Psychosocial Impacts
Most studies of memory of war-related trauma have focused on adults (PanterBrick et al. 2015, p. 814). Panter-Brick et al. point out that the sparse literature on child and adolescent trauma memory has shown that “the impact of war on mental health depends on whether youth are able to make sense of collective violence...and the nature of postwar social experiences” (2015, p.
815). In particular, nurturance, family stability, social capital, and neighborhood safety have “a disproportionate influence on mental health outcomes over time” (2015, p. 815). A study of war-affected Afghan youth intended to understand the inter-relationship between how trauma memories and subsequent social experiences impacted on mental health found that “Memories of violent events are malleable, embedded in social experiences, and present heterogeneous associations with posttraumatic distress” (Panter-Brick et al. 2015, p. 814). They found that youth were unexpectedly resilient to wartime trauma, with a third of the cohort reporting no trauma at baseline and 44% reporting no trauma at follow-up and 20% reporting no trauma at either point. Their results resonated with reviews “that conclude that ‘posttraumatic resilience’ is often the norm, where measured by the absence of clinical psychopathology” (2015 p. 821). Higher trauma exposure (especially, four or more traumatic events), ongoing stressful domestic violence, and being girls correlated with sustained high distress (2015, p. 821).A specific impact of war is parental bereavement. This remains an underresearched area in non-Western populations. Neshat Doost et al. (2008) argue that early parental bereavement impacts on autobiographical memory and that this, in turn, impacts negatively on adolescent development. Their psychometric tests of Afghan children living in Iran found that reduced autobiographical memory specificity was correlated both with parental bereavement and with depression.
The lasting impact of parental bereavement resonates with Panter-Brick et al. in their emphasis on the importance of context, for example, family stability in developing resilience to war trauma.The impact of the Iraq and Afghanistan wars on children has not been extensively researched. Perhaps surprisingly, most of the available research in English is on the impacts of the war on children in the UK and the USA, either on media exposure or on the effects on soldier’s families of the deployment of their parents to war zones. An exception is Dyregov et al.’s (2002) study of the psychological impact of war on children in Iraq who had witnessed the bombing of the al Ameriyah shelter in Iraq in February 1991 in which an estimated 1000 people were killed. They interviewed their respondents in 1991 and again in 1992 and 1993. The results “reveal a highly distressed population of children” who are “harbouring high, stable levels of psychological distress over time” (Dyregrov et al. 2002, p. 64) albeit with some diminishment in intensity. In other words, as time passed children were less traumatized by their memory of the event, but they still showed high levels of psychological distress identified in psychometric tests. In response to these studies and the need that they identified for specific psychosocial interventions with children, UNICEF cosponsored a center of psychosocial care for children.
Posttraumatic stress syndrome has been criticized as a “Western” concept in some of the anthropological literature. Hart (2008), for example, says that “Established conditions of enquiry [into the impacts of war on children] have been shaped primarily by mental health practitioners and rights activists. Both have relied heavily on instruments and measures that are highly normative and context-blind” (2008, p. 3). However psychometric instruments are generally adapted for the specific cultural conditions in which they are used, as was done in both the studies cited above.
Diab et al. comment that “Research confirms that war-affected children have an increased risk for developing PTSD, characterized by reexperiencing the horrors in dreams and flashbacks, by avoiding reminders of trauma and numbing of feelings, as well as by constant arousal and vigilance to threats” (Diab et al. 2014, p. 215). Family and social relationships are known to be protective of the impacts of trauma, but of course war disrupts social relationships. In the editorial to a special issue on “Children Affected by Armed Conflict: Views from the Global South,” Martha Bragin says “the experience of extreme violence is not a disease to be treated and cured, but rather a changed knowledge of human reality that must be engaged to help both children, adults and whole communities to move forward” (Bragin 2012, p. 180). In a comparable register to PTSD she notes that, “For children exposed to mass murder in a very short time, the fear that aggressive instincts may at any moment burst out from anyone and anything, including their own nightmares, creates an insidious sense that the world is unstable; fostering a chronic sense of dread” (Bragin 2012, p. 181).6