The Role of Cumulative Risk and Armed Conflict Exposure in Adolescent Psychological Symptoms in Turkey

Authors

Buket Kara, Lancaster University, United Kingdom
Bilge Selcuk, MEF University, Turkey

Background

Exposure to risk factors and adversity may cause immediate, and sometimes prolonged, psychological symptoms in adolescents. Identifying universal and specific risk factors in a particular context and examining their cumulative effects is crucial for understanding the mechanisms underlying psychological symptoms and informing about strategies for intervention. The current study aimed to examine the role of armed conflict experiences and cumulation of other risk factors (e.g., maternal psychological symptoms, socioeconomic indicators) in predicting adolescent psychological symptoms in an underresearched community. Using concurrent measures, we examined the role of armed conflict experiences and cumulation of other risk factors in psychological symptoms of adolescents in the east of Turkey, an area under the influence of prolonged conflict and substantial socioeconomic deprivation.

Method

Data was collected via face-to-face interview at a single time point in 2016, following an intense one-year period of combat and curfews. Random house visits, as well as exponential non-discriminative snowball sampling, were used to reach the participants. The sample included 161 adolescents (54.7% female) aged 11 to 14 years (M = 12.36, SD = 1.27) and their mothers living in the east of Turkey. Adolescents completed questionnaires, where they provided information about their armed conflict experiences and a range of risk factors. Mothers provided information about the demographic variables, psychological symptoms of their children, and their own psychological distress and armed conflict experiences. The cumulative risk index was calculated by summing the standardized scores of the corresponding factors.

Results

Hierarchical multiple regression analyses were conducted to predict internalizing and externalizing symptoms among adolescents by introducing demographic variables (age, gender) in the first step, armed conflict experiences and cumulative risk in the second step, and their interaction in the final step. Results showed that the levels of internalizing and externalizing symptoms were predicted by gender, armed conflict experience and cumulative risk. Being a girl was associated with higher levels of internalizing symptoms and lower levels of externalizing symptoms. Higher levels of internalizing and externalizing symptoms were predicted by exposure to armed and cumulative risk. After controlling for other factors, the interaction of armed conflict experience and cumulative risk significantly predicted externalizing, but not internalizing symptoms.

Conclusion

This study provided information about an underrepresented non-Western community that has been historically excluded from research. The results suggested that cumulative risk was a stronger predictor of psychological symptoms, and further amplified the strength of the association between armed conflict experiences and externalizing symptoms. These findings can be used in the formulation of intervention strategies and policies to promote psychological well-being in adolescents living in armed conflict zones under multiple risks.

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