Violence Exposure and Post-Traumatic Stress Disorder Among Children in Conflict-Affected Communities of Borno State, North East Nigeria

Children in conflict-affected communities face pervasive exposure to violence, displacement, and loss, creating a high-risk environment for post-traumatic stress disorder (PTSD) and other mental health sequelae. In Borno State, over a decade of armed conflict has exposed hundreds of thousands of children to traumatic events, yet systematic mental health burden data remain scarce. This cross-sectional analytical study estimates the prevalence of PTSD and examines its correlates among children aged 7 to 15 years residing in IDP settlements and recovered communities in Maiduguri and Konduga local government areas of Borno State. A total of 480 children were assessed using the UCLA Post-Traumatic Stress Disorder Reaction Index (PTSD-RI) administered by trained child health workers. Violence exposure inventory and sociodemographic questionnaires were completed by caregivers. PTSD prevalence was 38.6%, with 14.4% of children meeting criteria for severe PTSD. Witnessing the death of a family member (OR 5.4) and forced displacement more than twice (OR 3.8) were the strongest PTSD predictors. Female children had higher PTSD odds (OR 1.8). Presence of a stable caregiver relationship was significantly protective (OR 0.42). Only 3.1% of PTSD-positive children had received any form of psychosocial intervention. The study underscores a critical mental health emergency among conflict-affected Nigerian children and urges integration of child mental health services into humanitarian health responses. Keywords: PTSD, conflict-affected children, Borno State, violence exposure, North East Nigeria.