Studies explore effects of war on former child soldiers

July 15, 2010

Despite international bans, more than 250,000 children fight as soldiers in 86 countries across the globe, almost half of them in Africa. Two new studies explored how these children adjust after they return to their homes. Key to successful adaptation, the studies found, was the characteristics of the communities to which the children returned.

In the first study, researchers found that former child soldiers from Sierra Leone who lived in communities in which they felt accepted were less depressed and more confident, and children who were able to stay in school showed more positive attitudes and behaviors. However, these protective factors didn't fully counterbalance the war-related trauma the children experienced, a finding that has implications for public health.

In the second study, researchers found that the former child soldiers from Uganda who adapted the best were those who returned to less violent homes and communities. These children also had fewer feelings of survivor guilt, less motivation to seek revenge, better socioeconomic situations, and more perceived spiritual support.

The studies appear in a special section on children and disaster in the July/August 2010 issue of the journal Child Development.

The first study took a longitudinal look at adjustment in former child solders involved in Sierra Leone's bloody civil war. Researchers focused on more than 150 children ages 10 to 18, mostly male, following them over two years. The research was carried out by a team based at Harvard University in collaboration with partners at the International Rescue Committee and the U.S. Agency for International Development.

During Sierra Leone's 1991-2002 civil war, thousands of children, some as young as 7, were conscripted into fighting forces and paramilitary groups, and as a result, witnessed executions, death squad killings, torture, detention, rape, and massacres of family members. As the conflict ended, the young people were returned to civilian life. This study, carried out in 2002 and 2004, is the first of its kind to examine how these youths fared.

The researchers found that all of the former child soldiers were exposed to high levels of violence, such as massacres or village raids. More than a third of the girls reported having been raped, and almost a quarter of both girls and boys reported having injured or killed someone.

Children who reported surviving rape or reported hurting or killing others showed higher levels of hostility, while those who survived rape demonstrated higher levels of hostility and anxiety over time compared to those who didn't experience these types of trauma. This suggests that these categories of war trauma are highly toxic to children's psychological and social adjustment. The study also found that children who were abducted at younger ages were more likely to report symptoms of depression over time than those who were older.

"Witnessing general war violence, although very common, didn't have a strong effect on the children's psychological and social adjustment over time," according to Theresa Betancourt, assistant professor of child health and human rights at Harvard School of Public Health, who led the study. "In contrast, the effects of experiencing rape and wounding or killing others were longer lasting."

The authors recommend that particular attention be paid to war-affected children with an accumulation of toxic risk factors and few protective resources. Social and mental health services for war-affected youths are severely limited in Sierra Leone today. Without targeted attention to those showing continued need, the researchers point out, there may well be broader consequences for society as this generation enters adulthood--including the inability to make the most of current investments in education and development activities.

"We have a long way to go before being able to fully mitigate the effects of particularly toxic stressors in the lives of children affected by war," notes Betancourt.

In the second study on child soldiers in Child Development, researchers from the University of Hamburg in Germany looked at 330 former Ugandan child soldiers ages 11 to 17.

Since the late 1980s in Northern Uganda, an estimated 25,000 children and adolescents have been forcefully recruited into the Lord's Resistance Army. This study was carried out in 2006 at a government boarding school designed to support war-traumatized children and at the same time attempt to identify risk and protective factors to better target supports. On average, the children returned from the armed group after about 30 months; the study was carried out 4 months after they arrived at the school.

According to the study, almost all of the children had been exposed to shooting and beatings by armed forces, more than half had killed someone, and more than a quarter had been raped. The researchers found that a third of the children suffered from posttraumatic stress disorder, more than a third were depressed, and more than half had behavioral and emotional problems. Older children had more mental health problems than younger children, the study found.

The study also found that almost 90 percent of the child soldiers continued to be exposed to violence once they returned home--including caning, burning, being locked up, and being raped--and two thirds of them suffered from significant mental health problems. What helped foster the resilience of the one third of children who didn't have significant mental health problems? The researchers discovered it was the qualities of the child and the home environments to which they returned--such as less exposure to domestic and community violence, better family socioeconomic situations, less motivation to seek revenge, and more perceived spiritual support.

In Uganda, where there is only one psychiatrist for every 1.3 million people, training mental health professionals and creating sustainable intervention programs are urgently needed, according to the researchers. By identifying the factors that contribute to resilience in former child soldiers, this study can help those working with this population.
-end-
Summarized from Child Development, Vol. 81, Issue 4, Sierra Leone's Former Child Soldiers: A Follow-Up Study of Psychosocial Adjustment and Community Reintegration by Betancourt, TS (Harvard School of Public Health), Borisova, II (formerly with Harvard Graduate School of Education, now at Save the Children US), Williams, TP (Harvard School of Public Health), Brennan, RT (Harvard Medical School), Whitfield, TH (independent biostatistics consultant), de la Soudiere, M (independent consultant, UNICEF), Williamson, J (U.S. Agency for International Development), and Gilman, SE (Harvard School of Public Health), and Posttraumatic Resilience in Former Ugandan Child Soldiers by Klasen, F (University Medical Center of Hamburg and University of Hamburg), Oettingen, G (New York University and University of Hamburg), Daniels, J (University Medical Center of Hamburg), Post, M, and Hoyer, C (University of Hamburg), and Adam, H (University Medical Center of Hamburg). Copyright 2010 The Society for Research in Child Development, Inc. All rights reserved.

Society for Research in Child Development

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.