Children living in war zones are at a great risk of developing posttraumatic stress and other emotional disorders. Acute distress due to traumatic events in these children can also result in emotional problems that are not commonly recognised.
This observation came from a joint study by researchers from Palestine and Leicester, United Kingdom, who found that, the effects on children during the ongoing armed conflict in the Middle East is devastating (Lancet 2002; 359:1801-04). The researchers interviewed children aged 9-18 years residing around the Gaza strip, whose families either reside in war exposed areas or in regions not directly affected by bombardment. Children who are directly affected by the conflict, including bombardment and home demolition, developed greater incidences of post-traumatic stress disorders and fear. In comparison, children who did not endure those destructive acts but are living in war zones are less likely to develop those psychological disorders. More than twice as many children directly exposed to the conflict reported symptoms of feeling stressful when identifying with traumatic events, difficulty concentrating, sleep disturbance, and avoidance of reminders.
The researchers were surprised to discover that children living in unexposed war areas are more likely to have anxiety symptoms and disorders than children who are directly involved. They expected that all forms of psychological disturbance would be more common in exposed children. They speculated that children who were exposed to war and violence through the media, as well as adults, would be more likely to anticipate anxiety, worrying about what might happen. In comparison, directly exposed individuals have already developed thoughts, emotions, and physical reactions to bombardment, hence they are less anxious. Similar patterns are observed in other studies on children caught in other armed conflicts.
There is a need to recognise the special psychological impact of war on children, both directly and indirectly affected. On taking pre-emptive measures to protect these children, one of the researchers, Panos Vostanis, professor of child health in Leicester, pointed out: "I would not advocate for specialist services. Instead, the key lies with the agencies and organisations such as the Red Cross, which come in contact with children in these areas, that is in schools and charities." Referring to the homeless children and refugees displaced by war and seeking asylum, he added: "Future doctors can learn a lot from coming in contact with different groups of traumatised children, even if they do not have the opportunity to visit countries exposed to conflict."
