Factors moderating the risk of PTSD, emotional and behavioral problems amongst children in war zones and refugees escaping from warfare

Children who grow up in war zones are typically exposed to multiple stressors including physical harm, intimidation or other forms of psychological trauma. This can also lead to Post Traumatic Stress Disorder. On the other hand, resilient children show no psychiatric distress even when they are exposed to severe traumatic stress. Additionally, the number of refugee children due to warfare reasons is increasing. Past empirical studies have recognized that the process of migration and living life as a refugee is detrimental to the psychological health of young refugees. In this symposium we will examine the prevalence and determinants of resiliency among refugee children and children living in conditions of war and violence. The first study investigated the psychological, social and somatic effects of chronic traumatic experience on Palestinian children over six years (2000-2006). The sample consisted of 1,137 children who completed: Checklist of Traumatic Experiences, Symptoms of PTSD Scale, Network of Psycho-Social Support and Personality Assessment Questionnaire. It was found that 41% of the participants suffered from PTSD. From these 25% suffered from cognitive symptoms; 22% suffered from emotional symptoms; 22% suffered from social behavioral problems; 17% suffered from academic and 14% suffered from somatic symptoms. The support of family, friends, relatives and teachers, and positive personality traits were found to be strong protective factors aiding recovery from trauma and PTSD. The second study evaluated the relation of exposure to war traumas, and violence in the family, community, and school, to PTSD symptoms, emotional and behavioral problems amongst 330 Palestinian children. Results highlight the additive effects of exposure to war traumas and violence in different settings. In addition, it was found that psychosocial support reduced the effects of environmental factors in developing PTSD and behavioral problems. The third study included data from two refugee charity organizations in the UK. There were 200 refugee children coming from war zones and 210 control children (non-refugees). The study aimed to look at a range of factors to assess the differences between the above groups with regards to their well-being and peer and sibling relationships. Results showed that refugee children were significantly more likely to be in the clinical range for total difficulties and to have higher health and physical problems, negative friendship quality and low self esteem compared to the control group. Refugees who were bullied at home and at school were also more likely to develop PTSD symptoms. Protective factors are also discussed in this study. The above studies emphasize the fact that interventionists should consider the full range of sources of environmental risk for PTSD and emotional and behavioral problems and should strengthen the psychosocial support for children in or coming from war zones

Traumatic events and PTSD among Palestinian children and adolescents : the effect of demographic and socioeconomic factors

Background: This study investigates the prevalence of traumatic events and Posttraumatic Stress Disorder (PTSD) among Palestinian children and adolescents in the Gaza Strip. Methods: The sample consists of 1029 school pupils (11-17 years old): 533 (51.8%) were female and 496 (48.2%) were male. War-Traumatic Events Checklist (W-TECh) Post-Traumatic Stress Disorders Symptoms Scale (PTSDSS) were used. Results: 88.4% (N = 909) experienced personal trauma, 83.7% (N = 861) witnessed trauma to others, and 88.3% (N = 908) observed demolition of property during the war. Compared to girls, boys showed significantly more exposure to all three event types as well as overall traumatic events. Results also demonstrated that the prevalence of DSM-V PTSD diagnosis was 53.5% (N = 549). Further, children who had experienced personal trauma, trauma to others, and the demolition of property were significantly more likely to be diagnosed with PTSD compared to those who had not even when adjusting for demographic and socioeconomic factors

Systematic review and meta-analysis : fussing and crying durations and prevalence of colic in infants

Objective To determine the mean duration of fussing and crying and prevalence of colic using modified Wessel criteria in infants in the first 3 months of life. Study design A systematic literature search was performed using the databases Medline, PsycINFO, and Embase. The major outcome measure was mean total fuss/cry duration during 24 hours at ages 1-2 weeks (11 samples), 3-4 weeks (6 samples), 5-6 weeks (28 samples), 8-9 weeks (9 samples), and 10-12 weeks (12 samples). Results Of 5687 articles reviewed, 28 diary studies (33 samples) were suitable for inclusion in meta-analysis; these studies included 8690 infants. No statistical evidence for a universal crying peak at 6 weeks of age across studies was found. Rather, the mean fuss/cry duration across studies was stable at 117-133 minutes (SDs: 66-70) in the first 6 weeks and dropped to a mean of 68 minutes (SD: 46.2) by 10-12 weeks of age. Colic was much more frequent in the first 6 weeks (17%-25%) compared with 11% by 8-9 weeks of age and 0.6% by 10-12 weeks of age, according to modified Wessel criteria and lowest in Denmark and Japan. Conclusions The duration of fussing/crying drops significantly after 8-9 weeks of age, with colic as defined by modified Wessel criteria being rare in infants older than 9 weeks. Colic or excessive fuss/cry may be more accurately identified by defining fuss/cry above the 90th percentile in the chart provided based on the review