Theresa S Betancourt1, Dana L Thomson2, Robert T Brennan3, Cara M Antonaccio3, Stephen E Gilman4, Tyler J VanderWeele5. 1. Research Program on Children and Adversity, Boston College School of Social Work, Newton, Massachusetts. Electronic address: theresa.betancourt@bc.edu. 2. Child Trends, Bethesda Maryland. 3. Research Program on Children and Adversity, Boston College School of Social Work, Newton, Massachusetts. 4. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, and the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 5. Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Abstract
OBJECTIVE: To investigate the associations of war and postconflict factors with mental health among Sierra Leone's former child soldiers as adults. METHOD: In 2002, we recruited former child soldiers from lists of soldiers (aged 10-17 years) served by Disarmament, Demobilization, Reintegration centers and from a random door-to-door sample in 5 districts of Sierra Leone. In 2004, self-reintegrated child soldiers were recruited in an additional district. At 2016/2017, 323 of the sample of 491 former child soldiers were reassessed. Subjects reported on war exposures and postconflict stigma, family support, community support, anxiety/depression, and posttraumatic stress symptoms. RESULTS: Of the subjects, 72% were male, with a mean age of 28 years. In all, 26% reported killing or injuring others; 67% reported being victims of life-threatening violence; 45% of female subjects and 5% of male subjects reported being raped; and 32% reported death of a parent. In 2016/2017 (wave 4), 47% exceeded the threshold for anxiety/depression, and 28% exceeded the likely posttraumatic stress disorder threshold. Latent class growth analysis yielded 3 trajectory groups based on changes in stigma and family/community acceptance; "Improving Social Integration" (n = 77) fared nearly as well as the "Socially Protected" (n = 213). The "Socially Vulnerable" group (n = 33) had increased risk of anxiety/depression above the clinical threshold and possible PTSD, and were around 3 times more likely to attempt suicide. CONCLUSION: Former child soldiers had elevated rates of mental health problems. Postconflict risk and protective factors related to outcomes long after the end of conflict. Targeted social inclusion and family interventions could benefit the long-term mental health of former child soldiers.
OBJECTIVE: To investigate the associations of war and postconflict factors with mental health among Sierra Leone's former child soldiers as adults. METHOD: In 2002, we recruited former child soldiers from lists of soldiers (aged 10-17 years) served by Disarmament, Demobilization, Reintegration centers and from a random door-to-door sample in 5 districts of Sierra Leone. In 2004, self-reintegrated child soldiers were recruited in an additional district. At 2016/2017, 323 of the sample of 491 former child soldiers were reassessed. Subjects reported on war exposures and postconflict stigma, family support, community support, anxiety/depression, and posttraumatic stress symptoms. RESULTS: Of the subjects, 72% were male, with a mean age of 28 years. In all, 26% reported killing or injuring others; 67% reported being victims of life-threatening violence; 45% of female subjects and 5% of male subjects reported being raped; and 32% reported death of a parent. In 2016/2017 (wave 4), 47% exceeded the threshold for anxiety/depression, and 28% exceeded the likely posttraumatic stress disorder threshold. Latent class growth analysis yielded 3 trajectory groups based on changes in stigma and family/community acceptance; "Improving Social Integration" (n = 77) fared nearly as well as the "Socially Protected" (n = 213). The "Socially Vulnerable" group (n = 33) had increased risk of anxiety/depression above the clinical threshold and possible PTSD, and were around 3 times more likely to attempt suicide. CONCLUSION: Former child soldiers had elevated rates of mental health problems. Postconflict risk and protective factors related to outcomes long after the end of conflict. Targeted social inclusion and family interventions could benefit the long-term mental health of former child soldiers.
Authors: Theresa S Betancourt; Robert T Brennan; Julia Rubin-Smith; Garrett M Fitzmaurice; Stephen E Gilman Journal: J Am Acad Child Adolesc Psychiatry Date: 2010-05-01 Impact factor: 8.829
Authors: Theresa Stichick Betancourt; Ivelina Ivanova Borisova; Timothy Philip Williams; Robert T Brennan; Theodore H Whitfield; Marie de la Soudiere; John Williamson; Stephen E Gilman Journal: Child Dev Date: 2010 Jul-Aug
Authors: Brandon A Kohrt; Mark J D Jordans; Wietse A Tol; Rebecca A Speckman; Sujen M Maharjan; Carol M Worthman; Ivan H Komproe Journal: JAMA Date: 2008-08-13 Impact factor: 56.272