Predicting adolescent posttraumatic stress in the aftermath of war: differential effects of coping strategies across trauma reminder, loss reminder, and family conflict domains.

BACKGROUND AND OBJECTIVES The vast majority of youth who lived through the Bosnian war were exposed to multiple traumatic events, including interpersonal violence, community destruction, and the loss of a loved one. This study examined factors that predict post-war psychological adjustment, specifically posttraumatic stress, in Bosnian adolescents. DESIGN Regression analyses evaluated theorized differential relations between three types of post-war stressors - exposure to trauma reminders, loss reminders, and intrafamilial conflict - specific coping strategies, and posttraumatic stress symptom dimensions. METHODS We examined 555 Bosnian adolescents, aged 15-19 years, to predict their long-term posttraumatic stress reactions in the aftermath of war. RESULTS Findings indicated that post-war exposure to trauma reminders, loss reminders, and family conflict, as well as engagement and disengagement coping strategies, predicted posttraumatic stress symptoms. Secondary control engagement coping responses to all three types of post-war stressors were inversely associated with posttraumatic stress symptoms, whereas primary control engagement coping responses to family conflict were inversely associated with hyperarousal symptoms. Disengagement responses to trauma reminders and family conflict were positively associated with re-experiencing symptoms. CONCLUSIONS These findings shed light on ways in which trauma reminders, loss reminders, and family conflict may intersect with coping responses to influence adolescent postwar adjustment.