Children of the postwar years: A two-generational multilevel risk assessment of child psychopathology in northern Uganda

• Published in: Development and psychopathology 2016-05, Vol.28 (2), p.607-620
• Main Authors: Saile, Regina, Ertl, Verena, Neuner, Frank, Catani, Claudia
• Format: Article
• Language: English
• Subjects: Child; Child psychology; Cross-Sectional Studies; Developmental psychology; Domestic Violence - psychology; Female; Humans; Intergenerational relationships; Male; Mental Disorders - etiology; Mental Disorders - psychology; Problem Behavior; Psychopathology; Regular Articles; Risk Assessment; Risk Factors; Surveys and Questionnaires; Uganda; Warfare
• ISSN: 0954-5794; 1469-2198
• DOI: 10.1017/S0954579415001066

In postconflict settings risk factors at multiple levels of the social ecology, including community, family, and relationship factors, potentially affect children's mental health. In addition, intergenerational risk factors such as guardians’ history of childhood family violence, war exposure, and psychopathology may contribute to children's psychopathological symptoms. In this study, we aimed to identify risk constellations that predict child internalizing and externalizing behavior problems, depression, and posttraumatic stress symptoms in the postconflict setting of northern Uganda. In a cross-sectional epidemiological study, 513 second-grade students and their female guardians were interviewed using standardized clinical questionnaires. A higher exposure to traumatic events, more witnessed or experienced violence within the family, and lower child-reported care from female guardians independently predicted psychopathological symptoms in children. While controlling for intergenerational risk factors in female guardians, serial mediation modeling revealed that the effect of trauma exposure on children's psychopathological symptoms was partially mediated by higher exposure to family violence and lower child-perceived care from female guardians. The mediation appeared to be stronger for children's depression symptoms and internalizing and externalizing behavior problems than for posttraumatic stress symptoms. The current findings support the need for targeted interventions at the individual and family system levels that are matched to children's psychopathological symptoms.