Cited by 341Posttraumatic Stress Disorder ResearchChild Abuse and TraumaHealth and Conflict Studies

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The psychosocial aspects of children exposed to war: practice and policy initiatives

Barenbaum, Joshua, Ruchkin, Vladislav, Schwab‐Stone, Mary·2004·Journal of Child Psychology and Psychiatry

DOI 10.1046/j.0021-9630.2003.00304.x

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Abstract

The atrocities of war have detrimental effects on the development and mental health of children that have been documented since World War II. To date, a considerable amount of knowledge about various aspects of this problem has been accumulated, including the ways in which trauma impacts child mental health and development, as well as intervention techniques, and prevention methods. Considering the large populations of civilians that experience the trauma of war, it is timely to review existing literature, summarize approaches for helping war‐affected children, and suggest future directions for research and policy.

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Gilligan, C. (2008) · Journal of Peace Research · doi:10.1177/0022343308098407 · Cited by 69
Traumatised by peace? A critique of five assumptions in the theory and practice of conflict-related trauma policy in Northern Ireland
Gilligan, C. (2006) · Policy & Politics · doi:10.1332/030557306776315813 · Cited by 68
“This therapeutic turn can be seen in the area of humanitarian assistance to wartorn societies, which increasingly emphasises the issue of war trauma (see, for example, Pedersen, 2002; Powell and Durakovic-Belko, 2002; Barenbaum et al, 2004 ).”
Background
Unpacking Constructs: A Network Approach for Studying War Exposure, Daily Stressors and Post-Traumatic Stress Disorder
Schryver, M. D., Vindevogel, S., Rasmussen, A., & Cramer, A. O. J. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01896 · Cited by 74
“…by virtue of a selected set of common variables, and their measurement based on aggregated counts risk to mask important ways in which people are diﬀerentially exposed to and aﬀected by stressful events (Barenbaum et al., 2004; Netland, 2005; Layne et al., 2009; Betancourt et al., 2010).”
Screening for traumatic exposure and psychological distress among war-affected adolescents in post-conflict northern Uganda
McMullen, J. D., O’Callaghan, P. S., Richards, J. A., Eakin, J. G., & Rafferty, H. (2011) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-011-0454-9 · Cited by 67
“opment; and to develop interventions to treat children traumatised by war [1].”
BackgroundInfluential
Supporting Syrian families displaced by armed conflict: A pilot randomized controlled trial of the Caregiver Support Intervention
Miller, K. E., Koppenol‐Gonzalez, G. V., Arnous, M., Tossyeh, F., Chen, A., Nahas, N., & Jordans, M. J. D. (2020) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2020.104512 · Cited by 70
A controlled evaluation of a brief parenting psychoeducation intervention in Burundi
Jordans, M. J. D., Tol, W. A., Ndayisaba, A., & Komproe, I. H. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0630-6 · Cited by 72
“In other words, it reinforces the argument to direct interventions at parents of school-aged children, especially in settings where formal care structures are often absent and the importance of family networks ubiquitous, specifically to instruct them to recognize children’s distress and advice them to use appropriate…”
Background
Understanding resilience in armed conflict: Social resources and mental health of children in Burundi
Hall, B. J., Tol, W. A., Jordans, M. J. D., Bass, J., & de Jong, J. T. V. M. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2014.05.042 · Cited by 69
“Exposure to war and armed conflict is associated with adverse mental health outcomes in children and adolescents (Barenbaum et al., 2004; Betancourt and Khan, 2008).”
School-based interventions for minors in war-exposed countries: a review of targeted and general programmes.
Persson, T. J., & Rousseau, C. (2009) · PubMed · Cited by 64
Parental care protects traumatized Sri Lankan children from internalizing behavior problems
Sriskandarajah, V., Neuner, F., & Catani, C. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0583-x · Cited by 73
“Children growing up in such adverse life environments are at risk of developmental problems [3, 4] and impaired psychological health and well-being [5, 6].”
Background
Child soldiers as time bombs? Adolescents’ participation in rebel groups and the recurrence of armed conflict
Haer, R., & Böhmelt, T. (2015) · European Journal of International Relations · doi:10.1177/1354066115581910 · Cited by 69
“Notwithstanding, it is generally accepted that children represent a highly vulnerable population and that they have the least capacity to recover (Barenbaum et al., 2004; Singer, 2006: 115).”
Background
Implementation of a Mental Health Care Package for Children in Areas of Armed Conflict: A Case Study from Burundi, Indonesia, Nepal, Sri Lanka, and Sudan
Jordans, M. J. D., Tol, W. A., Susanty, D., Ntamatumba, P., Luitel, N. P., Komproe, I. H., & de Jong, J. T. V. M. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001371 · Cited by 61
“We synthesize the interplay between research and practice in this program according to a set of principles extracted from guidelines on psychosocial support for children in areas of conflict [5,14,15] and emergency settings [9].”
BackgroundMethod
War, trauma and children's development: Observations from a modern evolutionary perspective
Belsky, J. (2008) · International Journal of Behavioral Development · doi:10.1177/0165025408090969 · Cited by 81
The Elusive Peace Dividend of Development Policy: From War Traps to Macro Complementarities
Rohner, D., & Thoenig, M. (2021) · Annual Review of Economics · doi:10.1146/annurev-economics-073120-102652 · Cited by 62
“In the same vein, Barenbaum et al. (2004) and Derluyn et al. (2004) find that wars have adverse consequences on mental and psychological health.”
Background
Parenting in the Breach: How Parents Help Children Cope with Developmentally Challenging Circumstances
Bradley, R. H. (2007) · Parenting · doi:10.1080/15295190701306896 · Cited by 65
“, taking time to play) may help relieve worries and restore a sense that it is worthwhile to pursue normal daily goals (Barenbaum et al., 2004; Foa et al., 1999; Perry, 1996). There is some evidence that parental warmth and responsiveness can protect children from adverse reactions to DCCs, especially young children w…”
Background
Context matters: community characteristics and mental health among war‐affected youth in Sierra Leone
Betancourt, T. S., McBain, R. K., Newnham, E. A., & Brennan, R. T. (2013) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12131 · Cited by 59
Emotional legacies of war among former Colombian paramilitaries.
Nussio, E. (2012) · Peace and Conflict Journal of Peace Psychology · doi:10.1037/a0030327 · Cited by 58
Toward a culturally sensitive conceptualization of resilience: Participatory research with war-affected communities in northern Uganda
Vindevogel, S., Ager, A., Schiltz, J., Broekaert, E., & Derluyn, I. (2015) · Transcultural Psychiatry · doi:10.1177/1363461514565852 · Cited by 58
The Efficacy of a Group Cognitive Behavioral Therapy for War-Affected Young Migrants Living in Australia: A Cluster Randomized Controlled Trial
Ooi, C. S., Rooney, R. M., Roberts, C. M., Kane, R. T., Wright, B. R., & Chatzisarantis, N. L. D. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01641 · Cited by 58
Forced conscription of children during armed conflict: Experiences of former child soldiers in northern Uganda
Vindevogel, S., Coppens, K., Derluyn, I., Schryver, M. D., Loots, G., & Broekaert, E. (2011) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2011.03.011 · Cited by 58
Screening for Traumatic Exposure and Posttraumatic Stress Symptoms in Adolescents in the War-Affected Eastern Democratic Republic of Congo
Mels, C., Derluyn, I., Broekaert, E., & Rosseel, Y. (2009) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2009.56 · Cited by 57
“Therefore, it seems reasonable to conclude that, if psychological needs remain unattended, intrapsychological and consequently relational and community problems could persist.(13,15,16,19-21,34) Earlier research has also found that traumatic exposure and related symptoms predicted feelings of revenge and negative atti…”
BackgroundInfluential
A controlled trial of trauma-focused therapy versus problem-solving in Islamic children affected by civil conflict and disaster in Aceh, Indonesia
Dawson, K. S., Joscelyne, A., Meijer, C., Steel, Z., Silove, D. M., & Bryant, R. A. (2017) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867417714333 · Cited by 61
“There is considerable evidence of increased rates of psychological problems in children who have survived war and civil conflict (Attanayake et al., 2009; Barenbaum et al., 2004; Pat-Horenczyk et al., 2009; Stichick, 2001), with rates of post-traumatic stress disorder (PTSD) and depression being significantly higher i…”
Background
Internal displacement and health among the Palestinian minority in Israel
Daoud, N., Shankardass, K., O'Campo, P. J., Anderson, K. M., & Agbaria, A. K. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.12.041 · Cited by 56
Children and the Sphere standard on mental and social aspects of health
Morris, J. E., van Ommeren, M., Belfer, M. L., Saxena, S., & Saraceno, B. (2007) · Disasters · doi:10.1111/j.1467-7717.2007.00341.x · Cited by 58
“Accumulating evidence suggests that not only in Western settings ( Barenbaum, Ruchkin and Schwab-Stone, 2004 ), but also in non-Western contexts, children exposed to catastrophic events are at heightened risk of symptoms of depression and anxiety (including post-traumatic stress symptoms), behavioural problems, dimini…”
Background
A meta-review of school-based disaster interventions for child and adolescent survivors
Fu, C., & Underwood, C. R. (2015) · Journal of Child and Adolescent Mental Health · doi:10.2989/17280583.2015.1117978 · Cited by 83
The effect of constant threat of terror on Israeli Jewish and Arab adolescents
Cohen, M. W., & Eid, J. (2007) · Anxiety Stress & Coping · doi:10.1080/10615800601167546 · Cited by 55
“Adolescents reported lower levels of psychological distress than young children in reaction to traumatic experiences (Allen, 1998) and to living in war or violent conflict zones, due to their more developed cognitive capacities and coping resources (Barenbaum et al., 2004; Masten & Coatsworth, 1998).”
BackgroundResultInfluential
Connectedness, social support and internalising emotional and behavioural problems in adolescents displaced by the Chechen conflict
Betancourt, T. S., Salhi, C., Buka, S. L., Leaning, J., Dunn, G., & Earls, F. J. (2012) · Disasters · doi:10.1111/j.1467-7717.2012.01280.x · Cited by 59
Evaluation of a teacher-led, life-skills intervention for secondary school students in Uganda
McMullen, J. D., & McMullen, N. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.09.041 · Cited by 59
A call for greater conceptual clarity in the field of mental health and psychosocial support in humanitarian settings
Miller, K. E., Jordans, M. J. D., Tol, W. A., & Galappatti, A. (2021) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796020001110 · Cited by 61
“Numerous reviews reflect the same persistent reality: clinical and social-environmental interventions are seldom integrated into multilevel, integrated systems of support (Barenbaum et al ., 2005; Ellis et al ., 2012; Betancourt et al ., 2013; Jordans et al ., 2016).”
Internalizing and externalizing symptoms among unaccompanied refugee and Italian adolescents
Thommessen, S. A. O., Laghi, F., Cerrone, C., Baiocco, R., & Todd, B. K. (2012) · Children and Youth Services Review · doi:10.1016/j.childyouth.2012.10.007 · Cited by 50
Understanding the impact of political violence in childhood: A theoretical review using a social identity approach
Muldoon, O. T. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.07.004 · Cited by 54
Exploring the Support Role of Special Education Teachers After Hurricane Ike
Ducy, E. M., & Stough, L. M. (2011) · Journal of Family Issues · doi:10.1177/0192513x11412494 · Cited by 53
Community-based cross-cultural adaptation of mental health measures in emergency settings: validating the IES-R and HSCL-37A in Eastern Democratic Republic of Congo
Mels, C., Derluyn, I., Broekaert, E., & Rosseel, Y. (2009) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-009-0128-z · Cited by 48
“This re-affirms the need to also bring local views into account when assessing mental health, to improve the accuracy and relevance of the screening [3, 12, 29, 32, 37, 38].”
Background
Child development in developing countries 2 Child development: risk factors for adverse outcomes in developing countries
Walker, S. P., Wachs, T. D., Gardner, J. M., Lozoff, B., Wasserman, G. A., Pollitt, E., & Carter, J. A. (2007) · Cited by 48
Measuring Hope Among Children Affected by Armed Conflict: Cross-Cultural Construct Validity of the Children’s Hope Scale
Haroz, E. E., Jordans, M. J. D., de Jong, J. T. V. M., Gross, A. L., Bass, J., & Tol, W. A. (2015) · Assessment · doi:10.1177/1073191115612924 · Cited by 52
The Longitudinal Effects of Chronic Mediated Exposure to Political Violence on Ideological Beliefs About Political Conflicts Among Youths
Dvir-Gvirsman, S., Huesmann, L. R., Dubow, E. F., Landau, S. F., Boxer, P., & Shikaki, K. I. (2015) · Political Communication · doi:10.1080/10584609.2015.1010670 · Cited by 47
“Following such an explanation would suggest that parents carry part of the responsibility for their children’s initial beliefs (Bar-Tal, 1996; Barenbaum et al., 2004; Castelli, Zogmaister, & Tomelleri, 2009).”
Background
Building peace through education
Hymel, S. C., & Darwich, L. (2018) · Journal of Peace Education · doi:10.1080/17400201.2018.1535475 · Cited by 60
“…increasingly documented, including post-traumatic stress disorders, internalizing and externalizing problems (e.g. depression, aggression), academic challenges, and disturbances in personality and moral development (see Barber 2013; Barenbaum, Ruchkin, and Schwab-Stone 2004; Entholt and Yule 2006).”
Background
Screening for psychosocial distress amongst war‐affected children: cross‐cultural construct validity of the CPDS
Jordans, M. J. D., Komproe, I. H., Tol, W. A., & de Jong, J. T. V. M. (2009) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.02028.x · Cited by 48
“…countries to do clinical assessments within large populations (WHO, 2005); (2) facilitating early detection of at-risk populations when lay-screening is limited due to unawareness or stigmatization (Saltzman et al., 2003); and (3) planning for therapeutic interventions (Barenbaum et al., 2004).”
BackgroundInfluential
Trauma-Focused Public Mental-Health Interventions: A Paradigm Shift in Humanitarian Assistance and Aid Work
Schauer, M., & Schauer, E. (2010) · Springer eBooks · doi:10.1007/978-1-4419-5722-1_16 · Cited by 46
“However, having a caring and protective mother or father is not a panacea, and closeness to a responsible parent does not protect children from the traumatic impact of war and persecution, as parents cannot buffer their children from stress (Almqvist & Brandell-Forsberg, 1995; Barenbaum et al., 2004), which is a view…”
Background
Development and validation of the child psychosocial distress screener in Burundi.
Jordans, M. J. D., Komproe, I. H., Ventevogel, P., Tol, W. A., & de Jong, J. T. V. M. (2008) · American Journal of Orthopsychiatry · doi:10.1037/a0014216 · Cited by 45
Communal Violence and Child Psychosocial Well-being: Qualitative Findings from Poso, Indonesia
Tol, W. A., Reis, R., Susanty, D., & de Jong, J. T. V. M. (2010) · Transcultural Psychiatry · doi:10.1177/1363461510364573 · Cited by 44
A Coordinated Mental Health Crisis Response: Lessons Learned From Three Colorado School Shootings
Crepeau‐Hobson, F., Sievering, K. S., Armstrong, C., & Stonis, J. (2012) · Journal of School Violence · doi:10.1080/15388220.2012.682002 · Cited by 44
“The reunification process is an important piece of the crisis response as the re-establishment of natural social support systems is often the only crisis intervention needed for many individuals ( Barenbaum, Ruchkin, & Schwab-Stone, 2004 ) and family members are often identified as the greatest source of support follo…”
Background
Trauma rehabilitation for war‐affected persons in northern Uganda: A pilot evaluation of the EMPOWER programme
Sonderegger, R., Rombouts, S., Ocen, B., & McKeever, R. S. (2010) · British Journal of Clinical Psychology · doi:10.1348/014466510x511637 · Cited by 44
Daily stressors in the lives of Sri Lankan youth: a mixed methods approach to assessment in a context of war and natural disaster
Miller, K. E., Fernando, G. A., & Berger, D. E. (2009) · Intervention · doi:10.1097/wtf.0b013e3283346344 · Cited by 43
Victims and/or perpetrators? Towards an interdisciplinary dialogue on child soldiers
Derluyn, I., Vandenhole, W., Parmentier, S., & Mels, C. (2015) · BMC International Health and Human Rights · doi:10.1186/s12914-015-0068-5 · Cited by 43
“Not only are children forcibly recruited as child soldiers and thus actively participate in the armed conflict, also the frequently ethnic nature of these conflicts, amongst others, can turn every civilian into a potential victim or a perpetrator ready to defend his/her group’s interests [21].”
Background

Authors: Barenbaum, J., Ruchkin, V., & Schwab‐Stone, M.
Affiliations: Yale University (US)
Corresponding author: Ruchkin, Vladislav
ORCID: Ruchkin, Vladislav
Venue: Journal of Child Psychology and Psychiatry
Publisher: Wiley
Published: 2004-01
Volume: 45
Issue: 1
Pages: 41-62
ISSN: 0021-9630 (ISSN-L)
1469-7610
DOI: 10.1046/j.0021-9630.2003.00304.x
OpenAlex: W1998495462
Cited by: 341
References: 190
Citations by year: 2026: 6 · 2025: 6 · 2024: 11 · 2023: 9 · 2022: 12 · 2021: 9 · 2020: 18 · 2019: 17 · 2018: 13 · 2017: 16 · 2016: 15 · 2015: 16 · 2014: 15 · 2013: 34 · 2012: 18
FWCI: 13.68
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 8 d)
Locations: Journal of Child Psychology and Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
Keywords: war-affected children, child mental health, psychosocial trauma, child development, trauma intervention, injury prevention, humanitarian policy, civilian trauma
MeSH terms: Child, Culture, Humans, Psychology, Public Policy, Stress Disorders, Post-Traumatic, Warfare

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The psychosocial aspects of children exposed to war: practice and policy initiatives

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