Traumatic Loss, Grief, and Developmental Disruptions in War-Exposed Adolescents: A Three-Wave Study of Postwar Adversities and Adjustment.

Abstract

ObjectiveAn exploratory-descriptive three-wave survey was designed to explore the nature of wartime and postwar trauma, bereavement, grief, and developmental disruptions in war-exposed Bosnian adolescents; and to guide theory building, intervention, and policy. Specific aims included describing: Prevalence rates of war exposure types, war-related disruptions to social networks (traumatic deaths, disappearances, natural deaths, separations), short- and long-term postwar adversities, adolescent postwar grief reactions, and war-related disruptions in developmentally sensitive life domainsg. Method: A three-wave self-report survey (conducted 1.5-2.5 years after the Bosnian civil war, across multiple geographic/ethnic regions) assessed prewar, wartime, and postwar experiences and psychosocial adjustment in war-exposed Bosnian secondary school students. Results: Students reported: (a) high rates of exposure to both high-magnitude types of war trauma (including traumatic losses) and postwar adversities; (b) extensive war-related disruptions to their social networks, including deaths to natural and unnatural causes, and separation from loved ones. Significant effects were found for sex, type of death, and type of grief; but not for their interaction, age, or geographic region/ethnicity. (c) Pervasive war-related developmental impacts-primarily slowdowns-were reported for impulse control, help-seeking, identity formation, moral development, and understanding political issues. Conclusions: Many families were struggling economically and interpersonally 2.5 years after the war. Pervasive disruptions in youths' social networks persisted. Interventions for war-exposed youth should address a diverse array of problems including traumatic losses, ongoing separations, interpersonal conflict, and disruptions in developmentally important life domains. Balanced, strength-based grief interventions should both facilitate adaptive grief reactions and therapeutically reduce unhelpful grief reactions.