Psychological consequences of war-traumatized children and adolescents in Bosnia and Herzegovina


  • Mevludin Hasanović Department of Psychiatry University Clinical Center Tuzla Tuzla, School of Medicine University of Tuzla, Tuzla


Children, Adolescents, PTSD, Depression, Bosnia and Herzegovina


Research into the psychosocial consequences of war and politicalviolence on children’s and adolescent’s developmental wellbeing hasshown a steady increase over the last decades. Numerous studies, fromdiffering cultures in different war zones around the world, have documentedthe effect on children of exposure to war atrocities. The war inBosnia and Herzegovina (BH) 1992-1995, at the end of 20th centuryfound the citizens of BH and the world mental health professionalsand scientists unprepared to deal with the adverse consequences forthe entire BH population and especially for its most vulnerable part,children and adolescents, to be able to take adequate measures of sufficientmental health care to prevent devastating consequences of severemultiple traumas. Only a few research studies were done during andafter this war in BH, the United States, Sweden, Norway, the UK andGermany focusing on the relationship between war trauma, Posttraumaticstress disorder (PTSD), depression, suicidal thoughts, acculturation,repatriation, poverty, behavioral problems, school adjustment,relational problems of children and their mothers after deploymentof war PTSD veterans and war prisoners, and treatment of psychologicalconsequences in examined children and adolescents from BH.The major part of this paper reviewed available literature on Medlinethat reported national and international studies which investigated thepsychological consequences of war on BH children and adolescentsand several papers about children and adolescents from Srebrenica,that were not indexed on Medline, but showed very crucial results forthe issue described.


Download data is not yet available.


Smith P, Perrin S, Yule W, Rabe-Hesketh S. War exposure and maternal reactions in the psychological adjustment of children from Bosnia-Hercegovina. J Child Psychol Psychiatry. 2001;42(3):395-404.

Hasanović M, Sinanović O, Selimbašić Z, Pajević I, Avdibegović E. Psychological Disturbances of War-traumatized Children from Different Foster and Family Settings in Bosnia and Herzegovina. Croat Med J. 2006;47(1):85-94.

Hasanović M, Srabović S, Rasidović M, Sehović M, Hasanbasić E, Husanović J, Hodzić R. Psychosocial assistance to students with posttraumatic stress disorder in primary and secondary schools in post-war Bosnia Herzegovina. Psychiatr Danub. 2009;21(4):463-73.

Hasanovic M, Sinanovic O, Pavlovic S. Acculturation and psychological problems of adolescents from Bosnia and Herzegovina during exile and repatriation. Croat Med J. 2005;46:105-15.

Loga S, Cerić I, Stojak R, Kantardzić D, Danes V, Trograncić Z, Fiseković S, Stanić D, Termiz D, Kulenović F, Licanin I, Papović S, Resić D. Psychosocial research during the war in Sarajevo. Med Arh. 1999;53(3):139-44.

Goldstein RD, Wampler NS, Wise PH. War experiences and distress symptoms of Bosnian children. Pediatrics. 1997;100(5):873-8.

Bull D. Operation joint forge veterans - Balkan tour broadens scope. Vet. Center Voice. 2004;25(4):12-16.

Weinberg J, Simmonds S. Public health, epidemiology and war. Soc Sci Med. 1995;40:1663.

Jensen PS, Shaw J. Children as victims of war: current knowledge and future research needs. J Am Acad Child Adolesc Psychiatry. 1993;32:697-708.

Papageorgiou V, Frangou-Garunovic A, Iordanidou R, Yule W, Smith P, Vostanis P. War trauma and psychopathology in Bosnian refugee children. Eur Child Adolesc Psychiatry. 2000;9:84-90.

Husain SA, Nair J, Holcomb W, Reid JC, Vargas V, Nair SS. Stress reactions of children and adolescents in war and siege conditions. Am J Psychiatry. 1998;155:1718-9.

Rutter M. Maternal deprivation reassessed. 2nd ed. London: Penguin Books; 1991. p. 19.

Röper G, Gavranidou M. Capacity building in trauma therapy and trauma research in Bosnia-Herzegovina. New Dir Youth Dev, 2003;(98):99-110.

Hasanović M, Pavlović S, Sinanović O. Acculturation and Psychological Characteristics of Bosnian Internally Displaced and Refugee Adolescents from Srebrenica Region after the War 1992-1995 in Bosnia and Herzegovina. In: Rene S. Grenell (ed.) Adolescent Behavior Research Studies. New York: Nova Publishers; 2007 - 3rd Quarter. p. 155-91.

Lonigan CJ, Philips BM, Richey JA. Posttraumatic stress disorder in children: diagnosis, assessment, and associated features. Child Adolesc Psychiatr Clin N Am. 2003;12(2):171-94.

Jones L, Kafetsios K. Assessing adolescent mental health in war-affected societies: the significance of symptoms. Child Abuse Negl. 2002;26(10):1059-80.

Goldin S, Levin L, Persson LA, Hägglof B. Stories of pre-war, war and exile: Bosnian refugee children in Sweden. Med Confl Surviv. 2001;17(1):25-47.

Alwood MA, Bell-Dolan D, Husain SA. Children’s trauma and adjustment reactions to violent and nonviolent war experiences. J Am Acad Child Adolesc Psychiatry. 2002;41(4):450-7.

Allden K, Cerić I, Kapetanović A, Lavelle J, Loga S, Mathias M, & McInnes K. Merhamet Medical Team-Rijeka, Mollica RF, Puratić V, Ruke Team - Zagreb, Sarajlić N (alphabetical order). Harvard Trauma Manual: Bosnia-Herzegovina Version.

Cambridge (MA): Harvard Program in Refugee Trauma; 1998. (Available in English and Bosnian).

Allden K, Frančišković T, Lavelle J, Mathias M, McInnes K, Mollica RF & Moro L. (alphabetical order). Harvard Trauma Manual: Bosnia-Herzegovina Version. Cambridge (MA): Harvard Program in Refugee Trauma; 1998. (Available in English and Bosnian).

Goldin S, Levin L, Persson LA, Hägglof B. Child war trauma: a comparison of clinician, parent and child assessments. Nord J Psychiatry. 2003;57(3):173-83.

Angel B, Hjern A, Ingleby D. Effects of war and organized violence on children: a study of Bosnian refugees in Sweden. Am J Ortopsychiatry. 2001;71(1):4-15.

Horowitz MJ, Wilner N, Alvarez W. Imact of Event Scale: a measure of subjective stress. Psychosom Med. 1979;41:209-18.

Brennen T, Hasanović M, Zotović M, Blix I, Skar AM, Prelić NK, Mehmedović I, Pajević I, Popović N, Gavrilov-Jerković V. Trauma exposure in childhood impairs the ability to recall specific autobiographical memories in late adolescence. J Trauma Stress. 2010;23(2):240-7.

Dyregrov A, Kuterovac G, Barath A. Factor analysis of the impact of event scale with children in war. Scand J Psychol. 1996;37(4):339-50.

Connelly C. The new siege of Sarajevo. The Times. 2005 Oct 8.

Strange H. Serb general Dragomir Milosevic convicted over Sarajevo siege. The Times. 2007 Dec 12.

Bassiouni C. Final report of the United Nations Commission of Experts established pursuant to Security Council resolution 780. United Nations. 1994 May 27.

Duraković-Belko E, Kulenović A, Dapić R. Determinants of posttraumatic adjustment in adolescents from Sarajevo who experienced war. J Clin Psychol. 2003;59(1):27-40.

Daneš V, Horvat V. Psychological consequences of war stress in the developing population in Bosnia and Herzegovina. Psychiatr Danub. 2005;17(3-4):225-9.

Tahirović FH, Tulumović T, Uzeirbegović M, Hadžibegić N, Hasanović A. How war disrupts iodine prophylaxis: An example from Bosnia. IDD Newsletter. 1995:13.

Uvin P, Cohen MJ, Snyder AC, Hoehn RA, Harris M. Overview of world hunger. Causes of hunger. Fifth annual report on the state of world hunger. Bread for the World Institure; 1994. p. 10-20.

Tahirović H. The influence of abuse and terrorism on somatic growth of children. Arabisches Arzteblatt. 1996:56-9.

Hay A. Surviving the impossible: the long march from Srebrenica. An investigation of the possible use of chemical warfare agents. Med Confl Surviv. 1998;14(2):120-55.

Pavlović D, Bijedić S. Personal experience in the organization of mass admission of traumatized refugees. Med Arh. 1997;51(1-2 Suppl 1):21-2.

Hasanović M, Pavlović S, Sinanović O. (2008) Acculturation and Psychological Characteristics of Bosnian Internally Displaced and Refugee Adolescents from Srebrenica Region after the War 1992-1995 in Bosnia and Herzegovina. In: Monica K. Zimmermann (ed.) Political Refugees: Social

Conditions, Health and Psychological Characteristics. New York: Nova Publishers; 2008 - 3rd Quarter. p. 139-75.

Tahirovič FH. Menarchal age and the stress of war: an example from Bosnia. Eur J Pediatr. 1998;157:978-80.

Smith P, Perrin S, Yule W, Hacam B, Stuvland R. War exposure among children from Bosnia-Hercegovina: psychological adjustment in a community sample. J Trauma Stress. 2002;15(2):147-56.

Eytan A, Gex-Fabry M, Toscani L, Deroo L, Loutan L, Bovier PA. Determinants of postconflict symptoms in Albanian Kosovars. J Nerv Ment Dis. 2004;192(10):664-71.

Hasanović M, Haračić E, Ahmetspahić Š, Kurtović S, Haračić H. Poverty and Psychological Disturbances of War-Traumatized Adolescents from Rural and Urban Areas in Bosnia and Herzegovina. In: Fiedler A, Kuester I (Eds) Child Development

and Child Poverty. New York: Nova Publishers; 2010. p. 229-55.

Cerni Obrdalj E, Rumboldt M. Bullying among school children in postwar Bosnia and Herzegovina: cross-sectional study. Croat Med J. 2008;49(4):528-35.

Kerestes G. Children’s aggressive and prosocial behavior in relation to war exposure: testing the role of perceived parenting and child’s gender. Int J Behav Dev. 2006;30: 227–39.

Zalihić A, Zalihić D, Pivić G. Influence of posttraumatic stress disorder of the fathers on other family members. Bosn J Basic Med Sci. 2008;8(1):20-6.

Monson CM, Taft CT, Fredman SJ. Military-related PTSD and intimate relationships: from description to theory-driven research and intervention development. Clin Psychol Rev. 2009;29(8): 707-14.

Beardslee WR, Gladstone TR, Wright EJ, Cooper AB. A family-based approach to the prevention of depressive symptoms in children at risk: evidence of parental and child change. Pediatrics. 2003;112:119-31.

Dahl S, Mutapcic A, Schei B. Traumatic events and predictive factors for posttraumatic symptoms in displaced Bosnian women in a war zone. J Trauma Stress. 1998;11(1):137-45.

Selimbasic Z, Sinanovic O, Avdibegovic E, Kravic N. Contact network and satisfaction with contacts in children whose parents have post traumatic stress disorder. Med Arh. 2009;63(3):124-7.

Selimbasić Z, Avdibegović E, Sinanović O. Posttraumatic stress reaction in children. Med Arh.


McFarlane AC. Military deployment: the impact on children and family adjustment and the need for care. Curr Opin Psychiatry. 2009;22(4):369-73.

Smith P, Perrin S, Yule W, Rabe-Hesketh S. War exposure and maternal reactions in the psychological adjustment of children from Bosnia-Hercegovina. J Child Psychol Psychiatry. 2001;42(3):395-404.

Richardson LK, Frueh BC, Acierno R. Prevalence estimates of combat-related post-traumatic stress disorder: critical review. Aust N Z J Psychiatry. 2010;44(1):4-19.

Green KT, Calhoun PS, Dennis MF. Mid-Atlantic Mental Illness Research, Education and Clinical Center Workgroup, Beckham JC. Exploration of the resilience construct in posttraumatic stress disorder severity and functional correlates in military combat veterans who have served since September 11, 2001. J Clin Psychiatry. 2010;71(7): 823-30.

Berk JH. Trauma and resilience during war: a look at the children and humanitarian aid workers of Bosnia. Psychoanal Rev. 1998;85(4):640-58.

Björn A, Eriksson T. Released Bosnian prisoners of war. High risk of posttraumatic symptoms. Lakartidningen. 1993;90(24):2305-8.

Arie S. Conflict and Rape. After war, what next? BMJ. 2010;341:c6910.

Cairns E, Dawes A. Children: Ethnic and political violence – A commentary. Child Development. 1996;67:29-139.

Dybdahl R. Children and mothers in war: An outcome Study of a psychosocial intervention program. Child Development. 2001;72(4),1214-30.

Avdibegović E, Hasanović M, Selimbasić Z, Pajević I, Sinanović O. Mental health care of psychotraumatized

persons in post-war Bosnia and Herzegovina--experiences from Tuzla Canton. Psychiatr Danub. 2008;20(4):474-84.

Sinanović O, Avdibegović E, Hasanović M, Pajević I, Sutović A, Loga S, Cerić I. The organisation of mental health services in post-war Bosnia and Herzegovina. International Psychiatry.


Hasanović M, Sinanović O, Pajević I, Avdibegović E, Sutović A. (2006) Post-war mental health promotion in Bosnia-Herzegovina. Psychiatria Danubina. 18(1-2):74-78.

de Jong K & Stickers R. Early psychosocial interventions for war-affected populations. In: Orner R & Schnyder U (eds). Early interventions in emergencies. Oxford University Press; 2003.

Nelson BS. Post war trauma and reconciliation in Bosnia and Herzegovina: observations, experiences, and implications for marriage and family therapy. Am J Fam There. 2003;31(4):305-316.

Selimbasić Z, Pavlović S, Sinanović O, Vesnić S, Petrović M, Ferković V, Cipurković-Mustacević A. Posttraumatic stress disorder--effects of psychosocial treatment in children. Med Arh. 2001;55(1 Suppl 1):25-9.

Pajević I, Sinanović O, Hasanović M. Religiosity and mental health. Psychiatria Danubina. 2005;17(1-2):84-9.

Snyder CS, May JD, Zulcic NN, Gabbard WJ. Social work with Bosnian Muslim refugee children and families: a review of the literature. Child Welfare. 2005;84(5):607-30.

Brunvatne R, Lysgård KH, Hjortdahl P. Psychosocial preventive work among war refugees. A task for primary health care? Tidsskr Nor Laegeforen. 1995;115(1):23-6.

Geltman PL, Augustyn M, Barnett ED, Klass PE, Groves BM. War trauma experience and behavioral screening of Bosnian refugee children resettled in Massachusetts. J Dev Behav Pediatr. 2000;21(4):255-61.

Ehntholt KA, Yule W. Practitioner review: assessment and treatment of refugee children and adolescents who have experienced war-related trauma. Journal of Child Psychology and Psychiatry. 2006;47(12):1197-210.

Murray LK, Cohen JA, Ellis BH, Mannarino A. Cognitive behavioral therapy for symptoms of trauma and traumatic grief in refugee youth. Child Adolesc Psychiatr Clin N Am. 2008;17(3):585-604.

Wintsch H. Spreading hope: therapeutic teams with war-traumatized children and adolescents in Bosnia. Prax Kinderpsychol Kinderpsychiatr. 2000;49(3):209-30.




How to Cite

Hasanović, M. (2011). Psychological consequences of war-traumatized children and adolescents in Bosnia and Herzegovina. Acta Medica Academica, 40(1), 45–66. Retrieved from



Review Articles