{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T19:59:37Z","timestamp":1771271977503,"version":"3.50.1"},"reference-count":42,"publisher":"Bentham Science Publishers Ltd.","issue":"1","license":[{"start":{"date-parts":[[2014,10,21]],"date-time":"2014-10-21T00:00:00Z","timestamp":1413849600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["clinical-practice-and-epidemiology-in-mental-health.com","benthamopen.com"],"crossmark-restriction":true},"short-container-title":["CPEMH"],"published-print":{"date-parts":[[2014,10,21]]},"abstract":"<jats:p><jats:underline>Background<\/jats:underline>: The goal of this paper is to map the total occurrence and evaluate the risk of co-occurrence of childhood adversities (CA) and a wide variety of childhood traumatic events (including war)\u00a0in a national sample.<jats:italic><jats:underline>Method<\/jats:underline>:<\/jats:italic>The nationally representative sample included 2,857 respondents and the instrument used was the Composite International Diagnostic Interview which screened for all CAs and traumatic events.<jats:italic><jats:underline>Results<\/jats:underline>:<\/jats:italic>27.9% experienced CAs; the most common were parental death and parental mental\/substance use disorder. 70.6% experienced a war-related traumatic event during their lifetime, and around half of them (38.1%) experienced it below the age of 18 years. 51.3% of the subjects experienced a traumatic event not related to war during their lifetime, and 19.2% experienced it before the age of 18 years. Sexual abuse, being a refugee during war, and experiencing a natural disaster were associated with female gender. Having any CA was associated with active war exposure (OR: 4.2, CI: 2.0-8.6); war-related direct personal trauma (OR: 3.9, CI: 1.5-10.0); war-related trauma to others (OR: 2.4, CI: 1.3-4.4); non-war direct personal trauma (OR: 3.8, CI: 2.0-7.4); and any non-war childhood traumatic event (OR: 1.9, CI: 1.1-3.1).<jats:italic><jats:underline>Conclusion<\/jats:underline>:<\/jats:italic>Childhood is awash with adversities and traumatic events that co-occur and should be measured simultaneously; otherwise, the effects of a subset of traumata or adversities could be wrongly thought to be the contributor to negative outcomes under study.<\/jats:p>","DOI":"10.2174\/1745017901410010116","type":"journal-article","created":{"date-parts":[[2014,10,27]],"date-time":"2014-10-27T07:04:15Z","timestamp":1414393455000},"page":"116-125","update-policy":"https:\/\/doi.org\/10.2174\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Childhood Adversities and Traumata in Lebanon: A National Study"],"prefix":"10.2174","volume":"10","author":[{"given":"Lynn","family":"Itani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youmna C","family":"Haddad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Fayyad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aimee","family":"Karam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elie","family":"Karam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"965","reference":[{"key":"refR1","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1192\/bjp.bp.110.080499","volume":"197","author":"Kessler R","year":"2010","unstructured":"Kessler R, McLaughlin K, Green J , et al. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Brit J Psych 2010; 197 : 378-85.","journal-title":"Brit J Psych."},{"key":"refR2","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/jts.20357","volume":"21","author":"Darves-Bornoz J","year":"2008","unstructured":"Darves-Bornoz J, Alonso J, De Girolamo G , et al. Main traumatic events in Europe PTSD in the European study of the epidemiology of mental disorders survey. J Trauma Stress 2008; 21 (5) : 455-62.","journal-title":"J Trauma Stress."},{"key":"refR3","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1176\/appi.ps.53.8.1001","volume":"53","author":"Anda R","year":"2002","unstructured":"Anda R, Whitfield C, Felitti V , et al. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatr Ser 2002; 53 (8) : 1001-9.","journal-title":"Psychiatr Ser."},{"key":"refR4","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.amepre.2007.01.005","volume":"32","author":"Anda R","year":"2007","unstructured":"Anda R, Brown D, Felitti V , et al. Adverse childhood experiences and prescribed psychotropic medications in adults. Am J Prev Med 2007; 32 (5) : 389-94.","journal-title":"Am J Prev Med."},{"key":"refR5","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.jpsychires.2010.01.004","volume":"44","author":"Benjet C","year":"2010","unstructured":"Benjet C, Borges G, Medina-Mora M. Chronic childhood adversity and onset of psychopathology during three life stages Childhood, adolescence and adulthood. J Psychiatr Res 2010; 44 : 732-40.","journal-title":"J Psychiatr Res."},{"key":"refR6","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jad.2003.12.013","volume":"82","author":"Chapman D","year":"2004","unstructured":"Chapman D, Anda R, Felitti V , et al. Adverse childhood experiences and the risk of depressive disorders in adulthood. J Aff Dis 2004; 82 : 217-25.","journal-title":"J Aff Dis."},{"key":"refR7","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1176\/appi.ajp.160.8.1453","volume":"160","author":"Edwards V","year":"2003","unstructured":"Edwards V, Holden G, Anda R , et al. Experiencing multiple forms of childhood maltreatment and adult mental health results from the Adverse Childhood Experiences (ACE) Study. Amer J Psychiatr 2003; 160 (8) : 1453-60.","journal-title":"Amer J Psychiatr."},{"key":"refR8","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1176\/appi.ajp.2013.12070957","volume":"10","author":"Tiecher M","year":"2013","unstructured":"Tiecher M, Jaqueline J. Childhood Maltreatment and psycho-pathology a case for ecophenotypic variables as clinically and neurobiologically distinct subtypes. Amer J Psychiatr 2013; 10 (170) : 1114-33.","journal-title":"Amer J Psychiatr."},{"key":"refR9","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1192\/bjp.bp.109.074716","volume":"197","author":"Bruffaerts R","year":"2010","unstructured":"Bruffaerts R, Demyttenaere K, Borges G , et al. Childhood adversities as risk factors for onset and persistence of suicidal behavior. Brit J Psychiatr 2010; 197 (1) : 20-7.","journal-title":"Brit J Psychiatr."},{"key":"refR10","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.jpsychires.2010.08.002","volume":"45","author":"Fujiwara T","year":"2011","unstructured":"Fujiwara T, Kawakami N. Association of childhood adversities with the first onset of mental disorders in Japan Results from the World Mental Health Japan, 2002-2004. J Psychiatr Res 2011; 45 (4) : 481-7.","journal-title":"J Psychiatr Res."},{"key":"refR11","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1001\/archgenpsychiatry.2009.187","volume":"67","author":"McLaughlin K","year":"2010","unstructured":"McLaughlin K, Green J, Gruber M , et al. Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCSR) II Associations with persistence of DSM-IV disorders. Arch Gen Psychiatr 2010; 67 (2) : 124-32.","journal-title":"Arch Gen Psychiatr."},{"key":"refR12","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1002\/jts.20252","volume":"20","author":"Williams S","year":"2007","unstructured":"Williams S, Williams D, Stein D , et al. Multiple traumatic events and psychological distress the South Africa stress and health study. J Trauma Stres 2007; 20 (5) : 845-55.","journal-title":"J Trauma Stres."},{"key":"refR13","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1939-3938.2009.01025.x","volume":"5","author":"Abolfotouh M","year":"2009","unstructured":"Abolfotouh M, El-Bourgy M, Seif El Din A , et al. Corporal punishment Mother's disciplinary behavior and child's psychological profile in Alexandria, Egypt. J Forensic Nurs 2009; 5 (1) : 5-17.","journal-title":"J Forensic Nurs."},{"key":"refR14","first-page":"70","volume":"19","author":"Al-Mahroos F","year":"1997","unstructured":"Al-Mahroos F. Corporal punishment and psychological maltreatment among school girls in Bahrain. Bahrain Med Bulletin 1997; 19 (3) : 70-3.","journal-title":"Bahrain Med Bulletin."},{"key":"refR15","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.chiabu.2004.07.008","volume":"29","author":"Al-Mahroos F","year":"2005","unstructured":"Al-Mahroos F, Abdulla F, Kamal S , et al. Child abuse Bahrain's experience. Child Abuse Negl 2005; 29 : 187-93.","journal-title":"Child Abuse Negl."},{"key":"refR16","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1023\/A:1014335312219","volume":"15","author":"Dyregrov A","year":"2002","unstructured":"Dyregrov A, Gjestad R, Raundalen M. Children exposed to warfare a longitudinal study. J Trauma Stress 2002; 15 (1) : 59-68.","journal-title":"J Trauma Stress."},{"key":"refR17","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1093\/eurpub\/ckl260","volume":"17","author":"Giacaman R","year":"2007","unstructured":"Giacaman R, Shannon H, Saab H , et al. Individual and collective exposure to political violence Palestinian adolescents coping with conflict. Eur J Public Health 2007; 17 (4) : 361-8.","journal-title":"Eur J Public Health."},{"key":"refR18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1023\/A:1024453015176","volume":"11","author":"Hadi F","year":"1998","unstructured":"Hadi F, Llabre M. The Gulf crisis experience of Kuwaiti children psychological and cognitive factors. J Trauma Stress 1998; 11 (1) : 45-56.","journal-title":"J Trauma Stress."},{"key":"refR19","first-page":"329","volume":"83","author":"Ibrahim N","year":"2008","unstructured":"Ibrahim N, Jalali E, Al-Ahmadi J , et al. Prevalence, risk factors and outcome of childhood abuse reported by female university students in Jeddah. J Egypt Public Health Asstn 2008; 83 (5) : 329-51.","journal-title":"J Egypt Public Health Asstn."},{"key":"refR20","doi-asserted-by":"crossref","first-page":"435","DOI":"10.26719\/2001.7.3.435","volume":"7","author":"Jumaian A","year":"2001","unstructured":"Jumaian A. Prevalence and long-term impact of sexual abuse among a sample of male college students in Jordan. Eastern Med Health J 2001; 7 (3) : 435-40.","journal-title":"Eastern Med Health J."},{"key":"refR21","doi-asserted-by":"crossref","first-page":"672780","DOI":"10.1155\/2010\/672780","volume":"2010","author":"Lansford J","year":"2010","unstructured":"Lansford J, Alampay L, Al-Hassan S , et al. Corporal punishment of children in nine countries as a function of child gender and parent gender. Int J Pediatr 2010; 2010 : 672780.","journal-title":"Int J Pediatr."},{"key":"refR22","doi-asserted-by":"crossref","first-page":"229","DOI":"10.2190\/OM.56.3.b","volume":"56","author":"Morgos D","year":"2008","unstructured":"Morgos D, Worden J, Gupta L. Psychosocial effects of war experiences among displaced children in Southern Darfur. Omega 2008; 56 (3) : 229-53.","journal-title":"Omega."},{"key":"refR23","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s00787-003-0328-0","volume":"12","author":"Qouta S","year":"2003","unstructured":"Qouta S, Punam\u00e4ki R, El Sarraj E. Prevalence and determinants of PTSD among Palestinian children exposed to military voiolence. Eur Child Adolesc Psychiatr 2003; 12 (6) : 265-72.","journal-title":"Eur Child Adolesc Psychiatr."},{"key":"refR24","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/1359104505051208","volume":"10","author":"Qouta S","year":"2005","unstructured":"Qouta S, Punam\u00e4ki R, El Sarraj E. Mother-child expression of psychological distress in war trauma. Clin Child Psych Psychiatr 2005; 10 (2) : 135-56.","journal-title":"Clin Child Psych Psychiatr."},{"key":"refR25","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/S0145-2134(98)00077-5","volume":"22","author":"Youssef R","year":"1998","unstructured":"Youssef R, Attia M, Kamel M. Children experiencing violence I Parental use of corporal punishment. Child Abuse Negl 1998; 22 (10) : 959-73.","journal-title":"Child Abuse Negl."},{"key":"refR26","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/S0145-2134(98)00084-2","volume":"22","author":"Youssef R","year":"1998","unstructured":"Youssef R, Attia M, Kamel M. Children experiencing violence II Prevalence and determinants of corporal punishment in schools. Child Abuse Negl 1998; 22 (10) : 975-85.","journal-title":"Child Abuse Negl."},{"key":"refR27","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/BF01788030","volume":"24","author":"Chimienti G","year":"1989","unstructured":"Chimienti G, Nasr J, Khalifeh I. Children's reactions to war-related stress Affective symptoms and behavior problems. Social Psychiatr Psychiatr Epidem 1989; 24 (6) : 282-7.","journal-title":"Social Psychiatr Psychiatr Epidem."},{"key":"refR28","first-page":"227","volume":"2","author":"Cordahi C","year":"2002","unstructured":"Cordahi C, Karam E, Nehme G , et al. Les Orphelins De La Guerre Experience Libanaise et M\u00e9thodologie D'un Suivi Prospectif. Stress et Trauma 2002; 2 (4) : 227-35.","journal-title":"Stress et Trauma."},{"key":"refR29","author":"Karam E","unstructured":"Karam E, Fayyad J, Salamoun M , et al. Assessment study of psychosocial status of children and adolescents in the south of lebanon and southern suburbs of beirut after the july 06 war (SSSS) 2007. Beirut HCC\/HI\/EU-ECHO\/IDRAAC","journal-title":"Beirut HCC\/HI\/EU-ECHO\/IDRAAC."},{"key":"refR30","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1371\/journal.pmed.0050061","volume":"5","author":"Karam E","year":"2008","unstructured":"Karam E, Mneimneh Z, Fayyad J , et al. Lifetime prevalence of mental disorders in Lebanon First onset, treatment and exposure to war. PLOS Med 2008; 5 (4) : e61.","journal-title":"PLOS Med."},{"key":"refR31","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1002\/jts.2490090418","volume":"9","author":"Karam E","unstructured":"Karam E, Noujeim J, Saliba S , et al. PTSD How Frequently Should the Symptoms Occur\u03ba The Effect on Epidemiologic Research. J Traumat Stress 9 (4) : 899-905.","journal-title":"J Traumat Stress"},{"key":"refR32","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/0005-7967(91)90110-O","volume":"29","author":"Saigh P","year":"1991","unstructured":"Saigh P. The development of posttraumatic stress disorder following four different types of traumatization. Behaviour Res Therap 1991; 29 (3) : 213-6.","journal-title":"Behaviour Res Therap."},{"key":"refR33","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1365-2214.2010.01082.x","volume":"36","author":"Usta J","year":"2010","unstructured":"Usta J, Farver J. Child sexual abuse in Lebanon during war and peace. Child Care Health Develop 2010; 36 (3) : 361-8.","journal-title":"Child Care Health Develop."},{"key":"refR34","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1016\/S0140-6736(06)68427-4","volume":"367","author":"Karam E","year":"2006","unstructured":"Karam E, Mneimneh Z, Karam A , et al. Prevalence and treatment of mental disorders in Lebanon A national epidemiological survey. Lancet 2006; 367 (9515) : 1000-6.","journal-title":"Lancet."},{"key":"refR35","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/j.2051-5545.2008.tb00170.x","volume":"7","author":"Karam E","year":"2008","unstructured":"Karam E, Fayyad J, Karam A , et al. Effectiveness and specificity of a classroom-based group intervention in children and adolescents exposed to war in Lebanon. World Psychiatry 2008; 7 (2) : 103-9.","journal-title":"World Psychiatry"},{"key":"refR36","first-page":"95","volume":"13","author":"Kessler R","year":"2004","unstructured":"Kessler R, Ustun T. The World Mental Health (WMH) survey initiative version of the WHO-CIDI. Int J Methods Psychiatr Res 2004; 13 : 95-121.","journal-title":"Int J Methods Psychiatr Res."},{"key":"refR37","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s00787-010-0099-3","volume":"19","author":"Fayyad J","year":"2010","unstructured":"Fayyad J, Farah L, Cassir Y , et al. Dissemination of an evidence-based intervention to parents of children with behavioral problems in a developing country. Eur Child Adolesc Psychiatr 2010; 19 (8) : 629-36.","journal-title":"Eur Child Adolesc Psychiatr."},{"key":"refR38","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s00127-010-0311-2","volume":"47","author":"Al-Fayez G","unstructured":"Al-Fayez G, Ohaeri J, Gado O. Prevalence of physical, psychological, and sexual abuse among a nationwide sample of Arab high school students association with family characteristics, anxiety, depression, self-esteem, and quality of life. Soc Psychiatry Psychiatr Epidemiol 47 (1) : 53-66.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"refR39","doi-asserted-by":"crossref","first-page":"e10547","DOI":"10.1371\/journal.pone.0010547","volume":"5","author":"Stein D","year":"2010","unstructured":"Stein D, Chiu W, Hwang I , et al. Cross-national analysis of the associations between traumatic events and suicidal behavior Findings from the WHO World Mental Health Surveys. PLOS ONE 2010; 5 (5) : e10547.","journal-title":"PLOS ONE."},{"key":"refR40","doi-asserted-by":"crossref","first-page":"70","DOI":"10.2307\/1131687","volume":"67","author":"Macksoud M","year":"1996","unstructured":"Macksoud M, Aber J. The war experiences and psychosocial development of children in Lebanon. Child Develop 1996; 67 (1) : 70-88.","journal-title":"Child Develop."},{"key":"refR41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/00207590042000010","volume":"36","author":"Qouta S","year":"2001","unstructured":"Qouta S, El Sarraj E, Punam\u00e4ki R. Mental flexibility as resiliency factor among children exposed to political violence. Int J Psych 2001; 36 (1) : 1-7.","journal-title":"Int J Psych."},{"key":"refR42","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1111\/j.1469-7610.2004.00243.x","volume":"45","author":"Thabet A","year":"2004","unstructured":"Thabet A, Abed Y, Vostanis P. Comorbidity of PTSD and depression among refugee children during war conflict. J Child Psych Psychiatr 2004; 45 (3) : 533-42.","journal-title":"J Child Psych Psychiatr."}],"container-title":["Clinical Practice &amp; Epidemiology in Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/clinical-practice-and-epidemiology-in-mental-health.com\/contents\/volumes\/V10\/CPEMH-10-116\/CPEMH-10-116.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/clinical-practice-and-epidemiology-in-mental-health.com\/contents\/volumes\/V10\/CPEMH-10-116\/CPEMH-10-116.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/clinical-practice-and-epidemiology-in-mental-health.com\/contents\/volumes\/V10\/CPEMH-10-116\/CPEMH-10-116.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T17:57:05Z","timestamp":1650477425000},"score":1,"resource":{"primary":{"URL":"https:\/\/clinical-practice-and-epidemiology-in-mental-health.com\/VOLUME\/10\/PAGE\/116\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,21]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,10,21]]}},"alternative-id":["CPEMH-10-116"],"URL":"https:\/\/doi.org\/10.2174\/1745017901410010116","relation":{},"ISSN":["1745-0179"],"issn-type":[{"value":"1745-0179","type":"print"}],"subject":[],"published":{"date-parts":[[2014,10,21]]},"assertion":[{"value":"Peer Reviewed","order":0,"name":"review_status","label":"Review Status","group":{"name":"peer_review_details","label":"Peer Review Details"}},{"value":"Single blind","order":1,"name":"review_process","label":"Review Process","group":{"name":"peer_review_details","label":"Peer Review Details"}},{"value":"Checked with iThenticate","order":0,"name":"screening_status","label":"Screening Status","group":{"name":"plagiarism_screening","label":"Plagiarism Screening"}},{"value":"2014-6-3","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-8-2","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-8-2","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}