title: Differential roles of childhood adversities and stressful war experiences in the development of mental health symptoms in post-war adolescents in northern Uganda.
abstract: BACKGROUND
  Previous studies have shown a relationship between stressful war experiences and mental health symptoms in children and adolescents. To date, no comprehensive studies on the role of childhood adversities have been conducted with war-exposed adolescents living in post-war, low-resource settings in Sub-Saharan Africa.
  
  
  METHODS
  A cross-sectional study of 551 school-going adolescents aged 13-21 years old was undertaken four years post-war in northern Uganda. Participants completed self-administered questionnaires assessing demographics, stressful war experiences, childhood adversities, posttraumatic stress disorder (PTSD), depression, and anxiety symptoms.
  
  
  RESULTS
  Our analyses revealed a main effect of gender on all mental health outcomes except avoidance symptoms, with girls reporting higher scores than boys. Stressful war experiences were associated with all mental health symptoms, after adjusting for potential confounders. Childhood adversity was independently associated with depression symptoms but not PTSD, anxiety, and PTSD cluster symptoms. However, in situations of high childhood adversity, our analyses showed that stressful war experiences were less associated with vulnerability to avoidance symptoms than in situations of low childhood adversity.
  
  
  CONCLUSIONS
  Both stressful war experiences and childhood adversities are risk factors for mental health symptoms among war-affected adolescents. Adolescents with histories of high childhood adversities may be less likely to develop avoidance symptoms in situations of high stressful war experiences. Further exploration of the differential roles of childhood adversities and stressful war experiences is needed.
authors.affiliation: Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. drokellojames@gmail.com.
authors.forename: James
authors.initials: J
authors.lastname: Okello
authors.forename: Maarten
authors.initials: M
authors.lastname: De Schryver
authors.forename: Seggane
authors.initials: S
authors.lastname: Musisi
authors.forename: Eric
authors.initials: E
authors.lastname: Broekaert
authors.forename: Ilse
authors.initials: I
authors.lastname: Derluyn
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008603:Mental Health; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires; D014454:Uganda; D014857:Warfare; D055815:Young Adult