Youth mental health after civil war: the importance of daily stressors.
Newnham EA., Pearson RM., Stein A., Betancourt TS.
BACKGROUND: Recent evidence suggests that post-conflict stressors in addition to war trauma play an important role in the development of psychopathology. AIMS: To investigate whether daily stressors mediate the association between war exposure and symptoms of post-traumatic stress and depression among war-affected youth. METHOD: Standardised assessments were conducted with 363 Sierra Leonean youth (26.7% female, mean age 20.9, s.d. = 3.38) 6 years post-war. RESULTS: The extent of war exposures was significantly associated with post-traumatic stress symptoms (P<0.05) and a significant proportion was explained by indirect pathways through daily stressors (0.089, 95% CI 0.04-0.138, P<0.001). In contrast, there was little evidence for an association from war exposure to depression scores (P = 0.127); rather any association was explained via indirect pathways through daily stressors (0.103, 95% CI 0.048-0.158, P<0.001). CONCLUSIONS: Among war-affected youth, the association between war exposure and psychological distress was largely mediated by daily stressors, which have potential for modification with evidence-based intervention.