War-related exposure and psychological distress as predictors of health and sleep: a longitudinal study of Kuwaiti children

Psychosom Med. 2009 Sep;71(7):776-83. doi: 10.1097/PSY.0b013e3181ae6aee. Epub 2009 Jul 10.

Abstract

Objectives: 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.

Conclusion: Exposure to war-related events during childhood is associated with posttraumatic stress, poor sleep quality, high BMI, and poor self-reported health in adulthood.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Child
  • Child Behavior / psychology*
  • Combat Disorders / diagnosis
  • Combat Disorders / epidemiology
  • Combat Disorders / psychology
  • Female
  • Gulf War
  • Health Status
  • Humans
  • Iraq
  • Kuwait / epidemiology
  • Life Change Events*
  • Longitudinal Studies
  • Male
  • Obesity / diagnosis
  • Obesity / epidemiology
  • Obesity / psychology
  • Probability
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / psychology
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • Warfare*