Hina Saeed, Sehar Hassan, Gul Husain.
Risk and protective factors for traumatic stress in adolescents influenced by Swat crisis.
Pak Paed J Jan ;35(2):76-80.

Objective: To explore risk and protective factors associated with post-traumatic stress in children influenced by insurgency situation in Swat. Design: Descriptive with Cross-sectional study design Place and Duration of Study: Mingora City of Swat. April 2010 to June, 2010. Subjects and Methods: The sample for study comprised of 193 adolescents including (N=102 girls) and (N=91boys). They were selected from educational institutions of Swat. The mean age was 16.5 years. 63% of participants were in 9th and 10th grade and 36.8% were in 11th and 12th grade. Adolescents were examined by a pediatrician to rule out presence of any physical disease or disability. A set of questionnaire comprising of demographic sheet, scale assessing physical and emotional proximity to incident, amount of social support received and PTSD symptom checklist were administered. Data was analyzed using SPSS version 13. Discrete variables were expressed as frequencies. Chi-square test was applied to assess the significance of results. P-value of <0.05 was considered significant. Results: 46% of participants reported indirect exposure to insurgency situation, 14% reported that they witnessed shelling and bomb blasts, 6.2% saw the open firing and 5.2% had witnessed bombing through helicopter. 72.5% (N=193) adolescents scored above the cutoff score which was 40 on PTSD symptom checklist. Females had significantly higher scores on PTSD symptom checklist compared to males at p<.001. No significant difference in mean scores on PTSD symptom in different levels of physical proximity. Adolescents who reported high emotional proximity had significantly (p<.005) higher mean score as compared to others. Social support from mother, father, siblings, friends and neighbors, was associated with significantly (p< 0.01) low traumatic stress. Support from health facilities and psychologist were also associated with low traumatic stress at (p<.01) and (p<.003) respectively. Conclusion: The insurgency situation in Swat resulted in direct and indirect exposure of adolescents to traumatic incidents. This is associated with higher rates of traumatic stress in children. Physical and emotional proximity to incident were identified as risk factors and presence of social support as a protective factor. Some psycho-social support services should be incorporated in their institutional system to address the problem.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com