Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health
Objective To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Method Male and female former child sol...
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| Veröffentlicht in: | Journal of the American Academy of Child and Adolescent Psychiatry 2010-06, Vol.49 (6), p.606-615 |
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| container_title | Journal of the American Academy of Child and Adolescent Psychiatry |
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| creator | Betancourt, Theresa S., Sc.D., M.A Brennan, Robert T., Ed.D., Ed.M Rubin-Smith, Julia, M.S.P.H Fitzmaurice, Garrett M., Sc.D Gilman, Stephen E., Sc.D |
| description | Objective To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Method Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences. Results The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems ( b = −1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance ( b = −0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance ( b = 1.93). Conclusions Psychosocial interventions for former child soldiers may be more e ffective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended. |
| doi_str_mv | 10.1016/j.jaac.2010.03.008 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3157024</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ericid>EJ944579</ericid><els_id>1_s2_0_S0890856710002868</els_id><sourcerecordid>749024420</sourcerecordid><originalsourceid>FETCH-LOGICAL-c582t-db3b1792dad95ba3febfaa4a82f4fb7d88dffb3b01d6b516f6202c7208ab87b63</originalsourceid><addsrcrecordid>eNqFkl1v0zAUhiMEYmXwBxBCFhIaF2s5duzYQWjSVK0MVASicG05_tjcpfGw00r99zhqKbCLceXI5zlHr0-eoniOYYIBV2-Xk6VSekIgX0A5ARAPihFmhI8ZxeJhMQJRw1iwih8VT1JaAgDmQjwujgjQmhIOo8IvvI1RobkNnT1JaBbiykY0vfatQYvQmlxO79A5mofuyvdr4zvVokX-2KLg0Defbk7R1xh6q3u_sWimdB9iOkWqM-iz7fpMX1rV9tdPi0dOtck-25_HxY_Zxffp5Xj-5cPH6fl8rJkg_dg0ZYN5TYwyNWtU6WzjlKJKEEddw40QxrnMADZVw3DlKgJEcwJCNYI3VXlcnO3m3q6blTU6Z4iqlbfRr1TcyqC8_LfS-Wt5FTayxIwDoXnAyX5ADD_XNvVy5ZO2bas6G9ZJckYFx7SG_5MZIpSSgXxzL4kxYUSQCnBGX91Bl2Ed89aTLKuqLCmu6wyRHaRjSClad3gfBjnIIZdykEMOckgoZZYjN738ezOHlt82ZOD1HlBJq9ZF1Wmf_nBEUAFsiPhix9no9aF88ammlPEh3Pt9Of_mTRZIJu1tp63xMWsiTfD3xzy7065b3_kc6MZubTpsA8tEJMjFYPkgOc5-E1GJ8hdsMPWG</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>366334199</pqid></control><display><type>article</type><title>Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><creator>Betancourt, Theresa S., Sc.D., M.A ; Brennan, Robert T., Ed.D., Ed.M ; Rubin-Smith, Julia, M.S.P.H ; Fitzmaurice, Garrett M., Sc.D ; Gilman, Stephen E., Sc.D</creator><creatorcontrib>Betancourt, Theresa S., Sc.D., M.A ; Brennan, Robert T., Ed.D., Ed.M ; Rubin-Smith, Julia, M.S.P.H ; Fitzmaurice, Garrett M., Sc.D ; Gilman, Stephen E., Sc.D</creatorcontrib><description>Objective To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Method Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences. Results The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems ( b = −1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance ( b = −0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance ( b = 1.93). Conclusions Psychosocial interventions for former child soldiers may be more e ffective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended.</description><identifier>ISSN: 0890-8567</identifier><identifier>EISSN: 1527-5418</identifier><identifier>DOI: 10.1016/j.jaac.2010.03.008</identifier><identifier>PMID: 20494270</identifier><identifier>CODEN: JAAPEE</identifier><language>eng</language><publisher>Maryland Heights, MO: Elsevier Inc</publisher><subject>Acceptance ; Access to Education ; Adaptation, Psychological ; Adolescent ; Adolescents ; Aggression - psychology ; Anxiety Disorders - diagnosis ; Anxiety Disorders - epidemiology ; Anxiety Disorders - psychology ; Behavior Problems ; Biological and medical sciences ; Child ; Child & adolescent psychiatry ; Child clinical studies ; child soldiers ; Children ; Civil Disorders ; Community Attitudes ; Cross-Sectional Studies ; Depressive Disorder - diagnosis ; Depressive Disorder - epidemiology ; Depressive Disorder - psychology ; Developing Countries ; Evaluation Methods ; externalizing problems ; Female ; Foreign Countries ; Growth models ; Homicide - psychology ; Humans ; Internal-External Control ; Internalizing problems ; Investigations ; Longitudinal Studies ; longitudinal study ; Male ; Medical sciences ; Mental Disorders - diagnosis ; Mental Disorders - epidemiology ; Mental Disorders - psychology ; Mental Health ; Military Personnel - psychology ; Pediatrics ; Prejudice ; prosocial behaviors ; Protective factors ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Rape - psychology ; Resilience, Psychological ; Retention (Psychology) ; Risk ; Risk factors ; Secondary Education ; Sierra Leone ; Social Adjustment ; Social Behavior ; Social Identification ; Social Support ; Social Support Groups ; Soldiers ; Stigmatization ; Stress Disorders, Post-Traumatic - diagnosis ; Stress Disorders, Post-Traumatic - epidemiology ; Stress Disorders, Post-Traumatic - psychology ; Violence - psychology ; Violence - statistics & numerical data ; War ; Wounds and Injuries - psychology ; Young Adult</subject><ispartof>Journal of the American Academy of Child and Adolescent Psychiatry, 2010-06, Vol.49 (6), p.606-615</ispartof><rights>American Academy of Child and Adolescent Psychiatry</rights><rights>2010 American Academy of Child and Adolescent Psychiatry</rights><rights>2015 INIST-CNRS</rights><rights>2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Jun 2010</rights><rights>2011 American Academy of Child & Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c582t-db3b1792dad95ba3febfaa4a82f4fb7d88dffb3b01d6b516f6202c7208ab87b63</citedby><cites>FETCH-LOGICAL-c582t-db3b1792dad95ba3febfaa4a82f4fb7d88dffb3b01d6b516f6202c7208ab87b63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0890856710002868$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,30978,30979,65309</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ944579$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22848051$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20494270$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Betancourt, Theresa S., Sc.D., M.A</creatorcontrib><creatorcontrib>Brennan, Robert T., Ed.D., Ed.M</creatorcontrib><creatorcontrib>Rubin-Smith, Julia, M.S.P.H</creatorcontrib><creatorcontrib>Fitzmaurice, Garrett M., Sc.D</creatorcontrib><creatorcontrib>Gilman, Stephen E., Sc.D</creatorcontrib><title>Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health</title><title>Journal of the American Academy of Child and Adolescent Psychiatry</title><addtitle>J Am Acad Child Adolesc Psychiatry</addtitle><description>Objective To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Method Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences. Results The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems ( b = −1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance ( b = −0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance ( b = 1.93). Conclusions Psychosocial interventions for former child soldiers may be more e ffective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended.</description><subject>Acceptance</subject><subject>Access to Education</subject><subject>Adaptation, Psychological</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>Aggression - psychology</subject><subject>Anxiety Disorders - diagnosis</subject><subject>Anxiety Disorders - epidemiology</subject><subject>Anxiety Disorders - psychology</subject><subject>Behavior Problems</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child & adolescent psychiatry</subject><subject>Child clinical studies</subject><subject>child soldiers</subject><subject>Children</subject><subject>Civil Disorders</subject><subject>Community Attitudes</subject><subject>Cross-Sectional Studies</subject><subject>Depressive Disorder - diagnosis</subject><subject>Depressive Disorder - epidemiology</subject><subject>Depressive Disorder - psychology</subject><subject>Developing Countries</subject><subject>Evaluation Methods</subject><subject>externalizing problems</subject><subject>Female</subject><subject>Foreign Countries</subject><subject>Growth models</subject><subject>Homicide - psychology</subject><subject>Humans</subject><subject>Internal-External Control</subject><subject>Internalizing problems</subject><subject>Investigations</subject><subject>Longitudinal Studies</subject><subject>longitudinal study</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental Disorders - diagnosis</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Disorders - psychology</subject><subject>Mental Health</subject><subject>Military Personnel - psychology</subject><subject>Pediatrics</subject><subject>Prejudice</subject><subject>prosocial behaviors</subject><subject>Protective factors</subject><subject>Psychiatry</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Rape - psychology</subject><subject>Resilience, Psychological</subject><subject>Retention (Psychology)</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Secondary Education</subject><subject>Sierra Leone</subject><subject>Social Adjustment</subject><subject>Social Behavior</subject><subject>Social Identification</subject><subject>Social Support</subject><subject>Social Support Groups</subject><subject>Soldiers</subject><subject>Stigmatization</subject><subject>Stress Disorders, Post-Traumatic - diagnosis</subject><subject>Stress Disorders, Post-Traumatic - epidemiology</subject><subject>Stress Disorders, Post-Traumatic - psychology</subject><subject>Violence - psychology</subject><subject>Violence - statistics & numerical data</subject><subject>War</subject><subject>Wounds and Injuries - psychology</subject><subject>Young Adult</subject><issn>0890-8567</issn><issn>1527-5418</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkl1v0zAUhiMEYmXwBxBCFhIaF2s5duzYQWjSVK0MVASicG05_tjcpfGw00r99zhqKbCLceXI5zlHr0-eoniOYYIBV2-Xk6VSekIgX0A5ARAPihFmhI8ZxeJhMQJRw1iwih8VT1JaAgDmQjwujgjQmhIOo8IvvI1RobkNnT1JaBbiykY0vfatQYvQmlxO79A5mofuyvdr4zvVokX-2KLg0Defbk7R1xh6q3u_sWimdB9iOkWqM-iz7fpMX1rV9tdPi0dOtck-25_HxY_Zxffp5Xj-5cPH6fl8rJkg_dg0ZYN5TYwyNWtU6WzjlKJKEEddw40QxrnMADZVw3DlKgJEcwJCNYI3VXlcnO3m3q6blTU6Z4iqlbfRr1TcyqC8_LfS-Wt5FTayxIwDoXnAyX5ADD_XNvVy5ZO2bas6G9ZJckYFx7SG_5MZIpSSgXxzL4kxYUSQCnBGX91Bl2Ed89aTLKuqLCmu6wyRHaRjSClad3gfBjnIIZdykEMOckgoZZYjN738ezOHlt82ZOD1HlBJq9ZF1Wmf_nBEUAFsiPhix9no9aF88ammlPEh3Pt9Of_mTRZIJu1tp63xMWsiTfD3xzy7065b3_kc6MZubTpsA8tEJMjFYPkgOc5-E1GJ8hdsMPWG</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Betancourt, Theresa S., Sc.D., M.A</creator><creator>Brennan, Robert T., Ed.D., Ed.M</creator><creator>Rubin-Smith, Julia, M.S.P.H</creator><creator>Fitzmaurice, Garrett M., Sc.D</creator><creator>Gilman, Stephen E., Sc.D</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier BV</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100601</creationdate><title>Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health</title><author>Betancourt, Theresa S., Sc.D., M.A ; Brennan, Robert T., Ed.D., Ed.M ; Rubin-Smith, Julia, M.S.P.H ; Fitzmaurice, Garrett M., Sc.D ; Gilman, Stephen E., Sc.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c582t-db3b1792dad95ba3febfaa4a82f4fb7d88dffb3b01d6b516f6202c7208ab87b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Acceptance</topic><topic>Access to Education</topic><topic>Adaptation, Psychological</topic><topic>Adolescent</topic><topic>Adolescents</topic><topic>Aggression - psychology</topic><topic>Anxiety Disorders - diagnosis</topic><topic>Anxiety Disorders - epidemiology</topic><topic>Anxiety Disorders - psychology</topic><topic>Behavior Problems</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child & adolescent psychiatry</topic><topic>Child clinical studies</topic><topic>child soldiers</topic><topic>Children</topic><topic>Civil Disorders</topic><topic>Community Attitudes</topic><topic>Cross-Sectional Studies</topic><topic>Depressive Disorder - diagnosis</topic><topic>Depressive Disorder - epidemiology</topic><topic>Depressive Disorder - psychology</topic><topic>Developing Countries</topic><topic>Evaluation Methods</topic><topic>externalizing problems</topic><topic>Female</topic><topic>Foreign Countries</topic><topic>Growth models</topic><topic>Homicide - psychology</topic><topic>Humans</topic><topic>Internal-External Control</topic><topic>Internalizing problems</topic><topic>Investigations</topic><topic>Longitudinal Studies</topic><topic>longitudinal study</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental Disorders - diagnosis</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Disorders - psychology</topic><topic>Mental Health</topic><topic>Military Personnel - psychology</topic><topic>Pediatrics</topic><topic>Prejudice</topic><topic>prosocial behaviors</topic><topic>Protective factors</topic><topic>Psychiatry</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Rape - psychology</topic><topic>Resilience, Psychological</topic><topic>Retention (Psychology)</topic><topic>Risk</topic><topic>Risk factors</topic><topic>Secondary Education</topic><topic>Sierra Leone</topic><topic>Social Adjustment</topic><topic>Social Behavior</topic><topic>Social Identification</topic><topic>Social Support</topic><topic>Social Support Groups</topic><topic>Soldiers</topic><topic>Stigmatization</topic><topic>Stress Disorders, Post-Traumatic - diagnosis</topic><topic>Stress Disorders, Post-Traumatic - epidemiology</topic><topic>Stress Disorders, Post-Traumatic - psychology</topic><topic>Violence - psychology</topic><topic>Violence - statistics & numerical data</topic><topic>War</topic><topic>Wounds and Injuries - psychology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Betancourt, Theresa S., Sc.D., M.A</creatorcontrib><creatorcontrib>Brennan, Robert T., Ed.D., Ed.M</creatorcontrib><creatorcontrib>Rubin-Smith, Julia, M.S.P.H</creatorcontrib><creatorcontrib>Fitzmaurice, Garrett M., Sc.D</creatorcontrib><creatorcontrib>Gilman, Stephen E., Sc.D</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the American Academy of Child and Adolescent Psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Betancourt, Theresa S., Sc.D., M.A</au><au>Brennan, Robert T., Ed.D., Ed.M</au><au>Rubin-Smith, Julia, M.S.P.H</au><au>Fitzmaurice, Garrett M., Sc.D</au><au>Gilman, Stephen E., Sc.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ944579</ericid><atitle>Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health</atitle><jtitle>Journal of the American Academy of Child and Adolescent Psychiatry</jtitle><addtitle>J Am Acad Child Adolesc Psychiatry</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>49</volume><issue>6</issue><spage>606</spage><epage>615</epage><pages>606-615</pages><issn>0890-8567</issn><eissn>1527-5418</eissn><coden>JAAPEE</coden><abstract>Objective To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Method Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences. Results The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems ( b = −1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance ( b = −0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance ( b = 1.93). Conclusions Psychosocial interventions for former child soldiers may be more e ffective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended.</abstract><cop>Maryland Heights, MO</cop><pub>Elsevier Inc</pub><pmid>20494270</pmid><doi>10.1016/j.jaac.2010.03.008</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of the American Academy of Child and Adolescent Psychiatry, 2010-06, Vol.49 (6), p.606-615 |
| issn | 0890-8567 1527-5418 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Acceptance Access to Education Adaptation, Psychological Adolescent Adolescents Aggression - psychology Anxiety Disorders - diagnosis Anxiety Disorders - epidemiology Anxiety Disorders - psychology Behavior Problems Biological and medical sciences Child Child & adolescent psychiatry Child clinical studies child soldiers Children Civil Disorders Community Attitudes Cross-Sectional Studies Depressive Disorder - diagnosis Depressive Disorder - epidemiology Depressive Disorder - psychology Developing Countries Evaluation Methods externalizing problems Female Foreign Countries Growth models Homicide - psychology Humans Internal-External Control Internalizing problems Investigations Longitudinal Studies longitudinal study Male Medical sciences Mental Disorders - diagnosis Mental Disorders - epidemiology Mental Disorders - psychology Mental Health Military Personnel - psychology Pediatrics Prejudice prosocial behaviors Protective factors Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Rape - psychology Resilience, Psychological Retention (Psychology) Risk Risk factors Secondary Education Sierra Leone Social Adjustment Social Behavior Social Identification Social Support Social Support Groups Soldiers Stigmatization Stress Disorders, Post-Traumatic - diagnosis Stress Disorders, Post-Traumatic - epidemiology Stress Disorders, Post-Traumatic - psychology Violence - psychology Violence - statistics & numerical data War Wounds and Injuries - psychology Young Adult |
| title | Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health |
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