Investigating War Trauma, Its Effects, and Associated Risk Factors on Anxiety Among High School Students in Woldia Town, Northeast Ethiopia, 2022

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2024 Jul 26

PMID 39056017

Authors

Mulat Awoke Kassa

Tamrat Anbesaw

Girum Nakie

Mamaru Melkam

Molla Azmeraw

Elsabet Gezmu Semagn

Biruk Beletew Abate

Affiliations

Soon will be listed here.

Abstract

Background: Anxiety symptoms are the most frequent mental health problems in the world, and it is a serious public health concern, especially among adolescents, because if left untreated, adolescent anxiety can have a number of detrimental effects, including lower academic performance, strained relationships with friends and family, substance addiction, thoughts of suicide and homicide, and trouble finding work. While this vulnerability is concerning in all situations, it is particularly critical in armed conflict areas. Ethiopia is one of the most recent war-affected countries, but to the best of our knowledge, limited studies focused on adolescents in this context. Therefore, this study assessed the experience of war trauma and its effects on anxiety symptoms among high school students in Woldia town, Ethiopia.

Objective: We assessed the experience of war trauma and its effects on anxiety among high school students, as well as associated risk factors, in war-affected areas in Woldia town, northeast Ethiopia.

Methods: A cross-sectional study design was conducted from May 23 to June 08 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression analyses were used to identify independent factors associated with anxiety.

Results: A total of 624 out of 660 students participated in the study (94.5% response rate). The prevalence of anxiety among high school students in Woldia town was 39.7%. In the multivariable analysis, having depression (AOR = 9.24, 95% CI: 6.27, 13.64), witnessing the murder of family/friends (AOR = 1.93, 95% CI: 1.05, 3.57), being of female sex (AOR=1.59, 95% CI: 1.08, 2.36), and having a family history of mental illness (AOR=1.69, 95% CI: 1.00, 2.85) were factors significantly associated with anxiety.

Conclusions And Recommendations: The prevalence of anxiety in this study was approximately two in five high school students. Therefore, we recommend that the Ministry of Education collaborate with the Ministry of Health to expand and implement mental health services in high schools to promote the wellbeing of students for the prevention of anxiety.

Citing Articles

Prevalence and factors associated with TB among presumptive TB patients in war-affected areas of North Wollo, Ethiopia.

Asmare Z, Assefa A, Belay A, Mulie A, Aschil D, Gashaw Y JAC Antimicrob Resist. 2025; 7(1):dlae206.

PMID: 39748803 PMC: 11694660. DOI: 10.1093/jacamr/dlae206.

References

Nakie G, Melkam M, Desalegn G, Zeleke T . Prevalence and associated factors of social phobia among high school adolescents in Northwest Ethiopia, 2021. Front Psychiatry. 2022; 13:949124. PMC: 9640733. DOI: 10.3389/fpsyt.2022.949124. View

Maalouf F, Haidar R, Mansour F, Elbejjani M, El Khoury J, Khoury B . Anxiety, depression and PTSD in children and adolescents following the Beirut port explosion. J Affect Disord. 2022; 302:58-65. DOI: 10.1016/j.jad.2022.01.086. View

Gormez V, Kilic H, Orengul A, Demir M, Demirlikan S, Demirbas S . Psychopathology and Associated Risk Factors Among Forcibly Displaced Syrian Children and Adolescents. J Immigr Minor Health. 2017; 20(3):529-535. DOI: 10.1007/s10903-017-0680-7. View

Elbedour S, Onwuegbuzie A, Ghannam J, Whitcome J, Abu Hein F . Post-traumatic stress disorder, depression, and anxiety among Gaza Strip adolescents in the wake of the second Uprising (Intifada). Child Abuse Negl. 2007; 31(7):719-29. DOI: 10.1016/j.chiabu.2005.09.006. View

Riad A, Drobov A, Krobot M, Antalova N, Alkasaby M, Perina A . Mental Health Burden of the Russian-Ukrainian War 2022 (RUW-22): Anxiety and Depression Levels among Young Adults in Central Europe. Int J Environ Res Public Health. 2022; 19(14). PMC: 9318466. DOI: 10.3390/ijerph19148418. View

Ma L, Mazidi M, Li K, Li Y, Chen S, Kirwan R . Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis. J Affect Disord. 2021; 293:78-89. PMC: 9711885. DOI: 10.1016/j.jad.2021.06.021. View

Mboya I, John B, Kibopile E, Mhando L, George J, Ngocho J . Factors associated with mental distress among undergraduate students in northern Tanzania. BMC Psychiatry. 2020; 20(1):28. PMC: 6988278. DOI: 10.1186/s12888-020-2448-1. View

Wahab S, Abdul Rahman F, Wan Hasan W, Zamani I, Arbaiei N, Khor S . Stressors in secondary boarding school students: association with stress, anxiety and depressive symptoms. Asia Pac Psychiatry. 2013; 5 Suppl 1:82-9. DOI: 10.1111/appy.12067. View

Muris P, Mayer B, Kramer Freher N, Duncan S, van den Hout A . Children's internal attributions of anxiety-related physical symptoms: age-related patterns and the role of cognitive development and anxiety sensitivity. Child Psychiatry Hum Dev. 2010; 41(5):535-48. PMC: 2917553. DOI: 10.1007/s10578-010-0186-1. View

10.

Gebremedhin H, Bifftu B, Lebessa M, Weldeyes A, Gebru T, Petrucka P . Prevalence and Associated Factors of Psychological Distress Among Secondary School Students in Mekelle City, Tigray Region, Ethiopia: Cross-Sectional Study. Psychol Res Behav Manag. 2020; 13:473-480. PMC: 7250291. DOI: 10.2147/PRBM.S252779. View

11.

Kovner R, Oler J, Kalin N . Cortico-Limbic Interactions Mediate Adaptive and Maladaptive Responses Relevant to Psychopathology. Am J Psychiatry. 2019; 176(12):987-999. PMC: 7014786. DOI: 10.1176/appi.ajp.2019.19101064. View

12.

Gryczynski J, Kelly S, Mitchell S, Kirk A, OGrady K, Schwartz R . Validation and performance of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) among adolescent primary care patients. Addiction. 2014; 110(2):240-7. PMC: 4301997. DOI: 10.1111/add.12767. View

13.

Tang W, Lu Y, Xu J . Post-traumatic stress disorder, anxiety and depression symptoms among adolescent earthquake victims: comorbidity and associated sleep-disturbing factors. Soc Psychiatry Psychiatr Epidemiol. 2018; 53(11):1241-1251. DOI: 10.1007/s00127-018-1576-0. View

14.

Kolltveit S, Lange-Nielsen I, Thabet A, Dyregrov A, Pallesen S, Johnsen T . Risk factors for PTSD, anxiety, and depression among adolescents in Gaza. J Trauma Stress. 2012; 25(2):164-70. DOI: 10.1002/jts.21680. View

15.

Chrisman A, Dougherty J . Mass trauma: disasters, terrorism, and war. Child Adolesc Psychiatr Clin N Am. 2014; 23(2):257-79, viii. DOI: 10.1016/j.chc.2013.12.004. View

16.

de Jong J, Komproe I, van Ommeren M . Common mental disorders in postconflict settings. Lancet. 2003; 361(9375):2128-30. DOI: 10.1016/S0140-6736(03)13692-6. View

17.

Pieh C, Budimir S, Probst T . The effect of age, gender, income, work, and physical activity on mental health during coronavirus disease (COVID-19) lockdown in Austria. J Psychosom Res. 2020; 136:110186. PMC: 7832650. DOI: 10.1016/j.jpsychores.2020.110186. View

18.

Ogundele M . Behavioural and emotional disorders in childhood: A brief overview for paediatricians. World J Clin Pediatr. 2018; 7(1):9-26. PMC: 5803568. DOI: 10.5409/wjcp.v7.i1.9. View

19.

Nakie G, Segon T, Melkam M, Desalegn G, Zeleke T . Prevalence and associated factors of depression, anxiety, and stress among high school students in, Northwest Ethiopia, 2021. BMC Psychiatry. 2022; 22(1):739. PMC: 9707065. DOI: 10.1186/s12888-022-04393-1. View

20.

Veronese G, Mahamid F, Bdier D, Obaid H, Cavazzoni F . The development and validation of the Palestinian children's traumatic events checklist in a war-torn environment. BMC Psychiatry. 2024; 24(1):254. PMC: 10988932. DOI: 10.1186/s12888-024-05731-1. View