战争无声的创伤:对冲突地区儿童的身心影响和国际法律影响

Pietro Ferrara , Margherita Zona , Ida Giardino , Francesca Scaltrito , Clara Pettoello-Mantovani , Ignazio Cammisa
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引用次数: 0

摘要

身处战争中的儿童面临着一系列独特的逆境,远远超出了暴力和流离失所的直接威胁。虽然直接后果——如身体伤害、失去亲人和家园被毁——令人深感痛苦,但更为隐蔽和持久的损害往往源于关键发育过程的中断。武装冲突破坏了儿童健康发展所需的基本要素,包括情感安全、持续照料、教育、可获得的医疗保健、稳定的社会网络和人身安全。生活在冲突地区或逃离冲突地区的心理影响渗透到儿童生活的各个方面。社区基础设施的崩溃、被迫流离失所和长期的不确定性严重限制了同伴互动、有组织的游戏和社会学习经验的机会,而这些对塑造自我概念、同理心和情绪调节至关重要。在恐惧、不信任和暴力变得常态化的环境中,儿童可能难以形成安全的依恋关系或设想一个充满希望的未来。人们普遍认为,环境和背景因素对儿童的发展轨迹产生深远的影响,包括认知、情感和身体领域。研究一贯强调社区安全、获得保健和教育的机会以及社会经济稳定在形成发展成果方面的作用。在神经生物学水平上,长期暴露于压力会激活调节系统,如下丘脑-垂体-肾上腺(HPA)轴,如果持续参与,会干扰大脑的成熟。这种失调通常与记忆、注意力、语言习得和执行功能的损伤有关,并与内化障碍(如创伤后应激障碍(PTSD)、焦虑、抑郁和依恋相关困难)的易感性增加有关。从生理上讲,长期的压力会削弱免疫功能,扰乱睡眠模式,阻碍身体发育,增加急性健康问题和慢性疾病的风险。战争对儿童的普遍和多方面影响不仅要求进行学术调查,而且要求立即作出道德和政策反应。这篇文章强调,对创伤在整个发育系统中的影响进行细致入微的理解,对于告知有针对性的、创伤反应性的干预措施至关重要。其目的是提高人们对制定有效战略的重要性的重视,这些战略不仅必须优先考虑治疗个别症状,而且必须优先考虑旨在预防和系统恢复的更广泛努力,从而增强复原力并促进受冲突影响社区的长期恢复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The silent wounds of war: Psycho-physical impacts and international legal implications for children in conflict zones
Children exposed to war confront a distinct array of adversities that extend far beyond the immediate threats of violence and displacement. While the direct consequences—such as physical harm, the loss of loved ones, and the destruction of homes—are profoundly distressing, the more insidious and enduring damage often stems from the disruption of critical developmental processes. Armed conflict undermines the foundational elements required for healthy childhood development, including emotional security, consistent caregiving, education, accessible healthcare, stable social networks, and physical safety. The psychological impact of living in, or fleeing from, conflict zones infiltrates all aspects of a child's life. The breakdown of community infrastructure, forced displacement, and prolonged uncertainty severely limit opportunities for peer interaction, structured play, and social learning—experiences that are vital for shaping self-concept, empathy, and emotional regulation. In environments where fear, mistrust, and violence become normalized, children may struggle to form secure attachments or to envision a hopeful future. It is widely recognized that environmental and contextual factors exert a profound influence on children's developmental trajectories, encompassing cognitive, emotional, and physical domains. Research consistently highlights the role of neighborhood safety, access to healthcare and education, and socioeconomic stability in shaping developmental outcomes. At the neurobiological level, chronic exposure to stress activates regulatory systems such as the hypothalamic–pituitary–adrenal (HPA) axis, which, when persistently engaged, can interfere with brain maturation. This dysregulation is often associated with impairments in memory, attention, language acquisition, and executive functioning, and with increased susceptibility to internalizing disorders such as post-traumatic stress disorder (PTSD), anxiety, depression, and attachment-related difficulties.
Physiologically, prolonged stress can weaken immune function, disturb sleep patterns, hinder somatic growth, and elevate the risk of both acute health problems and chronic diseases. The pervasive and multi-dimensional impact of war on children calls not only for academic inquiry but also for immediate ethical and policy responses. This article emphasizes that a nuanced understanding of trauma's effects across developmental systems is critical to inform targeted, trauma-responsive interventions.
The aim is to raise attention on the importance of establishing effective strategies, which must prioritize not only the treatment of individual symptoms but also broader efforts aimed at prevention and systemic recovery, thereby fostering resilience and contributing to the long-term rehabilitation of communities affected by conflict.
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Global pediatrics
Global pediatrics Perinatology, Pediatrics and Child Health
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