EFFECTS OF WAR TRAUMA ON CAMBODIAN REFUGEE ADOLESCENTS FUNCTIONAL HEALTH AND MENTAL-HEALTH STATUS

Objective: To measure the effect of war trauma on the functional healt h and mental health status of Cambodian adolescents living in a refuge e camp on the Thai-Cambodian border. Method: A multistage probability sample identified 1,000 households in the camp known as Site Two. inte rviews were conducted in each household with randomly selected adults 18 years of age and older, All adolescents aged 12 and 13 years old, a long with one parent, were interviewed, One hundred eighty-two adolesc ents (94 girls, 88 boys) and their parents participated. Culturally se nsitive instruments were used, including Cambodian versions of the Chi ld Behavior Checklist (CBCL) and the Youth Self-Report (YSR). Results: Parents and adolescents reported the latter having experienced high l evers of cumulative trauma, especially lack of food, water, and shelte r. Mean Total Problem scares were in ranges similar to those of adoles cents receiving clinical care in the United States, Netherlands, and I srael. Nearly 54% (53.8%) had Total Problem scores in the clinical ran ge by parent report on the CBCL and 26.4% by adolescent report on the YSR. The most commonly reported symptoms were somatic complaints, soci al withdrawal, attention problems, anxiety, and depression. The dose-e ffect relationship between cumulative trauma and symptoms was strong f or parent reporting an the CBCL; the subscales on both the YSR and CBC L for Anxious/Depressed and Attention Problems revealed dose-effect as sociations. Dose-effect relationships between cumulative trauma and so cial functioning or health status were lacking. Conclusion: The high l evels of emotional distress in this population of Cambodian adolescent s and corresponding dose-effect relationships reveal the important neg ative psychosocial impact of violence on Cambodian adolescents. Lack o f findings related to physical health status and the presence of posit ive social functioning of many youths should not deter health care pro viders and public health officials from diagnosing and treating underl ying high levels of psychological distress.