Longitudinal studies on children's and adolescents' psychological reactions to conflict-related traumatic events in low- and middle-income countries are scarce. The present study aimed to analyze children's and adolescents' responses to conflict-related potentially traumatic events (PTEs) and the impact of the number of different types of PTEs on psychological symptoms and resilience over time. We investigated the presence of psychological symptoms and resilience, defined as low levels of symptoms and high levels of hope, in a sample of 597 conflict-affected children and adolescents allocated to a waiting list condition in four randomized trials conducted in Burundi, Indonesia, Nepal and Sri Lanka. A decrease in functional impairment (p < 0.001), symptoms of PTSD (p < 0.001), anxiety (p < 0.001), depression (p = 0.052), and an increase in social support (p < 0.001), was observed over a six-month follow-up. More than one third of children and adolescents (34.6%) exposed to conflict-related traumatic events improved at follow-up. Levels of hope did not significantly change. Improvement in psychological symptoms and resilience were significantly associated with the number of different types of PTEs experienced before study entry.

This study showed that children and adolescents have the capacity to react to multiple traumatic events, and that the number of different types of traumatic events has an impact on resilience mechanisms. This will help differentiate the choice and focus of psychosocial interventions according to the amount of traumatic events experienced by children and adolescents, and will inform the development and testing of new psychosocial interventions.

在低收入和中等收入国家，关于儿童和青少年对冲突相关创伤事件的心理反应的纵向研究很少。本研究旨在分析儿童和青少年对冲突相关潜在创伤事件 (PTE) 的反应，以及不同类型 PTE 的数量随时间推移对心理症状和复原力的影响。在布隆迪、印度尼西亚和尼泊尔进行的四项随机试验中，我们调查了被分配到等候名单条件的 597 名受冲突影响的儿童和青少年样本中的心理症状和适应力，定义为低水平的症状和高水平的希望和斯里兰卡。功能障碍（p  < 0.001）、PTSD 症状（p < 0.001）、焦虑（p < 0.p  = 0.052），并且在六个月的随访中观察到社会支持的增加（p < 0.001）。超过三分之一 (34.6%) 暴露于冲突相关创伤事件的儿童和青少年在后续行动中有所改善。希望的水平没有显着变化。心理症状和适应力的改善与进入研究前经历的不同类型 PTE 的数量显着相关。

这项研究表明，儿童和青少年有能力对多重创伤事件做出反应，不同类型创伤事件的数量对复原机制有影响。这将有助于根据儿童和青少年所经历的创伤事件的数量来区分社会心理干预的选择和重点，并将为新的社会心理干预的开发和测试提供信息。