Identifying Risk Profiles in War-Affected Children and Adolescents: Implications for Trauma-Informed Care

Abstract

Background:

Experiences associated with war, migration, and loss can result in complex psychological challenges in children and adolescents.

Aim:

The objective of this study was to identify distinct psychological profiles related to symptoms of depression and trauma among youth of Polish, Ukrainian, and displaced backgrounds.

Methods:

The study involved 222 participants aged 7 to 21 years, originating from Poland, Ukraine, and a group of displaced children from Ukraine. Hierarchical cluster analysis was conducted using the ITQ-CA questionnaire, while depressive symptoms were assessed with CDI-2. The obtained clusters were compared with psychological and sociodemographic factors.

Results:

The analysis identified two to three clusters with distinct symptom profiles. Cluster 1 was characterized by higher depressive symptoms and lower PTSD severity, whereas clusters 2 and 3 exhibited an opposite pattern. Factors such as age, exposure to war, loss experience, living arrangements, and interests distinguished cluster membership. Age was positively correlated with the severity of PTSD, although the degree of this relationship varied depending on the cluster. Additionally, associations were found between the frequency of healthcare utilization and the severity of psychopathological symptoms.

Conclusions:

Children and adolescents with war-related experiences do not constitute a homogeneous group in terms of psychological symptoms. In practice, this means that a one-size-fits-all approach to diagnosis and intervention is insufficient. Instead, profiling individual symptom patterns, considering factors like age, specific trauma exposures, living situations, and even engagement in hobbies, is essential for guiding trauma-informed care. The results have significant clinical implications for designing individualized, culturally sensitive psychological interventions, ensuring that support is specifically matched to the unique needs of each child or adolescent, rather than relying on broad diagnostic categories. For instance, interventions for younger children with higher depression may focus on emotional support, while older adolescents with higher PTSD may require targeted support for complex trauma.

Keywords

children’s trauma depression post-traumatic stress disorder (PTSD)war-driven migration

Get full access to this article

View all access options for this article.

References

Ajduković

(1993). Psychological well-being of refugee children. Child Abuse & Neglect, 17(6), 843–854. https://doi.org/10.1016/s0145-2134(08)80014-2

Barenbaum

Ruchkin

Schwab-Stone

(2004). The psychosocial aspects of children exposed to war: Practice and policy initiatives. Journal of Child Psychology and Psychiatry, 45(1), 41–62. https://doi.org/10.1046/j.0021-9630.2003.00304.x

Cloitre

Shevlin

Brewin

C. R.

Bisson

J. I.

Roberts

N. P.

Maercker

Karatzias

Hyland

(2018). The International Trauma Questionnaire: Development of a self-report measure of ICD-11 PTSD and complex PTSD. Acta Psychiatrica Scandinavica, 138(6), 536–546. https://doi.org/10.1111/acps.12956

Gerson

Rappaport

(2013). Traumatic stress and posttraumatic stress disorder in youth: Recent research findings on clinical impact, assessment, and treatment. Journal of Adolescent Health, 52(2), 137–143. https://doi.org/10.1016/j.jadohealth.2012.06.018

Gkintoni

Kourkoutas

Yotsidi

Stavrou

P. D.

Prinianaki

(2024). Clinical efficacy of psychotherapeutic interventions for post-traumatic stress disorder in children and Adolescents: A systematic review and analysis. Children, 11(5), 579. https://doi.org/10.3390/children11050579

Goto

Pinchuk

Kolodezhny

Pimenova

Kano

Skokauskas

(2024). Mental Health of adolescents exposed to the war in ukraine. JAMA Pediatrics, 178(5), 480. https://doi.org/10.1001/jamapediatrics.2024.0295

Haag

Fraser

Hiller

Seedat

Zimmerman

Halligan

S. L.

(2020). The emergence of sex differences in PTSD symptoms across development: Evidence from the ALSPAC cohort. Psychological Medicine, 50(10), 1755–1760. https://doi.org/10.1017/S0033291719001971

Jones

Kafetsios

(2002). Assessing adolescent mental health in war-affected societies: The significance of symptoms. Child Abuse & Neglect, 26(10), 1059–1080.

Joshi

P. T.

O’Donnell

D. A.

(2003). Consequences of child exposure to war and Terrorism. Clinical Child and Family Psychology Review, 6(4), 275–292. https://doi.org/10.1023/b:ccfp.0000006294.88201.68

10.

Kovacs

. (2011). Children’s depression inventory 2nd edition: Self-report. North Tonawanda, NY: Multi-Health Systems Inc

11.

Kuterovac-Jagodić

(2003). Posttraumatic stress symptoms in Croatian children exposed to war: A prospective study. Journal of Clinical Psychology, 59(1), 9–25. https://doi.org/10.1002/jclp.10114

12.

Meiser-Stedman

McKinnon

Dixon

Boyle

Smith

Dalgleish

(2019). A core role for cognitive processes in the acute onset and maintenance of post-traumatic stress in children and adolescents. Journal of Child Psychology and Psychiatry, 60(8), 875–884. https://doi.org/10.1111/jcpp.13054

13.

Pfefferbaum

Jacobs

A. K.

Griffin

Houston

J. B.

(2015). Children’s disaster reactions: The influence of exposure and personal characteristics. Current Psychiatry Reports, 17(7), 56. https://doi.org/10.1007/s11920-015-0598-5

14.

Pine

D. S.

Costello

Masten

(2005). Trauma, proximity, and developmental psychopathology: The effects of war and terrorism on children. Neuropsychopharmacology, 30(10), 1781–1792. https://doi.org/10.1038/sj.npp.1300814

15.

Punamäki

R. L.

(1996). Can ideological commitment protect children’s psychological well-being in situations of political violence? Child Development, 67(1), 55–69.

16.

Rossouw

Yadin

Alexander

Mbanga

Jacobs

Seedat

(2016). A pilot and feasibility randomised controlled study of prolonged exposure treatment and supportive counselling for post-traumatic stress disorder in adolescents: A third world, task-shifting, community-based sample. Trials, 17(1), 548. https://doi.org/10.1186/s13063-016-1677-6

17.

Sack

W. H.

Him

Dickason

(1999). Twelve-Year follow-up study of Khmer youths who suffered massive war trauma as children. Journal of the American Academy of Child and Adolescent Psychiatry, 38(9), 1173–1179. https://doi.org/10.1097/00004583-199909000-00023

18.

Stein

Comer

Gardner

Kelleher

(1999). Prospective study of displaced children’s symptoms in wartime Bosnia. Social Psychiatry and Psychiatric Epidemiology, 34(9), 464–469. https://doi.org/10.1007/s001270050221

19.

Y.-J.

Chen

S.-H.

(2015). Emerging posttraumatic growth: A prospective study with pre- and posttrauma psychological predictors. Psychological Trauma Theory Research Practice and Policy, 7(2), 103–111. https://doi.org/10.1037/tra0000008

20.

Trickey

Siddaway

A. P.

Meiser-Stedman

Serpell

Field

A. P.

(2012). A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents. Clinical Psychology Review, 32(2), 122–138. https://doi.org/10.1016/j.cpr.2011.12.001

21.

Wrocławska-Warchala

Wujcik

Kovacs

(2017). CDI2 set of questionnaires for the diagnosis of depression in children and adolescents [original: Zestaw kwestionariuszy do diagnozy depresji u dzieci i młodzieży CDI 2TM Maria Kovacs i zespół MHS]. Psychological Test Laboratory of the Polish Psychological Society [Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego].

22.

Zhang

Meiser-Stedman

Jones

Smith

Dalgleish

Boyle

Edwards

Subramanyam

Dixon

Sinclaire-Harding

Schweizer

Newby

McKinnon

(2022). Trajectory of post-traumatic stress and depression among children and adolescents following single-incident trauma. European Journal of Psychotraumatology, 13(1), 2037906. https://doi.org/10.1080/20008198.2022.2037906

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB