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Cited by 240Posttraumatic Stress Disorder ResearchConflict, Peace, and Violence in ColombiaChild Abuse and Trauma

Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health

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Betancourt, Theresa S., Brennan, Robert T., Rubin-Smith, Julia, Fitzmaurice, Garrett M., Gilman, Stephen E.·2010·Journal of the American Academy of Child & Adolescent Psychiatry
DOI 10.1016/j.jaac.2010.03.008PMC PMC3157024
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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 effective 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.

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  • A number of studies suggest that the degree to which community support increases over time plays an important ameliorative role for conflict- and war-affected children.

    “A number of studies suggest that the degree to which community support increases over time plays an important ameliorative role for conflict- and war-affected children.16,97,101,102”

    From Interventions for Children Affected by War: An Ecological Perspective on Psychosocial Support and Mental Health Care (2013) · cites this paper as [16]

  • Longitudinal research indicates that recovery from trauma of ecological disruption, loss, and exposure to violence is a developmental process and that interventions initiated at one time point may need to be revisited as children grow older.

    “Longitudinal research on children affected by war indicates that recovery from the trauma of ecological disruption, loss, and exposure to violence is a developmental process and that interventions initiated at one time point may need to be revisited as the children grow older.16,119–121”

    From Interventions for Children Affected by War: An Ecological Perspective on Psychosocial Support and Mental Health Care (2013) · cites this paper as [16]

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Authors
Betancourt, T. S., Brennan, R. T., Rubin-Smith, J., Fitzmaurice, G. M., & Gilman, S. E.
Affiliations
Harvard University (US)
Corresponding author
Betancourt, Theresa S.
ORCID
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2010-06
Volume
49
Issue
6
Pages
606-615
ISSN
0890-8567 (ISSN-L)
DOI
10.1016/j.jaac.2010.03.008
PMC
PMC3157024
OpenAlex
W1983068409
Cited by
240
References
33
Citations by year
2026: 10 · 2025: 6 · 2024: 10 · 2023: 8 · 2022: 12 · 2021: 11 · 2020: 15 · 2019: 13 · 2018: 18 · 2017: 15 · 2016: 22 · 2015: 21 · 2014: 26 · 2013: 26 · 2012: 18
FWCI
18.67
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • United States Agency for International Development
  • United States Institute of Peace
  • National Institute of Mental Health (K01MH077246)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Sociology and Political Science › Conflict, Peace, and Violence in Colombia
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
former child soldiers, Sierra Leone civil war, internalizing problems, externalizing problems, community acceptance, stigma, social support, psychosocial interventions, war exposure, rape, prosocial behavior, risk and protective factors
MeSH terms
Adaptation, Psychological, Adolescent, Aggression, Anxiety Disorders, Mental Disorders, Child, Civil Disorders, Cross-Sectional Studies, Depressive Disorder, Developing Countries, Female, Homicide, Humans, Internal-External Control, Longitudinal Studies, Male, Military Personnel, Prejudice, Rape, Sierra Leone, Social Adjustment, Social Behavior, Social Identification, Social Support, Stress Disorders, Post-Traumatic, Violence, Wounds and Injuries, Resilience, Psychological, Young Adult

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