Child war trauma: a comparison of clinician, parent and child assessments

This paper focuses on the difficulty of capturing child war trauma: the appropriateness of a standardized trauma questionnaire and the value of recruiting multiple reports. Three independent assessments of the war exposure of 75 Bosnian refugee children and teenage youths (aged 1-20), resettled in Sweden, are compared: clinician assessment based upon a semi-structured interview with the family, child self-report on the Harvard Trauma Questionnaire (HTQ) and parent report on the same questionnaire. Parent and clinician reports show marked group similarities but differ often with regard to the individual child. Clinician score reveals a social class gradient not visible on the HTQ. Parent and teenager assessments correlate strongly on total exposure but diverge markedly on specific events. Discrepancy derives as frequently from events affirmed by teenager alone as by parent alone. Primary school children, on the other hand, systematically offer a less-detailed account of their own war exposure. In summary, original HTQ functions "quite well" as a standardized questionnaire, but a Bosnian-specific version would expectedly afford greater validity and capture social class differences in child exposure. For teenagers, the value of multiple informants appears evident; for primary school children, a more adequately age-adjusted procedure remains the first priority.