Own and parental war experience as a risk factor for mental health problems among adolescents with an immigrant background: results from a cross sectional study in Oslo, Norway

BACKGROUND An increasing proportion of immigrants to Western countries in the past decade are from war affected countries. The aim of this study was to estimate the prevalence of war experience among adolescents and their parents and to investigate possible differences in internalizing and externalizing mental health problems between adolescents exposed and unexposed to own and parental war experience. METHOD The study is based on a cross-sectional population-based survey of all 10th grade pupils in Oslo for two consecutive years. A total of 1,758 adolescents were included, all with both parents born outside of Norway. Internalizing and externalizing mental health problems were measured by Hopkins Symptom Checklist-10 and subscales of the Strengths and Difficulties Questionnaire, respectively. Own and parental war experience is based on adolescent self-report. RESULTS The proportion of adolescents with own war experience was 14% with the highest prevalence in immigrants from Eastern Europe and Sub-Saharan Africa. The proportion of parental war experience was 33% with Sub-Saharan Africa being highest. Adolescents reporting own war experience had higher scores for both internalizing and externalizing mental health problems compared to immigrants without war experience, but only externalizing problems reached statistically significant differences. For parental war experience there was a statistically significant relationship between parental war experience and internalizing mental health problems. The association remained significant after adjustment for parental educational level and adolescents' own war experience. CONCLUSION War exposure is highly prevalent among immigrants living in Oslo, Norway, both among adolescents themselves and their parents. Among immigrants to Norway, parental war experience appears to be stronger associated with mental health problems than adolescents own exposure to war experience.