War-related exposure and psychological distress As predictors of health and sleep: A longitudinal study of Kuwaiti children

Maria Magdalena Llabre, Fawzyiah Hadi

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


Objectives: To determine whether exposure to war-related trauma during childhood predicted posttraumatic stress, self-reported health, sleep, and obesity in adulthood, and whether psychological distress mediated the relationships. Methods: We assessed 151 Kuwaiti boys and girls aged 9 to 12 years in 1993 to determine their level of exposure to war-related trauma during the Iraqi occupation and Gulf war, health complaints, and psychological distress. In 2003, 120 (79%) of the initial participants reported on their posttraumatic stress, general health, body mass index (BMI), and sleep quality. We tested a structural model where exposure to war-related trauma predicted psychological distress and health complaints 2 years after the war, and posttraumatic stress, self-reported health, BMI, and sleep quality and duration 10 years later, controlling for intermediary life events. We also tested effects of exposure to war-related trauma on self-reported health and sleep factors mediated by psychological distress. Results: Results indicated a direct effect of exposure on poor sleep quality and BMI. Exposure also predicted poor sleep quality through its association with concurrent posttraumatic stress. The effect of exposure on self-reported health was mediated by health complaints and psychological distress, which included symptoms of depression, anxiety, and posttraumatic stress. Conclusion: Exposure to war-related events during childhood is associated with posttraumatic stress, poor sleep quality, high BMI, and poor self-reported health in adulthood.

Original languageEnglish (US)
Pages (from-to)776-783
Number of pages8
JournalPsychosomatic medicine
Issue number7
StatePublished - Sep 2009


  • Children
  • Health related
  • Posttraumatic stress
  • War-related trauma

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology


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