Family violence, war, and natural disasters: A study of the effect of extreme stress on children's mental health in Sri Lanka
Open accessAbstract
BACKGROUND: The consequences of war violence and natural disasters on the mental health of children as well as on family dynamics remain poorly understood. Aim of the present investigation was to establish the prevalence and predictors of traumatic stress related to war, family violence and the recent Tsunami experience in children living in a region affected by a long-lasting violent conflict. In addition, the study looked at whether higher levels of war violence would be related to higher levels of violence within the family and whether this would result in higher rates of psychological problems in the affected children. METHODS: 296 Tamil school children in Sri Lanka's North-Eastern provinces were randomly selected for the survey. Diagnostic interviews were carried out by extensively trained local Master level counselors. PTSD symptoms were established by means of a validated Tamil version of the UCLA PTSD Index. Additionally, participants completed a detailed checklist of event types related to organized and family violence. RESULTS: 82.4% of the children had experienced at least one war-related event. 95.6% reported at least one aversive experience out of the family violence spectrum. The consequences are reflected in a 30.4% PTSD and a 19.6% Major Depression prevalence. Linear regression analyses showed that fathers' alcohol intake and previous exposure to war were significantly linked to the amount of maltreatment reported by the child. A clear dose-effect relationship between exposure to various stressful experiences and PTSD was found in the examined children. CONCLUSION: Data argue for a relationship between war violence and violent behavior inflicted on children in their families. Both of these factors, together with the experience of the recent Tsunami, resulted as significant predictors of PTSD in children, thus highlighting the detrimental effect that the experience of cumulative stress can have on children's mental health.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A survey one year after the Tsunami in the North-East of Sri Lanka showed a PTSD prevalence of 30.4% in a sample of school children.
“a survey conducted one year after the Tsunami in the North-East of Sri Lanka showed a PTSD prevalence of 30.4% in a sample of school children”
From Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in north-east Sri Lanka (2009) · cites this paper as [29]
In that survey, 30% of the children had not been affected by the Tsunami.
“out of which 30% had not even been affected by the Tsunami [29]”
From Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in north-east Sri Lanka (2009) · cites this paper as [29]
In that survey, 49% reported war experiences that had occurred in the past year.
“but 49% reported war experiences that had occurred in the past year.”
From Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in north-east Sri Lanka (2009) · cites this paper as [29]
Five questions related to the Tsunami experience were added to estimate the severity of Tsunami exposure.
“To estimate the severity of Tsunami exposure in the two post-Tsunami samples, five questions related to the Tsunami experience were added [29].”
From Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in north-east Sri Lanka (2009) · cites this paper as [29]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139 · see citing works
(1998) · PubMed · Cited by 10,216 · see citing works
The mini international neuropsychiatric interview
Lecrubier, Y., Sheehan, D. V., Hergueta, T., & Weiller, E. (1998) · European Psychiatry · doi:10.1016/s0924-9338(99)80239-9 · Cited by 5,882 · see citing works
Initial reliability and validity of a new retrospective measure of child abuse and neglect
(1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.8.1132 · Cited by 3,577 · see citing works
The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence
(1985) · American Journal of Psychiatry · doi:10.1176/ajp.142.11.1259 · Cited by 2,538 · see citing works
Straus, M., Hamby, S., Finkelhor, D., Moore, D. W., & Runyan, D. K. (1998) · International Journal of Child Abuse & Neglect · doi:10.1016/s0145-2134(97)00174-9 · Cited by 2,528 · see citing works
New and old wars: organized violence in a global era
Lopes, L. A. (1999) · Choice Reviews Online · doi:10.5860/choice.36-6532 · Cited by 2,096 · see citing works
Widom, C. S. (1989) · Science · doi:10.1126/science.2704995 · Cited by 1,976 · see citing works
The Effects of Family and Community Violence on Children
Margolin, G., & Gordis, E. B. (2000) · Annual Review of Psychology · doi:10.1146/annurev.psych.51.1.445 · Cited by 1,252 · see citing works
The University of California at Los Angeles post-traumatic stress disorder reaction index
Steinberg, A. M., Brymer, M. J., Decker, K. B., & Pynoos, R. S. (2004) · Current Psychiatry Reports · doi:10.1007/s11920-004-0048-2 · Cited by 1,212 · see citing works
Chaffin, M. J., Kelleher, K. J., & Hollenberg, J. A. (1996) · Child Abuse & Neglect · doi:10.1016/s0145-2134(95)00144-1 · Cited by 722 · see citing works
Alcohol abuse in individuals exposed to trauma: A critical review.
Stewart, S. H. (1996) · Psychological Bulletin · doi:10.1037/0033-2909.120.1.83 · Cited by 613 · see citing works
Growing up with parental alcohol abuse
Dube, S. R., Anda, R. F., Felitti, V. J., Croft, J. B., Edwards, V. J., & Giles, W. H. (2001) · Child Abuse & Neglect · doi:10.1016/s0145-2134(01)00293-9 · Cited by 536 · see citing works
Maxfield, M. G. (1996) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1996.02170290056009 · Cited by 504 · see citing works
Intergenerational transmission of abuse: A two-generational prospective study of an at-risk sample
Pears, K. C., & Capaldi, D. M. (2001) · Child Abuse & Neglect · doi:10.1016/s0145-2134(01)00286-1 · Cited by 493 · see citing works
Neuner, F., Schauer, M., Karunakara, U. K., Klaschik, C., Robert, C., & Elbert, T. R. (2004) · BMC Psychiatry · doi:10.1186/1471-244x-4-34 · Cited by 466 · see citing works
Self-citationPsychiatric Comorbidity in Children after the 1988: Earthquake in Armenia
Goenjian, A. K., Pynoos, R. S., Steinberg, A. M., Najarian, L. M., Asarnow, J. R., Karayan, I., GHURABI, M., & Fairbanks, L. A. (1995) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199509000-00015 · Cited by 428 · see citing works
Posttraumatic Stress and Depressive Reactions Among Nicaraguan Adolescents After Hurricane Mitch
Goenjian, A. K., Molina, L., Steinberg, A. M., Fairbanks, L. A., Alvarez, M. L., Goenjian, H. A., & Pynoos (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.5.788 · Cited by 379 · see citing works
Goenjian, A. K., Steinberg, A. M., Najarian, L. M., Fairbanks, L. A., Tashjian, M., & Pynoos, R. S. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.6.911 · Cited by 376 · see citing works
Thienkrua, W. (2006) · JAMA · doi:10.1001/jama.296.5.549 · Cited by 367 · see citing works
Prevalence and Effects of Child Exposure to Domestic Violence
Fantuzzo, J. W., & Mohr, W. K. (1999) · The Future of Children · doi:10.2307/1602779 · Cited by 354 · see citing works
Freisthler, B., Merritt, D. H., & LaScala, E. A. (2006) · Child Maltreatment · doi:10.1177/1077559506289524 · Cited by 340 · see citing works
Posttraumatic stress disorder in elderly and younger adults after the 1988 earthquake in Armenia
Goenjian, A. K., Najarian, L. M., Pynoos, R. S., Steinberg, A. M., Manoukian, G., Tavosian, A., & Fairbanks, L. A. (1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.6.895 · Cited by 332 · see citing works
Dixon, L., Browne, K. D., & Hamilton-Giachritsis, C. E. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.00339.x · Cited by 312 · see citing works
Comorbidity of PTSD and depression among refugee children during war conflict
Thabet, A. A. M., Abed, Y. A., & Vostanis, P. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.00243.x · Cited by 311 · see citing works
Neuner, F., Schauer, E., Catani, C., Ruf, M., & Elbert, T. (2006) · Journal of Traumatic Stress · doi:10.1002/jts.20121 · Cited by 196 · see citing works
Self-citationTen years after the genocide: Trauma confrontation and posttraumatic stress in Rwandan adolescents
Schaal, S., & Elbert, T. R. (2006) · Journal of Traumatic Stress · doi:10.1002/jts.20104 · Cited by 188 · see citing works
Trauma-related impairment in children—A survey in Sri Lankan provinces affected by armed conflict
Elbert, T., Schauer, M., Schauer, E., Huschka, B., Hirth, M., & Neuner, F. (2009) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2008.02.008 · Cited by 167 · see citing works
Self-citationSexually and physically abused foster care children and posttraumatic stress disorder.
Dubner, A. E., & Motta, R. W. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.67.3.367 · Cited by 162 · see citing works
Tolan, P. H., Gorman‐Smith, D., & Henry, D. B. (2005) · Annual Review of Psychology · doi:10.1146/annurev.psych.57.102904.190110 · Cited by 155 · see citing works
The development of posttraumatic stress disorder following four different types of traumatization
Saigh, P. A. (1991) · Behaviour Research and Therapy · doi:10.1016/0005-7967(91)90110-o · Cited by 129 · see citing works
Risk factors for suicide attempts among African American women
Kaslow, N., Thompson, M. P., Meadows, L. A., Chance, S., Puett, R., Hollins, L., Jessee, S., & Kellermann, A. (2000) · Depression and Anxiety · doi:10.1002/1520-6394(2000)12:1 · Cited by 129 · see citing works
Post-traumatic stress disorder in child witnesses to domestic violence.
Kilpatrick, K. L., & Williams, L. M. (1997) · American Journal of Orthopsychiatry · doi:10.1037/h0080261 · Cited by 123 · see citing works
Sexually and physically abused foster care children and posttraumatic stress disorder.
Dubner, A. E., & Motta, R. W. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.67.3.367 · Cited by 116 · see citing works
Glenn, D. M., Beckham, J. C., Feldman, M. E., Kirby, A. C., Hertzberg, M. A., & Moore, S. D. (2002) · Violence and Victims · doi:10.1891/vivi.17.4.473.33685 · Cited by 115 · see citing works
Psychiatric disorders in adolescents exposed to domestic violence and physical abuse.
Pelcovitz, D., Kaplan, S. J., DeRosa, R. R., Mandel, F. S., & Salzinger, S. (2000) · American Journal of Orthopsychiatry · doi:10.1037/h0087668 · Cited by 114 · see citing works
The Effect of Combat-Related Posttraumatic Stress Disorder on the Family
Solomon, Z. (1988) · Psychiatry · doi:10.1080/00332747.1988.11024407 · Cited by 85 · see citing works
Kuwert, P., Spitzer, C., Träder, A., Freyberger, H. J., & Ermann, M. (2006) · International Psychogeriatrics · doi:10.1017/s104161020600442x · Cited by 74 · see citing works
Incidence and Correlates of Posttrauma Symptoms in Children From Backgrounds of Domestic Violence
Mertin, P. G., & Mohr, P. B. (2002) · Violence and Victims · doi:10.1891/vivi.17.5.555.33712 · Cited by 66 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
McKay, M. T., Cannon, M., Chambers, D., Conroy, R. M., Coughlan, H., Dodd, P., Healy, C., O’Donnell, L., & Clarke, M. C. (2021) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13268 · Cited by 480 · see citing works
The emerging evidence for Narrative Exposure Therapy: A review
Robjant, K., & Fazel, M. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.07.004 · Cited by 397 · see citing works
Catani, C., Kohiladevy, M., Ruf, M., Schauer, E., Elbert, T., & Neuner, F. (2009) · BMC Psychiatry · doi:10.1186/1471-244x-9-22 · Cited by 290 · see citing works
Self-citationPsychological impact of disasters on children: review of assessment and interventions
Kar, N. (2009) · World Journal of Pediatrics · doi:10.1007/s12519-009-0001-x · Cited by 254 · see citing works
TOL, W. A., KOMPROE, I. H., JORDANS, M. J. D., VALLIPURAM, A., SIPSMA, H., SIVAYOKAN, S., MACY, R. D., & DE JONG, J. T. (2012) · World Psychiatry · doi:10.1016/j.wpsyc.2012.05.008 · Cited by 176 · see citing works
Posttraumatic Stress Disorder in Maltreated Youth: A Review of Contemporary Research and Thought
Kearney, C. A., Wechsler, A., Kaur, H., & Lemos-Miller, A. (2010) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-009-0061-4 · Cited by 169 · see citing works
Six rapid assessments of alcohol and other substance use in populations displaced by conflict
Ezard, N., Oppenheimer, E., Burton, A., Schilperoord, M., Macdonald, D., Adelekan, M., Sakarati, A., & van Ommeren, M. (2011) · Conflict and Health · doi:10.1186/1752-1505-5-1 · Cited by 160 · see citing works
Neuner, F., Catani, C., Ruf, M., Schauer, E., Schauer, M., & Elbert, T. (2008) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2008.03.001 · Cited by 130 · see citing works
Self-citationRoth, M., Neuner, F., & Elbert, T. (2014) · International Journal of Mental Health Systems · doi:10.1186/1752-4458-8-12 · Cited by 129 · see citing works
Self-citationRieder, H., & Elbert, T. (2013) · Conflict and Health · doi:10.1186/1752-1505-7-6 · Cited by 112 · see citing works
Extreme weather-driven disasters and children's health
Garcia, D. M., & Sheehan, M. C. (2016) · International Journal of Health Services · doi:10.1177/0020731415625254 · Cited by 98 · see citing works
Murphy, S., Elklit, A., Dokkedahl, S., & Shevlin, M. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.32678 · Cited by 71 · see citing works
PTSD, depression and anxiety among former abductees in Northern Uganda
Pfeiffer, A., & Elbert, T. (2011) · Conflict and Health · doi:10.1186/1752-1505-5-14 · Cited by 71 · see citing works
The silent crisis of child abuse in the COVID‐19 pandemic: A scoping review
Karbasi, Z., Safdari, R., & Eslami, P. (2022) · Health Science Reports · doi:10.1002/hsr2.790 · Cited by 29 · see citing works
- Authors
- Catani, C., Jacob, N., Schauer, E., Kohila, M., & Neuner, F.
- Affiliations
- University of Konstanz (DE)
- Corresponding author
- Catani, Claudia
- Venue
- BMC Psychiatry
- Published
- 2008-05-02
- Volume
- 8
- Issue
- 1
- Pages
- 33-33
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC2386780
- OpenAlex
- W2159525654
- Cited by
- 423
- References
- 39
- Citations by year
- 2026: 5 · 2025: 21 · 2024: 21 · 2023: 19 · 2022: 16 · 2021: 17 · 2020: 76 · 2019: 19 · 2018: 29 · 2017: 25 · 2016: 24 · 2015: 31 · 2014: 29 · 2013: 30 · 2012: 14
- FWCI
- 17.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- KOPS (University of Konstanz) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- child mental health, post-traumatic stress disorder, domestic violence, war violence, natural disasters, 2004 Indian Ocean tsunami, cumulative stress, child abuse, Sri Lankan civil war, childhood depression
- MeSH terms
- Adolescent, Child, Demography, Disasters, Family, Female, Health Surveys, Humans, Interviews as Topic, Male, Mental Health, Surveys and Questionnaires, Schools, Sri Lanka, Stress, Psychological, Violence, Warfare
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
