Mental health problems, family functioning and social support among
children survivors of Colombia’s armed conflict
Sánchez-Villegas, M., Reyes-Ruiz, L., Taylor, L. K., Pérez-Ruíz, N. A., & Carmona-Alvarado, F. A. (2021).
Mental health problems, family functioning and social support among children survivors of Colombia’s armed
conflict.
Journal of Aggression, Conflict and Peace Research
,
13
(1), 61-72. https://doi.org/10.1108/JACPR-08-
2020-0535
Published in:
Journal of Aggression, Conflict and Peace Research
Document Version:
Peer reviewed version
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Download date:10. Aug. 2022
Mental health problems, family functioning and social support among children survivors of
Colombia’s armed conflict
Abstract
Purpose - Colombia has one of the largest armed conflict in the world. Children exposed directly
or indirectly to armed conflicts lives the emotional footprints left by war. This study identified
mental health problems among children survivors of Colombia’s armed conflict and associated
factors. Design/methodology/approach – A cross-sectional study with (n=80) children aged 7
to 11 years (M=9.8 years; SD= 1.4) was conducted using the Child Behavior Checklist, Family
APGAR and MOS social support survey adaptation to children. Linear regression analyses were
also performed with emotional and behavioral problems as the outcomes and related factors as
the predictors. Findings - Clinical levels of emotional and behavioral problems were found in
56.3% of children. Internalizing problems (63.7%) were more common than externalizing
problems (51.2%). Older children had greater emotion problems, at the trend level, and those
with higher functioning families had lower emotion problems. Children with higher perceived
social support had lower behavior problems, at the trend level. Research
limitations/implications - This study includes a sample facing multiple risks and uses a holistic
approach to consider family and social resources that may support children who are survivors of
the armed conflict in Colombia. These results provide a foundation for future promotion and
prevention programs related to children’s mental health problems in order to support
peacebuilding within the framework of the Colombian post conflict process. Originality/value –
To the best of authors’ knowledge, this is the first study to collect empirical data on the mental
health of children survivors of Colombia’s armed conflict focused in the Atlantic Department.
Keywords: Mental health problems, Family functioning; Social support; Internalizing
problems; Externalizing problems; Children, Armed conflict, Colombia
Paper type - Research paper
Introduction
Mental health in childhood means reaching developmental and emotional milestones,
such as learning healthy social skills and how to cope with problems. Children with good mental
health have a positive quality of life and can function well at home, in school, and in their
communities (CDC, 2019; Lippman et al., 2011; U.S. Departmemt of Health and Human
Services, 2001; World Health Organization, 2005). On the contrary, children with mental health
challenges face serious changes in the way they typically learn, behave, or handle their emotions,
which cause distress and problems getting through the day. Occasional mental health challenges,
such as fears and worries, or disruptive behaviors, are common in childhood. If symptoms are
severe and persistent, however, it may interfere with school, home, or play activities. Such
mental health challenges are an important public health issue because of their prevalence, early
onset, and impact on the child, family, and community (Perou et al., 2013).
Mental health challenges in childhood may be related to proximate risks factors within
the family, such as sexual, physical and psychological abuse, low social support, violence,
history of traumatic experiences or parental abuse of alcohol or drugs, and to broader social risk
factors, such as poverty, inequality, war and displacement (Cree et al., 2018; (Karam et al., 2008;
Karam et al., 2014; WHO, 2004). For example, in Latin America, exposure to violence has been
identified as a predictor of mental health problems particularly among people living in poverty
(Franco et al., 2006). Moreover, war can leave an emotional footprint on children that persists
throughout their lives, with indirect effects on subsequent generations (Chapple et al., 2005;
Fremont, 2004; Garbarino & Kostelny, 1996; Kadir et al., 2019). These findings suggest the need
to study the intergenerational transmission of war-related trauma in internally displaced children
and children indirectly exposed to armed conflict (Flink et al., 2013). That is, because of their
age and compounded exposure, children may be particularly vulnerable to mental health
challenges posed by armed conflict (Gómez-Restrepo et al., 2018). Toward this end, global
research has found high rates of post-traumatic stress disorder (PTSD), internalizing behaviors,
anxiety and psychosomatic symptoms (Bannon et al., 2009; Chemtob et al., 2008; DeVoe et al.,
2006; Dimitry, 2012; Dybdahl, 2001; Kaufman-Shriqui et al., 2013; Klein et al., 2009; Slone &
Mann, 2016) and externalizing behaviors (Pat-Horenczyk et al., 2012; Rosenthal & Levy‐Shiff,
1993; Thabet et al., 2006; Zahr, 1996) among children affected by war. Because the experience
of trauma may contribute to inputs which may take a person closer towards engaging in
aggression (Worthington, 2012). Yet, the family environment may be able to help children
respond to war stress. For example, a well-functioning family may provide social support for
children, which can have a positive impact on their mental health (Slone & Mann, 2016).
Complementing the existing research on effects of armed conflict on children's mental
health, the current study focuses on the impact of the Colombian armed conflict (Gómez-
Restrepo et al., 2018) and family factors on children’s mental health. Over the past 50 years,
Colombia has lived in a permanent situation of internal armed conflict resulting from complex
phenomena of political violence (Centro Nacional de Memoria Histórica, 2013; Gómez-Restrepo
et al., 2016). One of the world’s longest conflicts, it has left in its wake countless victims and
almost irreparable consequences (Rojas, 2016). Although Colombia’s armed conflict is often
described as ‘low intensity’, independent data suggest remarkably high levels of exposure to
conflict-related violence in the civilian population (Tamayo Martínez et al., 2016). Almost 9
million people where 1,151,130 are children between 6 and 11 years old, have been recognized
as victims of this conflict and have been included in the National Registry of Victims (Registro
Único de Víctimas, RUV). Yet, in Colombia, violence does not occur at the same space and
intensity throughout the country (Taylor., 2012).
The Atlantic Department is in the Colombian Caribbean coast which is a developing
region divided into five municipalities with 2,342,265 inhabitants (Departamento Administrativo
Nacional de Estadística - DANE, 2019). This population represents 3% of the Colombian
population (Rangel-Buitrago et al., 2017). The Colombian Caribbean coast has been affected by
the growth of paramilitarism, drug trafficking, and the increase in criminal organizations, which
has implications for adult mental health (Taylor, 2016a; 2016b). As a result, the Atlantic
Department, has received many the displaced populations from surrounding regions (Gómez
Builes et al., 2008). Currently, the National Registry of Victims confirms that more than 50,000
children between the ages of 6 and 11 are recognized as victims of this conflict and
approximately 16,000 children need psychosocial attention in the Atlantic Department. Rooted to
this reality, the current study further focuses on children survivors of the armed conflict in this
department. The choice of 'survivor', vs ‘victim’s,’ is more than semantic (Bustamante, 2017). It
reflects the emphasis in Colombia and the Atlantic for survivors to actively participate in their
holistic healing, energizing possibilities for deeper attention, assistance and reparation. Although
Colombia has had a prolonged internal conflict, not much is known about the mental health
status of survivors, particularly of children. Consequently, this study aimed to describe the
impact of the armed conflict on the mental health of the child population in the Atlantic
Department. Bearing in mind that health requirements in the child population highlight the need
