Sleep and psycho-behavioral problems in internally displaced children in Georgia

Objective: The aim of this study was to examine sleep and psycho-behavioral variables in Georgian Internally Displaced (ID) Children and their population-based controls. Methods: One hundred and sixty one children (10.85 +/- 0.9) from ID families escaped from Shida Kartli, Georgia, and 161 non-ID children (10.94 +/- 0.9) were studied after seven years of displacement. Children completed the Pre-Sleep Arousal Scale, Buss-Perry Aggression Questionnaire (BPAQ), Children's Depression Inventory (CDI), and the Child Trauma Screening Questionnaire (CTSQ). In addition, we assessed the children's appraisal of the family environment. Moreover, parents reported socio-demographic information, their children's academic excellence, and completed the Sleep Disturbance Scale for Children (SDSC), Beck Depression Inventory II (BDI), and Perceived Stress Scale (PSS). Results: Compared with the control group, ID children had a lower level of academic excellence and family environment (p < 0.01) as well as higher scores in all SDSC dimensions with the significant difference for breathing (p < 0.001), hyperhidrosis and SDSC total scores (p < 0.05). Cognitive pre-sleep arousal was significantly higher in non-IDs (p < 0.01), while there was no difference between groups in somatic pre-sleep arousal level. All BPAQ component and total scores were higher in IDs than in non-IDs but the difference was significant only in Physical Aggression (p < 0.01). Mean scores for BDI and PSS were significantly higher in ID than non-ID parents (p < 0.001). Both cognitive and somatic pre-sleep arousal predicted SDSC total score in non-IDs (p < 0.01) while cognitive but not somatic arousal was significant predictor in IDs (p < 0.01). Conclusion: Sleep and psycho-behavioral problems are noticeable even in those ID children who were very young at the time of displacement. Psycho-social environment in which children are growing up warrants major consideration in ID population