Hasanović Mevludin, Sinanović Osman, Pavlović Slobodan
University Clinical Center Tuzla, Department of Psychiatry, Trnovac bb, 75000 Tuzla, Bosnia and Herzegovina.
Croat Med J. 2005 Feb;46(1):105-15.
To estimate the frequency, type, and severity of psychological trauma among Bosnian refugee adolescents during the process of repatriation after the 1992-1995 war in Bosnia and Herzegovina.
A sample of 239 pupils (120 girls and 119 boys), with a mean age (+/-standard deviation) of 15.2+/-2.1 years were assessed for war traumatic events, acculturation and repatriation maladjustments, school behavioral problems, and presence of post-traumatic stress disorder (PTSD). The sample consisted of adolescents who were in the process of repatriation after exile in a foreign country (n=120) and internally displaced adolescents (n=119).
Adolescents who had been exposed to severe psychological war trauma still had high level of trauma more than three years after the end of war. The level of recalling traumas they experienced (mean+/-standard deviation=3.9+/-1.2 on a scale from 0 to 5) and frequency of PTSD symptoms (1.5+/-1.0 on a scale from 0-5) were significantly lower among repatriated than internally displaced adolescents (4.4+/-0.7 and 2.2+/-1.1, respectively; P<0.001). The prevalence of PTSD did not differ between repatriated (56.7%) and internally displaced adolescents (68.1%). Returnees with more acculturation problems reported more functional and relational problems after return but less psycho-emotional dysfunctions. Those who adapted to the culture in the exile country had difficulties in adapting back to the culture in the home country.
PTSD was still very frequent among Bosnian refugee adolescents 3.5 years after the end of war. Adolescents who had spent more than five years as refugees in foreign countries had significantly lower level of experienced trauma recall and frequency of PTSD symptoms, as well as less anxious/depressed and withdrawn/depressed behavioral problems, and somatic complaints. Returnees who had more acculturation problems in exile reported more functional and relational problems but less psycho-emotional problems after repatriation. Schools and other institutions involved in the education of adolescents should develop programs to address these issues.
评估1992 - 1995年波斯尼亚和黑塞哥维那战争后波斯尼亚难民青少年在遣返过程中心理创伤的发生率、类型及严重程度。
对239名学生（120名女生和119名男生）进行评估，他们的平均年龄（±标准差）为15.2 ± 2.1岁，评估内容包括战争创伤事件、文化适应及遣返适应不良情况、学校行为问题以及创伤后应激障碍（PTSD）的存在情况。样本包括在国外流亡后正在遣返的青少年（n = 120）和国内流离失所的青少年（n = 119）。
经历过严重心理战争创伤的青少年在战争结束三年多后仍有较高的创伤水平。遣返青少年回忆起的创伤经历水平（平均±标准差，在0至5分的量表上为3.9 ± 1.2）和PTSD症状频率（在0 - 5分的量表上为1.5 ± 1.0）显著低于国内流离失所青少年（分别为4.4 ± 0.7和2.2 ± 1.1；P < 0.001）。遣返青少年（56.7%）和国内流离失所青少年（68.1%）的PTSD患病率无差异。文化适应问题较多的归国者回国后报告的功能和人际关系问题较多，但心理情绪功能障碍较少。那些适应了流亡国家文化的人在重新适应祖国文化方面存在困难。
战争结束3.5年后，PTSD在波斯尼亚难民青少年中仍然非常常见。在国外作为难民度过五年以上的青少年经历的创伤回忆水平、PTSD症状频率显著较低，焦虑/抑郁及退缩/抑郁行为问题和躯体不适也较少。在流亡中文化适应问题较多的归国者在遣返后报告的功能和人际关系问题较多，但心理情绪问题较少。参与青少年教育的学校和其他机构应制定方案来解决这些问题。
