Impact of War on Children’s Mental Health
Psychiatric and psychological studies have shown that war leaves enduring episodes in children and adolescents. During the war, children face (to differing degrees) exposure to two types of traumatic events: type I (sudden traumatic event) and type II (protracted exposure to adverse events resulting in dysfunctional coping mechanisms). As a result, they suffer from conditions such as anxiety disorders, Post-Traumatic Stress Disorder (PTSD), depression, dissociative disorders (disengagement in the external world, depersonalization, derealization, numbing, catatonia), behavioral disorders (especially aggression, asocial and violent criminal behavior), and alcohol and substance abuse, more than their counterparts – in countries not torn by war (Joshi and O’Donnell 2003, Machel 2001, Wexler et al 2006). According to Joshi and O’Donnell (2003:288), mental health problems are actually a “normal reaction to abnormal events”. Underlying that, in children, prolonged exposure to violence results in “risk for the development of multiple and sometimes protracted forms of biopsychosocial maladjustment”.
Murthy and Lakohminarayana (2006) reviewed all the studies on children’s mental health done in the following armed conflict zones: Afganistan, the Balkans, Cambodia, Chechnya, Iraq, Israel, Lebanon, Palestine, Rwanda, Sri Lanka, Somalia and Uganda. They concluded that war trauma leads to long-term consequences on the psyche of children – the more prolonged the conflict, the more severe the symptoms. According to World Health Organization, who called for protection of children in armed conflicts, 10% of people who experience traumatic events will later have symptoms of trauma, while another 10% will develop changes in behavior or psychological conditions that prevent them of functioning in everyday life (the most common conditions being anxiety, depression and psychosomatic problems) (WHO 2005 in Murthy and Lakohminarayana 2006). Smith (2001) claims that the most important variables that determine the impacts of war on children’s mental health are: deprivation of basic resources (such as shelter, water, food, schools, health care, etc); disrupted family relationships (due to loss, separation or displacement); stigma and discrimination (significantly affecting the identity); a pessimistic outlook (the persistent feeling of loss and grief, inability to see the brighter future) and the normalization of violence.
However, the western psychological approach to mental health of children in conflict areas, predominantly seen through PTSD prism, has been largely criticized recently for its ethnocentric point of view that excludes local cultural belief systems as well as children’s agency and resilience (De Jong 2002, Fernando and Ferrari 2013, Jones 2013). Children should not be considered only as the passive victims deprived of agency upon whom the violence has been enacted, but rather as the active participants in the society that develop their own ways to cope and survive, capable of choosing to resist or to participate in the armed conflict (Dupuy and Peters 2010).
Although exposed to dehumanizing conditions, recent psychosocial studies point out the enormous capacity for resilience in children (De Jong 2002, Fernando and Ferrari 2013, Jones 2013), which enables them to grow up into fully functioning individuals despite their traumas. Several protective mechanisms have been identified, among the most important of these are the effects of coping strategies, belief systems, healthy family relationships and friendships. Poverty, inappropriate housing, domestic violence, discrimination and social isolation are only few issues that have to be addressed in the aftermath of war to successfully avoid the consequences of traumatic events and enhance the resilience (De Jong 2002, Fernando and Ferrari 2013, Jones 2013).
The extent of the effects of war also depends on the events in the aftermath, primarily whether reconstruction of the country has been successful and whether the socio-economic situation has improved. Moreover, the prosecution of perpetrators, appropriate parties assuming responsibility for atrocities and the implementation of local mechanisms for reconciliation are crucial. By integrating conflict resolution techniques in school curriculums, the schooling system is of utmost importance for children to successfully resolve conflicts and come to terms with past (Dupuy and Peters 2010).
The complexity of the impact of war on children and adolescents, and their multilayered lived experience, can be reached only by obtaining testimonials in their narrative form – whether as life stories or drawings (Jones 2013, Lustig and Tennakoon 2008).
Through the audio-video testimonies of people who were children and adolescents during the war, the War Childhood Museum provides valuable insight in everyday life in war settings with all its precarity, evils and horrors. In addition, it aims to retrospectively identify and illuminate protective factors that could strengthen children’s resilience. In this way, by depicting the lived experience of Bosnian children and adolescents, the War Childhood Museum would like to contribute to deepening the understanding of the specificities of living in conflict and post-conflict zones. This knowledge could help enhance the protection of children in contemporary war zones and could strengthen the efforts for peacekeeping in the world.
De Jong, J et al
2002 Trauma, War and Violence: Public mental health in socio-economic context. New York, Boston, Dordrecht, London, Moscow: Kluwer Academic Press.
Dupuy, KE and Krijn Peters
2010 War and children: a reference handbook. Santa Barbara, Denver, Oxford: Praeger Security International, ABC Clio
Fernando, C and Michel Ferrari
2013 Handbook of Resilience in Children of War. New York, Heidelberg, Dordrecht, London: Springer
2013 Then they started shooting: Children of the Bosnian war and the adults they become. New York: Bellevue Literary Press.
Joshi, PT and Deborah O’Donnell
2003 Consequences of child exposure to war and terrorism. Clinical Child and Family Psychology Review 6(4):279-291.
Lustig, SL and Lakshika Tennakoon
2008 Testimonials, Narratives, Stories and Drawings: Child Refugees as Witnesses. Child and Adolescent Psychiatric Clinics of North America 17:569-584.
Morina, N et al
2011 War and bereavement-consequences for mental and physical distress. PLoS ONE 6(7):e22140.
Murthy, SS and R. Lakshminarayana
2006 Mental health consequences of war: a brief review of research findings. World Psychiatry 5(1):25-30.
2001 Children in the heat of war. APA Monitor 32(8):29.