity, and was most prominent in highly sensitive children with lower levels of adversities; in sensitive children experiencing high levels of adversities, the effects of war exposure on PTSD were less pronounced.Conclusions When considering the effects of war on PTSD in refugee children, it is important to take account of the presence of other adversities as well as of children's sensitivity. Sensitive children may be more vulnerable to the negative effects of war exposure, but only in contexts that are characterised by low childhood adversities.Declaration of interest None. © 2019 The Royal College of Psychiatrists.

Author Keywords

Mental disorders War childhood adversities PTSD Sensitivity

Index Keywords

male age female battle injury refugee childhood adversity posttraumatic stress disorder war exposure gender Article Lebanon human Syrian Child Adolescent
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85065790900&doi=10.1192%2fbjp.2018.272&partnerID=40&md5=ae6274f3c81d1cfe5a213423b8311776
DOI: 10.1192/bjp.2018.272
ISSN: 00071250
Cited by: 1
Original Language: English