Severe war trauma and post-traumatic stress disorder in adolescents with sensory impairments: a cross-sectional study

Abstract

A paucity of studies of the psychological status of adolescents with sensory impairments in political conflict areas is noted. This study was set up to examine the exposure of adolescents with sensory impairments (ASIs) to severe war trauma and development of posttraumatic stress disorder (PTSD) as compared to their able-bodied peers (ABPs). It also answers the question whether their impairments have made them more resilient in facing traumatic events. A cross-sectional study of all ASIs attending special schools in three administrative districts in Lebanon (n=166) as well as a group of 166 age and sex-matched ABPs from neighboring schools was conducted. The Post Traumatic Stress Reaction Checklist for children (PTSRC) was used to assess exposure to severe trauma, PTSD and their determinants. ASIs reported a lower exposure to severe traumatic events (24.1%) as compared to their ABPs (69.9%), and risk factors for their exposure were an older age group, a fatherless family, and severe visual impairment. Prevalence rates for PTSD were similar in the two study groups (17.5% and 16.4%). Younger ASIs were at a significantly higher risk of developing PTSD. Lower exposure to trauma among ASIs points to the more sheltered life that they lead. Given the same exposure as ABPs, similar rates of PTSD are noted among the two study groups. This may indicate that having a sensory impairment may protect from PTSD due to decreased exposure to severe trauma and not due to increased resilience of subjects.

Post-Traumatic Stress Disorder in Adolescents in Lebanon as Wars Gained in Ferocity: A Systematic Review

“…All the included studies measured PTSD as a primary outcome. PTSD diagnosis was based on DSM III criteria (4 studies), 13-16 DSM IIIR criteria (6 studies), 12 , 17-21 and DSM IV criteria (1 study). 22 The civil war (1975-1990) was covered by six studies, 12-17 the Grapes of Wrath War (1996) was covered by one study, 18 and the July 2006 war was covered by four studies.…”

“…19-22 Time elapsed between the war experience and data collection ranged between three weeks to four years ( Table 1 ). Risk of PTSD was based on the Post-Traumatic Stress Disorder Reaction Checklist for Children (PTSRC), 23 (two studies), 12 , 17 Children’s PTSD Inventory, 24 (four studies), 13-16 Children’s Revised Impact of Event Scale (CRIES), 25 (one study), 19 Diagnostic Interview for Children and Adolescents-Revised (DICA-R), 26 (two studies), 18 , 20 Davidson PTS Scale, 27 (one study), 21 and clinical interview (one study), 22 ( Table 1 ). Study designs were mainly cross-sectional surveys (8 studies).…”

“… 13-14 The schools were either private schools (2 studies), 15 , 16 public schools (2 studies), 20 , 22 or both public and private schools (5 studies). 17-19 , 21 One study included adolescents with sensory disabilities as the primary group. 17 Geographical regions covered were the capital Beirut (5 studies), 12-16 South Lebanon (2 studies), 20 , 22 and several regions in Lebanon (4 studies).…”

“… 17-19 , 21 One study included adolescents with sensory disabilities as the primary group. 17 Geographical regions covered were the capital Beirut (5 studies), 12-16 South Lebanon (2 studies), 20 , 22 and several regions in Lebanon (4 studies). 17-19 , 21 Sample sizes varied from 85 to 3109 for a total of 5965 adolescents ( Table 1 ).…”

“…The explanatory variables that were investigated besides age and sex were father’s occupation (3 studies), 12 , 17 , 22 mother’s education (2 studies), 12 , 22 financial difficulty (2 studies), 20 , 22 type of traumatic event (7 studies), 12 , 17 , 18-22 disability (one study), 17 self efficacy (one study), 15 scholastic impairment (one study), 16 and ideology and religiosity (one study). 22 …”