This article was downloaded by: [Flinders University of South Australia]On: 06 October 2014, At: 20:20Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Alcoholism Treatment QuarterlyPublication details, including instructions for authors andsubscription information:http://www.tandfonline.com/loi/watq20

Assessing the Aftermath of War amongTeens in Bosnia & Serbia: Measures ofSubstance Abuse and Delinquency withthe POSIT (Problem-Oriented ScreeningInstrument for Teens)Laurence Armand French a , Goran Kovacevic b & Lidija Nikolic-Novakovic ca Justiceworks Institute, University of New Hampshire , Durham ,New Hampshire , USAb Faculty of Criminal Sciences , University of Sarajevo , Sarajevo ,Bosnia-Herzegovinac International University of Novi Pazar , Pancevo , SerbiaPublished online: 17 Jan 2013.

To cite this article: Laurence Armand French , Goran Kovacevic & Lidija Nikolic-Novakovic (2013)Assessing the Aftermath of War among Teens in Bosnia & Serbia: Measures of Substance Abuse andDelinquency with the POSIT (Problem-Oriented Screening Instrument for Teens), Alcoholism TreatmentQuarterly, 31:1, 95-106, DOI: 10.1080/07347324.2013.746620

To link to this article: http://dx.doi.org/10.1080/07347324.2013.746620

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the“Content”) contained in the publications on our platform. However, Taylor & Francis,our agents, and our licensors make no representations or warranties whatsoever as tothe accuracy, completeness, or suitability for any purpose of the Content. Any opinionsand views expressed in this publication are the opinions and views of the authors,and are not the views of or endorsed by Taylor & Francis. The accuracy of the Contentshould not be relied upon and should be independently verified with primary sourcesof information. Taylor and Francis shall not be liable for any losses, actions, claims,proceedings, demands, costs, expenses, damages, and other liabilities whatsoever orhowsoever caused arising directly or indirectly in connection with, in relation to or arisingout of the use of the Content.

This article may be used for research, teaching, and private study purposes. Anysubstantial or systematic reproduction, redistribution, reselling, loan, sub-licensing,

systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

Alcoholism Treatment Quarterly, 31:95–106, 2013

Copyright © Taylor & Francis Group, LLC

ISSN: 0734-7324 print/1544-4538 online

DOI: 10.1080/07347324.2013.746620

Assessing the Aftermath of War amongTeens in Bosnia & Serbia: Measures of

Substance Abuse and Delinquency with thePOSIT (Problem-Oriented Screening

Instrument for Teens)

LAURENCE ARMAND FRENCH, PhDJusticeworks Institute, University of New Hampshire, Durham, New Hampshire USA

GORAN KOVACEVIC, PhDFaculty of Criminal Sciences, University of Sarajevo, Sarajevo, Bosnia-Herzegovina

LIDIJA NIKOLIC-NOVAKOVIC, MAInternational University of Novi Pazar, Pancevo, Serbia

The Balkan Wars of 1991 to 2002 left the former Yugoslavia in

ruins, a situation made only worst with the recent worldwide re-

cession. Untreated civilians and Veterans caught up in the war, the

worst in Europe since World War II, has had an even greater im-

pact on youth. Sectarian hostilities and prejudices within and be-

tween the three major ethnic populations in Bosnia–Herzegovina—

Orthodox Serbs, Muslim Bosniaks, and Catholic Croats, as well

as the Orthodox Serbs and Muslim Albanians in Serbia/Kosovo—

has led to impulsive violence and increasing mental and physi-

cal health problems among these second-generation war victims.

The authors’ pilot study administered a Slavic-language Problem-

Oriented Screening Instrument for Teens to schools in Bosnia–

Herzegovina that represented the three major sectarian groups

(Orthodox, Bosniak, Catholic) as well as in the war-torn Vojvodina

province of Serbia.

KEYWORDS Teens, alcohol use/abuse; mental health; family co-

hesion; sectarianism

Address correspondence to Laurence A. French, PhD, University of New Hampshire,Justiceworks, 208 Huddleston Hall, 73 Main Street, Durham, NH 03824. E-mail: frogwnmu@

yahoo.com

95

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

96 L. A. French et al.

INTRODUCTION

The Balkan wars of 1991 to 2002 had some of their greatest impact on theSarajevo area in Bosnia–Herzegovina prior to the Dayton Peace Accord ofDecember 1995 and in the Pancevo/Belgrade region of Serbia during theMarch to June NATO bombings in 1999 (Dahl, 2002; Institute for Energy andEnvironmental Research [IEER], 1999). An unresolved problem surroundingthese events is the fact that sectarianism remains as much a problem todayas it did during the conflict itself. The 70th Rose-Roth Seminar presented atthe NATO Parliamentary Assembly in 2009 noted that sectarianism amongMuslim Bosniaks, Bosnian Croat Catholics, and Orthodox Serbs is a situationperpetrated by parents and schools resulting in youth today being ‘‘moreprovincial than their parents’’ (Rose-Roth, 2009).

This study measures the extent of youth issues among these populationsusing a Slavic-language version of the Problem-Oriented Screening Instru-ment for Teens (POSIT) as a comparative measure of 10 items: substanceuse/abuse, physical health, mental health, family relations, peer relations,educational status, vocational status, social skills, leisure & recreation, andaggressive behavior/delinquency. In 2010 and 2011, we administered thePOSIT to high school classes representing the three major ethnic/sectariangroups in the divided Bosnia–Herzegovina as well as to a high school classin Pancevo, the largest target of the heavily bombed Vojvodina province inSerbia.

REVIEW OF THE LITERATURE

The NATO Parliamentary Assembly’s 70th Rose-Roth Seminar was held inSarajevo in March 2009 at the invitation of the Parliamentary Assembly ofBosnia and Herzegovina to discuss security, political, and economic chal-lenges in Bosnia and Herzegovina and the Western Balkans. It was noted thatrising unemployment and budgetary pressures in the region have contributedto continued social and political unrest. Indeed, increased sectarianism hasslowed European Union (EU) and NATO-sponsored reforms with all sidesresisting making essential compromises needed to advance key reforms.Sectarian leaders continue to exploit deeply held fears and pervasive ethnicmistrust slowing the pace of political change.

An outcome of this process is that the young people have acquired aneven more provincial and narrow outlook than that of their parents. Part ofthis problem is that the schools in Bosnia and Herzegovina are now almostexclusively segregated along sectarian lines with each sect promoting itsskewed version of the Balkan wars of 1991 to 2001. There was a cry forthe establishment of a ‘‘truth and reconciliation committee’’ in Bosnia toovercome these sectarian-biased perspectives of the history of the Balkan

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

Assessing Teens in Bosnia and Serbia 97

wars. It was also noted that Serbia needs to address the plight of its na-tional minorities as well: Hungarians, Albanians, Bosniaks, Croats, Czechs,Germans, and Roma.

The Rose-Roth report stated that in Serbia, as in Bosnia, there has beena tendency to segregate schools where before the Balkan wars they weremultiethnic. Nongovernmental organizations (NGOs) are attempting to draftnew Slavic-language history books characteristic of a broader, more complexanalysis of the Balkan wars to replace the current nationalistic versions, butthey are finding considerable resistance to these efforts in all the breakawaycountries of the former Yugoslavia including Bosnia–Herzegovina and Serbia(Rose-Roth, 2009).

A review of Slavic-language articles dealt with traumatic stress associatedwith the 1991 to 2001 Balkan Wars including the 44-month-long siege ofSarajevo (April 1992–February 1996); the NATO bombing of the federalrepublic of Yugoslavia (now the States of Serbia, Montenegro, and Kosovo)from March to June 1999; as well as the tens of thousands of refugeesdisplaced, many still not back in their homeland, during the entire Balkanconflict (Donev, Onceva, & Gligorov, 2002; Lazic & Bojanin, 1995). It isimportant to note that people on all sides of the Balkan conflict, Veteransand civilians alike, were subjected to war-related trauma, either directly orindirectly, and that these social/clinical features pertain to anyone, regardlessof their ethnic/sectarian origin.

Many articles focused on the effects of the war on children and youth.A sampling of these studies portrays the complexity of this problem withinthe Balkans. Milosavljevic and his associates noted that though war is themost significant human stressor, children are the most vulnerable to itseffects. They studied the effect of war psychic trauma syndrome (WPTS)among youth age 10 to 16 residing in Banja Luka, Republika Srpska (RS), inNovember and December 1995. Milosavljevic’s team found that the effectsof WPTS (psychophysiological, emotional, and cognitive impairments) wasmore frequent among females than males and that these effects were moreintense and frequent among those youth who lost somebody close tothem in the conflict (Milosavljevic, Savic, Gutovic, & Kutalac, 1996). Manyresearchers found that the prolonged nature of the conflict, in conjunctionto the unpredictability of their situation, contributed to the intensity of post-traumatic crisis (Basoglu et al., 2005; Hasanovic, Sinanovic, & Pavlovic,2005; Hasanovic, Sinanovic, Selimbasic, Paqevic, & Avdibegovic, 2006:Herceg, Melamed, & Pregrad, 1996; Klaric, Klaric, Slevanovic, Grkovic, &Jonovska, 2007; Klaric et al., 2008; Terzic, Mestrovic, Dogas, Furlan, & Biocic,2001).

Petrovic (2004), in her study of 1,934 primary school children in Vojvo-dina, Serbia, compared war-related traumatization (NATO bombings) withthat of single-event nonwar childhood trauma finding that repeated (chronic)stress leads to a higher level of traumatization coupled with serious person-

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

98 L. A. French et al.

ality changes. Another study of children and youth in Vojvodina, conducted14 months following the end of the NATO bombing attacks, found that nearly60% of the children showed signs of trauma that affected on their everydaycoping skills (Gavriolvic-Jankovic, Lecic-Tosevski, & Jovic, 1998; Selakovic-Bursic, Vuckovic, & Sekulic-Bartos, 2000; Selakovic-Bursic, Sekulic-Bartos,Vojislava, Srdanovic, & Donoski, 2001; Zotovic, 2005). And a study conductedby the University of Novi Sad found that children (age 7 at the time of theNATO bombings) from towns that were directly hit by the air campaignshowed more marked signs of personal distress 5 years later, in comparisonto those children not directly affected by these attacks. This phenomenonwas more common in males than in females (Nikoloski-Koncar, Zotovic, &Hautekeete, 2006).

A study of traumatized children in Prishtina in 2000 found similaritiesamong this population to that of a sample from Sarajevo (Barath, 2002a). TheKosovo sample differed from the besieged Sarajevo study in that the Prishtinachildren involved refugees relocated to camps in Macedonia hence havingthe additional feature of sociocultural anomie—a common factor among allgroups of refugee children regardless of ethnic/sectarian/national origin. Thestudy reported three major groups of stressors: (1) a lack of cultural and socialsecurity resources they once enjoyed in their native homeland, (2) poor men-tal and physical health conditions, and (3) school-related stressors. The study,conducted by the Canadian International Children’s Institute (ICI), warnedthat environmental, educational, and social/cultural circumstances need to betaken into account when addressing traumatized children, especially thosewho were refugees (Barath, 2002; Donev et al., 2002b).

A similar conclusion was noted by Ajdukovic (1995) in her study ofchildren in Croatia. She stated that 969 children were wounded during thewar in Croatia (254 killed) whereas another 4,273 children lost one par-ent and 54 lost both parents. Consequently, numerous children witnessedviolence and death with many displaced from their home environment. Astudy done by UNICEF indicated that childhood trauma was most intenseamong those children who were displaced due to the war, especially thosewho also experienced or witnessed violence (Ajdukovic, 1995). A similarstudy, comparing refugee children from Croatia and Bosnia–Herzegovinawith their counterparts who remained home, indicated that refugee victimstended to be plagued by the death of a family member, and forced expulsionin addition to intrusive memories of the bombardments while the nonrefugeechildren were plagued mainly by the bombardments (Herceg et al., 1996).Intrusive traumatic experiences were true for those youth who were victimsof landmines, a problem that continues to plague many communities inBosnia and Herzegovina (Ceranic, 2003).

The focus on unmet social/cultural and psychological needs of trauma-tized children and youth is important because not doing so could be costlyto the society in terms of later disorganization by this group as they mature.

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

Assessing Teens in Bosnia and Serbia 99

Substance abuse, dysfunctional families, and poor educational and employ-ment records are likely to increase among this untreated population. A studyof psychological problems in children of war veterans with posttraumaticstress disorder (PTSD) in Bosnia–Herzegovina showed more developmentalproblems with their children indicating problematic long-term effects of thefather’s PTSD on the family matrix (Klaric et al., 2008).

Collectively, psychological crises among children and youth serve toimpede any reconciliation efforts within the various ethnic/sectarian groupscaught up in the Balkan conflicts. Studies on ethnic stereotypes in Bosnia–Herzegovina measured the nature of continued outgroup negative imagesharbored by Bosniak and Serbian youth. One study between youths inSarajevo (Bosniaks) and Banja Luka (Serbs) showed significant intergroupnegative stereotypes between the two groups—a clear reflection of theirrespective socialization within a polarized society (Turjacanin, 2004).

Another study on the ethnic preference of citizens of RS and the Federa-tion of Bosnia and Herzegovina (FBiH) indicated a broader spectrum of eth-nic dislikes among adults within these two entities. The FBiH sample dislikedRomas the most followed in descending order: Albanians, Macedonians,Serbs, and Montenegrians. Slovenians and Croats were the least rejectedby the citizens of FBiH. The Croats were most adamant about their ethnicrejections than their more populous Bosniaks within the greater FBiH sample.The RS sample rejected the Bosniaks the most followed in descending order:Romas, Croats, Slovenians, and Macedonians. They rejected Montenegriansthe least. The RS sample was more adamantly against interethnic/sectarianmarriages as well (Puhalo, 2003).

Research clearly indicates that children and youth are influenced by theirinteractions with traumatized parents and close family members. Impulsiveviolence and substance abuse are common attributes among untreated andfrustrated Veterans (fathers, sons, husbands). Obviously, these behaviorsaffect greatly the immediate and extended family (Ilic, 1998; Gavrilovic-Jankovic et al., 2005; Jovanociv, Tosevski, Ivkovic, Damjanovic, & Gasic,2009; Kuljic, Miljanovic, & Svicevic, 2004; Opalic, 2008; Varsek, 1999). Familyand personal disruptions also afflict women (mothers, daughters, wives)especially those taken away from their families and subjected to rape, torture,and confinement during the conflicts. One study clearly showed that civilianwomen who experienced long-term exposure to war stressors, coupled withcontinued postwar stressors (broken families or displaced family members,unemployment, problems with their spouse and/or children), suffered se-rious psychological problems including PTSD (Klaric et al., 2007). Evenmore devastating are studies on the psychological consequences of rape onwomen during the 1991 to 1995 war. A substantial number of captive womenwere raped repeatedly as well as being subjected to torture (Loncar, Medved,Jovanovic, & Hotujac, 2006). It is an understatement to say that wartimerapes left deep psychological scars among this population. Research showed

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

100 L. A. French et al.

that of Veterans, former prisoners, rape victims, and refugees, rape victimsand former prisoners were shown to have the most severe PTSD symptoms(Drezgic-Vulkic, Nezevic, Siladi, Borisev, & Ivezic, 1996; Gregurek et al.,1996; Henigsberg, Folnegovic-Smalc, & Moro, 2001). Clearly, violated warvictims represent a difficult class of traumatized people to treat effectively.Suicide is often being the final solution to their suffering. The children ofthese victims certainly are at a high risk of suffering from secondary PTSDand consequently more prone to resorting to alcohol as the treatment ofchoice for their untreated problems.

RESEARCH DESIGN

The research was conducted within classrooms, with school officials’ ap-proval and supervision. Each school took the responsibility of contactingthe student’s parents regarding their approval for participation in the study.Parents were told that the study was designed to provide a classwide profileand that no individual data would be gleaned from the study. The MuslimBosniak school in Sarajevo, the Orthodox Serb school in East Sarajevo,and the Serb school in Pancevo involved local approval from the schooladministrators whereas the Catholic school sample required permission fromthe Catholic Bishop of the Sarajevo diocese. Teachers were in the classroomswhile the authors conducted the questionnaire but did not interfere withthe process. The results were made available to the participating schoolsonce the data was analyzed. Each school only received their respectivesample’s results. The instrument used was a Slavic-language translation ofthe POSIT.

In 1991, the National Institute on Drug Abuse (NIDA) published itsAdolescent Assessment/Referral System (AARS). A major strength of thisinstrument is its clinical methodology (Rahdert, 1991). The initial assessmentcomponent of the AARS is the Problem-Oriented Screening Instrument forTeenagers (POSIT) that consists of 139 forced-choice items covering 10 do-mains: substance use/abuse, physical health, mental health, family relations,peer relations, educational status, vocational status, social skills, leisure &recreation, and aggressive behavior/delinquency. It is geared for youth age12 to 19. The original standardization (reliability and validity) of the POSITprovided cutting scores (critical scores) for each of the 10 functional areas(domains). The AARS provides three stages of referral: (1) the POSIT that iscompleted along with the corresponding Client Personal History Question-naire (for use with individual administration of the POSIT), (2) the Compre-hensive Assessment Battery comprising widely acceptable English-languageclinical measures, and (3) the Directory of Adolescent Services available inthe United States. The standardization (reliability and validity) of the POSITprovided cutting scores (critical score) for each of the 10 functional areas. A

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

Assessing Teens in Bosnia and Serbia 101

profile sheet allows for either individual or aggregate presentation of the 10functional areas and their level of significance.

In the 1990s, French adapted the POSIT for aggregate profiles andapplied this concept to the measurement of ethnic comparisons as well as tomeasure the outcome of treatment programs in clinical and school settings.In the ethnic comparison model, the POSIT is administered collectively toa sample of various ethnic adolescent populations within a heterogeneousmilieu, and then comparisons are made between gender differences withinan ethnic group as well as between the various groups involved in the study.French and Picthall-French (1996, 1998) conducted research in the U.S. Southand Southwest comparing the aggregate POSIT scores of a sample (468)of rural White, African American, Mexican American, Mexican, and Navajoyouth.

French (1998) also adapted the aggregate POSIT as an effective outcomemeasurement tool for school and treatment center programs, notably thoseaddressing substance abuse and delinquency. Here, the POSIT would beadministered to a class cohort prior to the administration of the experimentalprogram (pretest) and then the POSIT would again be administered to thecohort following the program. This protocol usually followed the studentsthrough the academic year. Another similar application was merely to mea-sure the collective maturity or decompensation of a class/grade cohort byadministering the POSIT to the entire class beginning in the sixth grade andthen again at regular intervals of 1 or 2 years. The advantage of this processwas that individual students measuring with marked pathology would besingled out for further clinical and/or social interventions. Those individualswith extreme spikes in POSIT scores would also be eliminated from thecollective cohort norm so as not to contaminate the norm.

This pertains to the current study, in which French combined thesetwo aspects of the POSIT by gleaning ethnic samples from the three majorsectarian groups in Bosnia–Herzegovina (Muslim Bosniaks, Catholic Croats,Orthodox Serbs) as well as an Orthodox Serb sample in the Vojvodinaprovince of Serbia. Although the authors (French, Kovacevic, & Nikolic-Novakovic) knew of the overall research design, the school administerswere told only of their school’s participation. The Slavic-language POSIT wasoffered as a tool designed not only to ascertain the current collective profileof their students and to weed out those with serious substance abuse andmental health issues but also as a tool to follow these students overtime asthey progress through school with special attention to outcome measurementfor intervention programs.

The research was conducted in 2010 with the exception of the CatholicCroat sample that was done during the fall semester of 2011. This delaywas due to the opposition of the Catholic Bishop in the Croat sections ofthe FBiH. His stated opposition was due to the last question (#139) thataddresses sexual intercourse and the use of condoms (‘‘Have you ever had

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

102 L. A. French et al.

sexual intercourse without using a condom?’’). We finally gained permissionto test in the Catholic public school when a new Bishop was appointed.Each of the schools was entirely sectarian although many schools in theFBiH are segregated within the same school. This was not the case with ourstudy. We tested a high school class in each of the represented schools witha total of 217 students tested (131 males and 86 females). The first schooltested was a typical high school within RS in East Sarajevo (the Orthodoxsection of the capital city that is partitioned between the RS and the FBiH).This class comprised 48 students (32 males, 16 females). Next we tested theentire high school population of a Muslim high school in Sarajevo. The totalstudent population comprised 68 students (29 males, 39 females). We thentested a high school class in Pancevo Serbia located in Vojvodina Province.The class had 49 students (39 males, 10 females). All three schools weretested during the spring semester of 2010. The last school to be tested wasa Catholic high school in Kiseljak, FBiH. This sample consisted of 31 malesand 21 females for a total sample of 52 students.

FINDINGS

Each sample is represented in Table 1 with a further demarcation madeaccording to male and female participants. The mean age for all samples

TABLE 1 Comparative Problem–Oriented Screening Instrument for Teens Scores for SectarianSchools in Bosnia-Herzegovina and Serbia

FBiHCatholics

BosniakMuslims

RSOrthodox

SerbianOrthodox

M F M F M F M F

Critical itemscore forpathology

Substance use/abuse 2 1.2 2.5 0.4 2 0 1.9 2.6 (1)Physical health 2.4 3.2 3 2 2 3 3 4.9 (3)Mental health 7.5 8.4 9 7 7 8.6 7 11 (4)Family relations 2.1 2.7 2.5 1.8 2 2.5 2 3.3 (4)Peer relations 4 4.2 3.8 1.9 4 3.5 4 6 (1)Educational status 9 8 9 7.4 9 9 8 10.7 (6)Vocational status 5.7 7.2 6 7 5.4 9 5 6.3 (5)Social skills 3 4.2 3.9 3.2 2.8 3.7 3 3.6 (3)Leisure & recreation 4.7 5.9 4.3 3.8 4.7 5.5 4 5.1 (5)Aggressive behavior/

delinquency7.2 4.5 6 3.3 7 4.9 6 9.5 (6)

Minimum Mean scores 47.6 49.5 50 37.8 46 50 44 63

FBiH D Federation of Bosnia and Herzegovina; RS D Repbulika Srpska.

‘‘Minimum Mean score’’ of 38 is the aggregate baseline for item pathology.

Mean age of student samples D 16.5.

Date collected in 2010/2011 academic years. Serbian Orthodox, RS Orthodox, & Bosniak Muslim samples

collected during 2010 academic year; FBiH Catholics collected in 2011 academic year.

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

Assessing Teens in Bosnia and Serbia 103

was 16. The ‘‘minimum Mean score’’ (MMS), 38, is the total of the minimumcritical item scores signifying aggregate teen problems.. The only subsamplethat fell below the MMS was the female Muslim Bosniak sample with a scoreof 37.8. The group with the highest MMS was the Serbian Orthodox femalesample (MMS D 63). The Bosniak male and RS Orthodox female sampleseach had a MMS of 50 whereas the FBiH Catholics follow close behind withthe females scoring 49.5 and their male counterparts with a MMS of 47.6.

When looking at the relationship between substance use/abuse, mentalhealth, and aggressive behavior/delinquency, the combination most likelyto manifest destructive behaviors among youth, the Muslim Bosniak malesscored the highest on the substance use/abuse item (2.5) among the Bosnia–Herzegovina sample whereas the Serbian female sample scored highest (2.6)on this item. Interestingly alcohol, the most common form of substance usein BiH, is forbidden among the Muslim Bosniak and is not available inany of the Muslim community stores. When looking at mental health, theMuslim Bosniak males scored highest (9) among the BiH sample whereasthe Serbian females scored highest for their sample. And when looking atthe third element of the impulsive/destructive formula, the Serbian femalesscored highest (9.5) of all the samples tested whereas Catholic Croat malesscored highest (7.2) among the BiH samples. Another interesting finding wasthe lack of problems among the teen sample on the family relations itemsignifying the cohesion of each sectarian ethnic enclave, especially amongthe BiH samples. Only the Serbian female sample approached problems onthis item (3.3) on this item (a score of 4 indicates pathology). This item atteststo the insular interethnic socialization that has emerged following the Balkanwars.

This information has been provided to the respective school districtswith efforts now being made to incorporate the aggregate POSIT throughthe two major entities in Bosnia–Herzegovina: the FBiH and RS. Additionally,efforts are being made to provide a state-wide Directory of AdolescentServices for clinicians throughout Bosnia–Herzegovina. This effort is cur-rently being conducted by the international NGO: The Wings of Hope.Efforts in Serbia and Kosovo are currently stalled given the impasse overthe unilateral declaration of independence of the latter. Nonetheless, ourapproach provides a model for addressing impulsive group violence, bingedrinking, and increasing mental and physical health problem among youthin all of the former Yugoslavia.

CONCLUSION

Bosnia–Herzegovina and Serbia continue to experience the disruptions ofthe Balkan wars especially with the reemergence of nationalist in their re-spective governments. Bosnia–Herzegovina continues to be fragmented be-

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

104 L. A. French et al.

tween the three major sectarian groups: Muslim Bosniaks, Orthodox Serbs,and Catholic Croats whereas Serbia continues to resist acceptance of thebreakaway province: Kosovo. The EU requires better cooperation betweenthese factions before either Bosnia–Herzegovina or Serbia can gain full mem-bership. Ironically, a finding of this study, strong family cohesion, indicatesthat sectarian separatism is a major factor in school and family socializationmaking the postwar teens even more nationalistic than their parents who en-countered the Balkan wars firsthand. Even then, intergroup tensions continueto plague Bosnian and Serbian teens resulting in escapism mainly throughalcohol use and abuse. Substance abuse and mental health issues are alsopotential indicators of PTSD These factors provide considerable challengesfor mental health and substance abuse treatment facilities, especially thoseattempting to work with all sectarian groups.

REFERENCES

Ajdukovic, M. (1995). Children in war in Croatia. Croatian Journal of Social Policy,2, 295–304.

Barath, A. (2002a). Children’s well-being after the war in Kosovo: Survey 2000.Croatian Medical Journal, 43, 199–208.

Barath, A. (2002b). Psychological status of Sarajevo children after war: 1999–2000survey. Croatian Medical Journal, 43, 213–220.

Ceranic, S. (2003). Psycho-social consequences in adolescent: Victims of landmines.Engrams, 25, 49–54.

Dahl, F. (2002). Serb town still waiting for NATO bombing clean-up. Common

Dreams.Org. Retrieved from www.commondreams.org/cgi-bin/print.cgi?fileD

headlines02/0504-08.htmDonev, D., Onceva, S., & Gligorov, I. (2002). Refugee crisis in Macedonia during

the Kosovo conflict in 1999. Croatian Medical Journal, 43, 184–189.Drezgic-Vulkic, S. M., Knezevic, A., Siladi, D., Borisev, L., & Ivezic, A. (1996). War

stress and alcoholism in veterans. Current Topics in Neurology, Psychiatry and

Related Disciplines, 4, 35–39.French, L. A., & Picthall-French, N. (1996). Assessing three adolescent groups in

New Mexico using the Problem-Oriented Screening Instrument. Psychological

Reports, 79, 242.French, L. A., & Picthall-French, N. (1998). The role of substance abuse among rural

youth by race, culture and gender. Alcoholism Treatment Quarterly, 16(3), 101–108.

Gavrilovic, J., Lecic-Tosevski, D. M., & Jovic, V. (1998). Actual symptomatology,defense mechanisms and childhood traumatic experience in war traumatizedpatients. Psychiatry Today, 30, 297–305.

Gavrilvic-Jankovic, J., Lecic-Tosevski, D., Colovic, O., Dimic, S., Susic, V., PejovicMilovancevic, M., : : : Priebe, S. (2005). Association of posttraumatic stress andquality of life in civilians after air attacks. Psychiatry Today, 37, 289–305.

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

Assessing Teens in Bosnia and Serbia 105

Gregurek, R., Vakusic, H., Bavetic, V., Potrebica, S., Krbot, V., Didic, I., : : : Sljepcevic,B. (1996). Anxiety and post-traumatic stress disorder in disabled war veterans.Croatian Medical Journal, 37, 38–41.

Hasanovic, M., Sinanovic, O., & Pavlovic, S. (2005). Acculturation and psycholog-ical problems of adolescents from Bosnia and Herzegovina during exile andreparation. Croatian Medical Journal, 46, 105–115.

Hasanovic, M., Sinanovic, O., Selimgasic, Z., Pajevic, I., & Avdibegovic, E. (2006).Psychological disturbances of war-traumatized children from different foster andfamily settings in Bosnia and Herzegovina. Croatian Medical Journal, 47, 85–94.

Henigsberg, N., Folnegovic-Smalc, V., & Moro, L. (2001). Stressor characteristics andpost-traumatic stress disorder symptom dimensions in war victims. Croatian

Medical Journal, 42(5), 543–550.Herceg, M., Melamed, B. G., & Pregrad, J. (1996). Effects of war on refugee and

non-refugee children from Croatia and Bosnia-Herzegovina. Croatian Medical

Journal, 37, 10–111.Ilic, Z. P. (1998). Post-traumatic stress in war prisoners. Psychiatry Today, 30, 73–

85.Institute for Energy and Environment Research. (1999). Ecological and health im-

plications of NATO bombing in Yugoslavia. Institute for Energy and Envi-

ronmental Research, 7. Retrieved from http://www.ieer.org/sdafiles/vol_7/7-4/nato.html

Jovanovic, A. A., Tosevski, D., Ivkovic, M., Damjanovic, A., & Gasic, M. (2009).Predicting violence in veterans with posttraumatic stress disorder. Military-

Medical and Pharmaceutical Review, 66, 13–21.Klaric, M., Klaric, B., Stevanovic, A., Grkovic, J., & Jonovska, S. (2007). Psychological

consequences of war trauma and postwar social stressors in women in Bosniaand Herzegovina. Croatian Medical Journal, 48, 167–176.

Klaric, M., Franciskovic, T., Klaric, B., Kastelan, A., Graovac, M., & Diminic Lisica, I.(2008). Psychological problems in children of war veterans with posttraumaticstress disorder in Bosnia and Herzegovina: Cross-sectional study. Croatian

Medical Journal, 49, 491–498.Kuljic, B., Miljanovic, B., & Svicevic, R. (2004). Posttraumatic stress disorder in

Bosnian war veterans: Analysis of stress events and risk factors. Military-Medical

and Pharmaceutical Review, 61, 283–289.Lazic, D., & Bojanin, S. S. (1995). New forms of deviant behavior in adolescent

refugees. Psychiatry Today, 27, 103–116.Loncar, M., Medved, V., Jovanovic, N., & Hotujac, L. (2006). Psychological con-

sequences of rape on women in 1991–1995 war in Croatia and Bosnia andHerzegovina. Croatian Medical Journal, 47, 67–75.

Milosavljevic, B., Savic, J., Gutovic, V., & Kutalac, M. (1996). War, the warfareenvironment and the syndrome of war psychic trauma in children. Psychology,

29(4), 465–476.Nikoloski-Koncar, N., Zotovic, M., & Hautekeete, M. (2006). Effects of bombing after

five years: Development of early maladaptive cognitive schemas in children.Psychology, 39(2), 229–246.

Opalic, P. D. (2008). Disarrangement: Dominant symptoms of traumatized peoplein Serbia. Sociology, 50, 417–432.

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4

106 L. A. French et al.

Petrovic, V. (2004). Levels of psychopathology in children with war related trauma.Psychiatry Today, 36, 17–28.

Puhalo, S. (2003). Ethnical distance of the citizens of Republicka Srpska and thefederation of Bosnia and Herzegovina to the nations of the former SocialistFederal Republic of Yugoslavia. Psychology, 36(2), 141–156.

Rahdert, E. R. (1991). The Adolescent Assessment/Referral System Manual (DHHSPublication ADM 91-1735). Rockville, MD: National Institute on Drug Abuse.

Rose-Roth (2009, March 19–21)). South Eastern Europe: From Dayton to Brussels

(Mission Report). (092SEM09E) Sarajevo, Bosnia and Herzegovina: NATO Par-liamentary Assembly, 70ty Rose-Roth Seminar.

Selakovic-Bursic, S. D., Vuckovic, N. S., & Sekulic-Bartos, O. (2000). Crisis inter-vention during NATO bombings. Current Topics in Neurology, Psychiatry and

Related Disciplines, 8, 1–9.Selakovic-Bursic, S. D., Sekulic-Bartos, O., Vojislava, B., Srdanovic, & Doroski, M.

(2001). Suicide behavior during NATO bombing in Yugoslavia, Current Topics

in Neurology, Psychiatry and Related Disciplines, 9, 1–7.Terzic, J., Mestrovic, J., Dogas, Z., Furlan, D., & Biocic, M. (2001). Children war

casualties during the 1991–1995 wars in Croatia and Bosnia and Herzegovina.Croatian Medical Journal, 42, 156–160.

Turjacanin, V. (2004). Ethnic stereotypes among Bosniak and Serbian youth in Bosniaand Herzegovina. Psychology, 37(3), 357–374.

Varsek, I. (1999). Problems connected with return of refugees and displaced persons.Polemos: Journal of Interdisciplinary Research on War and Peace, 2, 171–217.

Zotovic, M. (2005). PTSD and depression after the NATO air campaign: Individualdifferences in stress reactions. Psychology, 38(1), 93–109.

Dow

nloa

ded

by [

Flin

ders

Uni

vers

ity o

f So

uth

Aus

tral

ia]

at 2

0:20

06

Oct

ober

201

4