War trauma, child labor, and family violence: Life adversities and PTSD in a sample of school children in Kabul


  • We are grateful to all children, teachers, counselors, and staff members in Afghanistan who took part in the study. The research conducted in this study was supported by Vivo Foundation, by the DFG (Deutsche Forschungsgemeinschaft), and by funding from the German Technical Cooperation (GTZ). The authors would like to thank Emad Wejdan and Dr. Michael Hirth from GTZ for their logistical support in Afghanistan, and Dr. Katy Robjant for editing. Authors declare they have no conflict of interest. The corresponding author had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.


The extent of cumulative adverse childhood experiences such as war, family violence, child labor, and poverty were assessed in a sample of school children (122 girls, 165 boys) in Kabul, Afghanistan. Strong gender differences were found with respect to both the frequency of such experiences and the association of different types of stressors with posttraumatic stress disorder (PTSD) symptoms. Boys reported higher overall amounts of traumatic events, specifically experiences of violence at home. This was reflected in a 26% prevalence of probable PTSD in boys compared to 14% in girls. Child labor emerged as a common phenomenon in the examined sample and was furthermore associated with an increased likelihood of experiencing family violence for girls. The results suggest that the interplay of multilevel stressors in Afghan children contributes to a higher vulnerability for the development of PTSD.