| This dissertation focuses on children's psychological and behavioral responses to war trauma, specifically on 182 Cambodian refugee adolescents, ages 12 and 13, who were survivors of the Pol Pot regime and residents of the Site Two refugee camp in Thailand. Subjects were exposed to prolonged war trauma conditions consisting of deprivations of food, water, shelter, and medical care; witnessing the death of family or friends; exposure to shelling and bombing; imprisonment; beatings and injuries; and separation from family. Unlike past studies on children, war trauma and post-traumatic stress disorder, this study systematically tests the relationship between specific war trauma events and psychological and behavioral problems, assessed via a culturally sensitive survey and a self-evaluation instrument, the Youth Self Report (YSR) (Achenbach, 1991). The objectives of this study are to determine the relationship between the total number of behavior problems, chronic problems, and tendencies toward internalizing/externalizing behaviors (from the YSR) with specific war trauma events, levels of trauma, and children's total trauma experience and to identify a set of culture-specific syndromes including a culture-specific trauma syndrome.; The Cambodian refugee children in this subject sample had more behavior and psychological problems than the children in Achenbach's normative Western sample. The expectation that Cambodian refugee children use internalization to express their behaviors and emotions was confirmed. Contrary to expectations, the number of war trauma events and levels of war trauma were not highly correlated with the total number of problems experienced.; However, a principal component analysis and varimax rotation conducted on the individual behavior problem items listed in the YSR yielded 11 culture- and war-specific syndromes. Correlations of the 11 syndromes with trauma confirmed a culture-specific trauma syndrome for the children in this sample. This 20-item syndrome consisted of symptoms of hyperactivity, poor concentration, attention-seeking behaviors, and fearfulness. Nightmares, a pathognomic symptom of the DSM III-R diagnosis of post-traumatic stress disorder and a universal indicator of emotional distress in children, correlated highly with level of trauma and with the trauma syndrome as did specific war trauma events with the syndrome scores on the YSR and the trauma syndrome. |
