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Children in chronic war-zones are often neglected by adults, as their issues pertaining to politics, economy, religion, etc. Numerous children's development is impeded through war experiences, war-affected youth experience several negative psychological effects.

Scope

During the Second World War, over one million children were evacuated without their parents in Britain. According to United Nations Children's Fund (UNICEF), the estimated casualties of children in the last decade are: "2 million killed; 4-5 million disabled; 12 million left homeless; more than 1 million orphaned or separated from their parents; some 10 million psychologically traumatized". Now, there are over two million child refugees fleeing from Syria and over 870,000 refugees from Somalia

Risk factors

Direct exposure to violence

Children get psychologically impacted when they directly witness any form of violence; a direct exposure to armed conflict, shootings and bloodshed can affect their psychological development. Children compose a large part of the population affected by wars, statistics show of the 95 percent of civilians killed in recent years’ by modern armed conflicts conflicts, approximately 50 percent of them were children.

War attacks frequently target schools and civilian villages. Sexual violence in war-zone is prevalent, which also causes sexually transmitted diseases – such as HIV/AIDS – to spread. Children are many times forced into the war effort, or would serve to war to support their families.

Unmet basic needs

War can disrupt the supply of basic services to children and their families like food, water, shelter, health services and, education. The loss of access to these basic needs deprives children to grow physically, emotionally, and psychologically. The family and the community are also not able to provide children with an environment conducive to their development. The war can further impact the parents’ behavior towards children with more use of violence to teach them behavior or it can degrade their parenting capabilities because of reduced mental and emotional capabilities. Disruption of education also happens as schools are often destroyed during wars. This educational gap makes it hard for children to get essential education, build social-emotional skills, and reintegrate to society.Moreover, mother's educational level affects the probability of emigration escaping from a war.

Psychological impact

Children can lose their family members in conflict, get separated in an attack, coerced to leave their family to join the army. War can contribute many factors that affect children psychologically. It can make children form a cynical model of the world around them, turn pessimistic, lose motivation to make situations better. This can further have short-term (e.g. – not motivated to get an education) or long-term (poor relationships and interpersonal skills) effects on them.^[3] Experiences of war in early years can lead the children to form a model where violence is a solution to resolve their personal conflicts. Children who were evacuated in Britain during the Second World War showed long-term psychological distress pertaining to relationship and attachment.

Impact on psychological development of children

Children exposed to violence in their early years are more susceptible to developing behavioral problems, anxiety, depression, problems in the immune system and central nervous systems, mood disorders etc. This happens through impact on their stress response system and the development of neurotransmission circuits in their brain early in life.^[7] Early childhood experience accounts for a large part of human brain development. Neural connections for sensory ability, language, and cognitive function are all actively made during the first year of a child. The plasticity and malleability which refer to the flexibility of the brain is the highest in the early brain development years.^[8] Therefore, the impact of surrounding environment is the strongest in early childhood.^[8]

The brain architecture is gravely affected by stress. War is considered as toxic stress which is a chronic stress that children cannot control nor overcome easily and fast. Stress in early childhood can impede brain development of children that results in both physical and mental health problems.

Children who are detached from a family in early age may go through problems regarding attachment, Children under five are more likely to experience a greater risk of depression and anxiety compared to adolescents. Attachment theory suggests that the ability of a child to create attachment can be deterred by deviant environmental conditions and reflected experiences with caregivers. Different types of attachments can be formed with different caregivers and upbringing environment. In addition, different experiences of attachment in childhood are known to be related to mental health issues in adulthood.

Various factors contribute to the intensity and occurrence of these effects on a child’s physiology and the nervous system. Few of the main factors are the age of the child when he/she experienced war or conflict, the duration and intensity of this experience, the quality and how quickly was the relief provided to the child after a traumatic experience, if any, from family, community or relief programs.^[9] Okasha and Elkholy (2012) have theorized that psychological immunization can help children who are frequently exposed to conflict to acclimate themselves to the stressors of war.^[10]

Children in war zones are more susceptible to psychological disorders.^[11] The incidence of the effects of war has a 10 to 90 percent variation in terms of developing Posttraumatic stress disorder (PTSD), depression and behavior problems.^[12] According to studies, 80% of the 94 Iraqi children exposed to the Feb 13, 1991 bombing showed PTSD symptoms.^[9] 41 percent of Palestinian children were found to have severe symptoms of PTSD, these children were 6–11 years of age.^[9] Furthermore, PTSD is even regarded to have intergenerational effects.^[13]

Rehabilitation issue

Reintegration to society for child soldiers

There are around 300,000 child soldiers around the world. Disarmament, demobilization, and reintegration (DDR) programs are conducted to rehabilitate child soldiers and war-affected children. Child soldiers are often stigmatized and confronted with discrimination from community. Reintegration and rehabilitation depends on the level of violence occurred in the region, acceptance from family and community, and resources like education and training programs to recover war-affected youth. Issues reside in reintegration process of child soldiers. A release from military groups to reintegration into civilian life requires efforts along with support and assistance from diverse organizations.

Psychological treatment process

The problem with psychological treatment is that it can get extremely difficult after a child reaches certain age. This is because the plasticity of brain reduces after the age of five since the brain development mainly takes place before the age of six. In that sense, long-term psychological treatment is required. Some children develop resilience and are able to overcome significant adversity. Environments like helpful community surroundings and stable caregiver can build capacity to recover adverse childhood experiences.