War-related exposure and psychological distress as predictors of health and sleep: a longitudinal study of Kuwaiti children.
OBJECTIVE
To determine whether exposure to war-related trauma during childhood predicted posttraumatic stress, self-reported health, sleep, and obesity in adulthood, and whether psychological distress mediated the relationships.


METHODS
We assessed 151 Kuwaiti boys and girls aged 9 to 12 years in 1993 to determine their level of exposure to war-related trauma during the Iraqi occupation and Gulf war, health complaints, and psychological distress. In 2003, 120 (79%) of the initial participants reported on their posttraumatic stress, general health, body mass index (BMI), and sleep quality. We tested a structural model where exposure to war-related trauma predicted psychological distress and health complaints 2 years after the war, and posttraumatic stress, self-reported health, BMI, and sleep quality and duration 10 years later, controlling for intermediary life events. We also tested effects of exposure to war-related trauma on self-reported health and sleep factors mediated by psychological distress.


RESULTS
Results indicated a direct effect of exposure on poor sleep quality and BMI. Exposure also predicted poor sleep quality through its association with concurrent posttraumatic stress. The effect of exposure on self-reported health was mediated by health complaints and psychological distress, which included symptoms of depression, anxiety, and posttraumatic stress.


CONCLUSIONS
Exposure to war-related events during childhood is associated with posttraumatic stress, poor sleep quality, high BMI, and poor self-reported health in adulthood.
Llabre
Maria Magdalena
MM
Department of Psychology, University of Miami, PO Box 248185, Coral Gables, FL 33124, USA. mllabre@miami.edu
Hadi
Fawzyiah
F
D000328:Adult; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D047830:Gulf War; D006304:Health Status; D006801:Humans; D007493:Iraq; D007730:Kuwait / Q000453:epidemiology; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011336:Probability; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014857:Warfare