The Adverse Mental Health Outcomes in Early Childhood Following Exposure to War, Conflict, and Displacement

Background

Early childhood development is, from birth to age seven, fundamental aspects of a child's life. The UN Sustainable Development Goal 4, focusing on target 4.2, ensures universal access to high-quality early childhood development, care, and pre-primary education by 2030. However, achieving this goal faces significant hurdles in regions plagued by wars and conflicts. One in ten children is affected by armed conflicts including exposure to violence and displacement during such tumultuous times which disrupts the trajectory of early childhood development, leading to psychological ramifications such as post-traumatic stress disorder (PTSD), depression, anxiety, and various phobias. These adversities hinder children from experiencing a nurturing environment essential for their growth. Consequently, the mental and physical well-being of affected children is severely compromised. This study seeks to investigate the relationship between exposure to violence, war, conflict, and displacement and children's mental health outcomes, such as posttraumatic stress, depression, and anxiety. We also explore the moderation of parenting practice in this relationship.

Methods

We used the baseline data from the longitudinal study conducted by Semillas de Apego in Colombia. Children’s mental health outcomes were assessed using an adapted version of the Symptom Checklist-90 for caregivers and the Child Trauma Symptom Checklist for Young Children. The standardized variable ranges for depression, anxiety, and posttraumatic stress are 0-100. Multivariate linear regression models were conducted to explore the association of the outcomes and independent variables (number of exposures to violent events, experience of displacement, and parent stress score) and the interaction terms of independent variables with negative discipline, while controlling for variables including the child's age, sex, household size and both biological parents at the baseline.

Results

The study sample included 1,376 children, comprising 50.22% males and 49.78% females, and all aged between 1 and 5 years (Mean=2.51, SD=0.70). Approximately 50% of children had experienced forced displacement and had been victimized during conflicts. On average, scores for depression, anxiety, and trauma were 59.80 (SD=6.99), 57.09 (SD=6.87), 57.93 (SD=6.09), respectively. After controlling for age, sex, and household size, and both biological parents at the baseline, the number of violent events experienced by a child, experiences of displacement, parental stress, and negative disciplinary actions significantly predicting the level of depression, anxiety and posttraumatic stress, (R²=0.27, F (12, 1363)=42.19, p<0.001, R²=0.25, F(12, 1363)=38.36, p<0.001, and R²=0.33, F(12, 1363)=56.50, p<0.001), respectively. The interaction between the number of violent events experienced by a child and the parent stress is associated with depression and anxiety but not moderation the posttraumatic stress.

Conclusion

The exposure to violence and forced displacement in conflict areas on young children’s mental health are linked to forced displacement and exposure to violence in conflict areas. Additionally, parenting plays a crucial role in moderating depression, and anxiety. Based on the findings of our analysis, it is imperative to develop programs aimed at assisting families and children, thereby preventing long-term psychological consequences such as intergenerational trauma. Future research should concentrate on early childhood development to better understand the need for timely assistance and support.