Goldstein R D, Wampler N S, Wise P H
Department of Social Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA.
Pediatrics. 1997 Nov;100(5):873-8. doi: 10.1542/peds.100.5.873.
The war in Bosnia has had a tremendous impact on civilians. Little is known about the impact of modern warfare on children. This survey documents the nature and frequency of war-related experiences among Bosnian children and describes their manifestations of selected psychological sequelae.
A cross-sectional survey of 364 internally displaced 6- to 12-year-old children and their parents living in central Bosnian collectives was conducted during the war. Parents were surveyed for their children's war experiences; the children were surveyed for war-related distress symptoms.
The children were exposed to virtually all of the surveyed war-related experiences. The majority had faced separations from family, bereavement, close contact with war and combat, and extreme deprivation. The prevalence and severity of experiences were not significantly related to a child's gender, wealth, or age, but were related to their region of residence, with children from the region of Sarajevo having the highest prevalence of experiences. Almost 94% of the children met Diagnostic and Statistical Manual of Mental Disorders, 4th ed, criteria for posttraumatic stress disorder. Significant life activity affecting sadness and anxiety were reported by 90.6% and 95.5% of the children, respectively. High levels of other symptoms surveyed were also found. Children with greater symptoms had witnessed the death, injury, or torture of a member of their nuclear family, were older, and came from a large city.
The war-related experiences of the children studied were both varied and severe, and were associated with a variety of psychological sequelae. This experience underscores the vulnerability of civilians in areas of conflict and the need to address the effects of war on the mental health of children.
波斯尼亚战争对平民产生了巨大影响。关于现代战争对儿童的影响，人们知之甚少。本次调查记录了波斯尼亚儿童与战争相关经历的性质和频率，并描述了他们某些心理后遗症的表现。
在战争期间，对居住在波斯尼亚中部集体住所中的364名6至12岁国内流离失所儿童及其父母进行了横断面调查。对父母就其子女的战争经历进行了调查；对儿童就与战争相关的痛苦症状进行了调查。
这些儿童几乎经历了所有被调查的与战争相关的经历。大多数儿童面临与家人分离、亲人丧亡、与战争和战斗的近距离接触以及极度匮乏。经历的普遍性和严重程度与儿童的性别、财富或年龄没有显著关系，但与他们的居住地区有关，来自萨拉热窝地区的儿童经历的普遍性最高。几乎94%的儿童符合《精神障碍诊断与统计手册》第4版中创伤后应激障碍的标准。分别有90.6%和95.5%的儿童报告了影响悲伤和焦虑的重大生活事件。还发现了所调查的其他症状的高水平。症状更严重的儿童目睹了其核心家庭成员的死亡、受伤或遭受酷刑，年龄较大，且来自大城市。
所研究儿童的与战争相关经历既多样又严重，并与多种心理后遗症相关。这一经历凸显了冲突地区平民的脆弱性以及应对战争对儿童心理健康影响的必要性。
