PTSD symptoms linked to more feelings of revenge in former African child soldiers

July 31, 2007

Former Ugandan and Congolese child soldiers who have more symptoms of posttraumatic stress disorder (PTSD) are less likely to be open to reconciliation and more likely to have feelings of revenge, according to a study in the August 1 issue of JAMA, a theme issue on violence and human rights.

Tens of thousands of the estimated 250,000 child soldiers worldwide are abused or have been abused during the last decade in Africa's Great Lakes Region, according to background information in the article. Christophe Pierre Bayer, L.L.B., of University Clinic Hamburg, Germany, and colleagues conducted a study to assess the prevalence of PTSD symptoms in 169 former Ugandan and Congolese child soldiers and to examine how PTSD symptoms are associated with these children's openness to reconciliation and feelings of revenge on the person or group they consider their enemy. The participants, age 11-18 years, were living in rehabilitation centers in Uganda and the Democratic Republic of the Congo at the time of the study in 2005.

Of the 169 former child soldiers interviewed, 34.9 percent met symptom criteria for PTSD. Children who showed clinically relevant symptoms of PTSD had significantly less openness to reconciliation and significantly more feelings of revenge than those with fewer symptoms.

The children reported that they had been (violently) recruited by armed forces at a young age (average, 12 years), had served an average of 38 months, and had been demobilized an average of 2.3 months before participating in this study. They reported having been exposed to a high level of potentially traumatic events (average, 11.1). The most commonly reported traumatic experiences were having witnessed shooting, having witnessed someone being wounded, and having been seriously beaten. A total of 54.4 percent reported having killed someone, and 27.8 percent reported that they were forced to engage in sexual contact.

"The results of this study cannot determine whether openness to reconciliation and fewer feelings of revenge are inner personal characteristics that prevent PTSD symptoms or whether PTSD symptoms mediate the openness to reconciliation and feelings of revenge. However, our findings indicate that mental distress and mental illness, namely, symptoms of PTSD, are associated with war-affected children's attitudes toward reconciliation and could therefore impose barriers to sustainable and long-term peace building. Hence, the results of this study support the need to fulfill the obligation under the United Nations Convention on the Rights of the Child to promote psychological recovery for war-affected children, such as child soldiers," the authors conclude.
(JAMA. 2007;298(5):555-559. Available pre-embargo to the media at

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