Displaced Adolescents In Croatia: Sources Of Stress And Posttraumatic Stress Reaction - Statistical Data Included

Adolescence, Spring, 1998 by Marina Ajdukovic

ABSTRACT

This study explored sources of stress and psychosocial reactions of adolescents displaced as a result of the war in the Republic of Croatia. The most frequent stressful events they faced were loss of home (80%), loss of personal belongings (66.7%), separation from family members (66.7%), damage to property (48.9%), exposure to enemy attacks (46.7%), and death of a family member or friend (37.8%). Among the most frequent posttraumatic stress reactions were intrusive images (48.9%), loss of interest (40.9%), restlessness (37.8%), appetite disturbances (33.3%), and increased irritability (31.1%). The exposure to a greater number of stressful events was related to increased depression. More posttraumatic stress reactions were evident in females, in adolescents who were exiled for longer periods, and in those whose parents were more anxious. Adolescents who manifested a higher number of stress reactions had poorer expectations regarding their future.

Adolescence, defined here as the transition from childhood to adulthood, is a critical period of development characterized by dramatic physiological, emotional, and cognitive changes. Family values are challenged as the adolescent strives for independence. It is a time when persons become increasingly aware of themselves as social beings, and the establishment of an adult identity, a complex and demanding process, is initiated. Erikson (1982) has stated that the identity established by the end of adolescence includes identifications with past significant figures, modified to fashion a unique and integrated individual.

The adolescent begins to make important decisions, ones that will permanently affect future life. Such decisions involve education, family, and health, and the consequences may lead to confusion, excitement, frustration, or anxiety. It is not surprising, then, that adolescence has been referred to as a period of "storm and stress" (Seifert & Hoffnung, 1987).

Adolescents who grow up in a war environment face issues of security and social structure that threaten normal biopsychosocial development. Their lives and the lives of their family and friends are at risk daily. They may have lost or been separated from family members, and been uprooted or expelled from their homes. Their parents are typically unemployed, and relations within the family dramatically altered.

The basic processes that characterize adolescence, such as separation from parents, choice of social role, and the search for an adult identity, cannot proceed normally in time of war. For example, separation from a parent, who may be missing, displaced, or in the military, complicates dependence-independence issues. Another example is when adolescents have lost their peer group and must find a new one in which socialization can take place.

War brings into question many traditional ethical values, such as "do not kill" and "love your fellow man." As a result, formation of a personal, group, and "philosophical" identity is, at best, difficult. Thus, it is inevitable that war-related stress intensifies adolescent anxiety, impulsiveness, and identity crises (Pregrad, 1993).

Exposure to traumatic experiences can cause a temporary increase in adolescents' risk-taking behavior (Newman, 1976; Pynoos & Nader, 1993; Bell & Bell, 1993). Traumatized adolescents may drop out of school, engage in promiscuous sexual activity, and abuse drugs or alcohol. Juvenile delinquency, eating disorders, and other maladaptive behaviors are common. Such behaviors--a "turning against oneself"--are frequently described as a defense mechanism. Pregrad (1993) states that adolescents "are too old to work out their trauma through play or to annul it through fantasies, so they turn to self-destruction to maintain distance and keep the painful memories away and to make up for their guilty feelings." (p. 197).

While studies addressing the effect of war and displacement on younger children's development are numerous, there is a dearth of knowledge about adolescents' adjustment when under such circumstances. This study explored some sources of stress and psychosocial reactions among displaced adolescents.

METHOD

Data were collected as part of a comprehensive program of psychosocial assistance provided to families at a refugee center in Zagreb, Croatia, which has sheltered people since July 1991. The study was undertaken in order to (1) identify sources of stress, (2) identify families and individuals with adjustment difficulties, and (3) determine the effects of supportive activities on displaced families.

Subjects

Forty-five adolescents (25 males and 20 females) participated. Their average age was 17.1 years (range = 14-19). The majority (95.6%) attended high school. At the time of the study, the average length of displacement was 18 months.

Instruments

Ten instruments were administered to determine psychosocial reactions and sources of stress: (1) stress events, (2) posttraumatic stress reactions in exile scale, (3) appraisal of the refugee situation scale, (4) depression scale (Zung, 1965), (5) expectations scale, (6) competence scale (Bezinovic, 1990), (7) external locus of control scale (Bezinovic, 1990), (8) psychosocial climate scale, (9) family relation scale, and (10) structured interview. The instruments were chosen according to a previously published model for providing psychosocial assistance to refugees (D. Ajdukovic, 1993), and were administered during an extensive interview. Interviews were conducted by senior students in social work and psychology who had worked with the youths since September 1991.