Meta-analysis of the prevalence of internalizing disorders among children exposed to armed conflicts

Context and relevance. The increase in geopolitical conflicts and humanitarian crises worldwide exposes millions of children to extreme adversity, such as armed conflicts, which might compromise their resilience and contribute to the onset of mental disorders. Sharing similar pathophysiological and psychological mechanisms, such disorders can be combined into a single group, which would allow researchers and clinicians to diagnose them at an early stage and identify both common risk factors and protective mechanisms. Objective. To assess the prevalence of internalizing disorders in children exposed to armed conflicts using a meta-analysis of foreign and Russian studies, with the aim of further identifying psychological intervention resources for individuals exposed to extreme adversity. Methods and materials. The search in 7 foreign and 2 Russian databases yielded 2 024 sources, out of which 82 studies covering 105 601 participants across 21 regions of armed conflict were selected. A random-effects model was used for analyzing cases with high heterogeneity between studies. Results. As a result of the meta-analysis the weighted average prevalence of post-traumatic stress was 38.3%, anxiety disorders — 23.4%, affective disorders — 19.2%, and any mental disorders — 33.4%. Conclusions. At least one fifth of children in regions of armed conflict are at risk of developing internalizing disorders. This should draw the attention of the Russian scientific and practical psychological community to the issues of assessing the negative psychological impact of armed conflicts, as well as enhancing protective factors of psychosocial support and resilience of children and their families.

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