Association of Trauma and PTSD Symptoms With Openness to Reconciliation and Feelings of Revenge Among Former Ugandan and Congolese Child Soldiers

Bayer, Christophe Pierre; Klasen, Fionna; Adam, Hubertus

doi:10.1001/jama.298.5.555

Cited by 252 publications

(250 citation statements)

References 15 publications

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“…General witnessing of war violence, for example, was not associated with changes in mental health, while being raped was predictive of higher levels of internalizing problems but not of increased externalizing problems or decreased prosocial behavior. Our findings - particularly the associations we observed between perpetration of violence, increases in externalizing problems, and decreases in adaptive/prosocial behaviors - are consistent with relationships observed in other studies of former child soldiers 3, 5 and adult war veterans. 32 …”

Section: Discussionsupporting

confidence: 92%

“…1, 2 Despite the documentation of risks facing child soldiers due to war-related violence, 3 little is known about what influences long-term mental health trajectories and processes of social reintegration. Recent studies on former child soldiers from northern Uganda, 4 the Democratic Republic of the Congo, 5 and Nepal 6 have provided insight into the impact of war experience on reintegration and psychosocial adjustment. Research documents that witnessing, experiencing and perpetrating violence, younger age of involvement, and longer engagement with an armed group all have negative consequences for the mental health and social reintegration of young people.…”

Section: Introductionmentioning

confidence: 99%

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

Betancourt¹,

Brennan²,

Rubin-Smith³

et al. 2010

Journal of the American Academy of Child & Adolescent Psych

160

240

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Objective To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether post-conflict factors contribute to adverse or resilient mental health outcomes. Method Male and female former child soldiers (N=260, ages 10–17 at baseline) were recruited from the roster of an 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 post-conflict experiences. Results The long-term mental health of former child soldiers was associated with war experiences and post-conflict risk factors, which were partly mitigated by post-conflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and post-conflict stigma while increased community acceptance was associated with decreases in externalizing problems (B=−1.09). High baseline levels of internalizing problems were associated with surviving rape while 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 post-conflict 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 post-conflict 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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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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

Betancourt¹,

Brennan²,

Rubin-Smith³

et al. 2010

Journal of the American Academy of Child & Adolescent Psych

160

240

View full text Add to dashboard Cite

show abstract

“…Child soldiers are also often abducted into armed groups such as the LRA against their wishes and attempts to escape are accompanied by severe physical attacks or death. Former child soldiers have the additional burden of being both recipients and perpetrators of violence (Amone-P’Olak, Dokkedahl, & Elklit, 2017), with studies showing greater difficulties in psychological recovery and reintegration into the community (Amone-P’Olak, Elklit & Dokkedahl, 2017; Bayer, Klasen, & Adam, 2007), which ultimately may impede trauma recovery.…”

Section: Discussionmentioning

confidence: 99%

Testing competing factor models of the latent structure of post-traumatic stress disorder and complex post-traumatic stress disorder according to ICD-11

Murphy

Elklit

Dokkedahl

et al. 2018

European Journal of Psychotraumatology

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With the publication of the International Statistical Classification of Diseases and Related Health Problems, 11th edition (ICD-11) due for release in 2018, a number of studies have assessed the factorial validity of the proposed post-traumatic stress disorder (PTSD) and complex (CPTSD) diagnostic criteria and whether the disorders are correlated but distinct constructs. As the specific nature of CPTSD symptoms has yet to be firmly established, this study aimed to examine the dimension of affect dysregulation as two separate constructs representing hyper-activation and hypo-activation. Seven alternative models were estimated within a confirmatory factor analytic framework using the International Trauma Questionnaire (ITQ). Data were analysed from a young adult sample from northern Uganda (n = 314), of which 51% were female and aged 18–25 years. Forty per cent of the participants were former child soldiers (n = 124) while the remainder were civilians (n = 190). The prevalence of CPTSD was 20.8% and PTSD was 13.1%. The results indicated that all models that estimated affective dysregulation as distinct but correlated constructs (i.e. hyper-activation and hypo-activation) provided satisfactory model fit, with statistical superiority for a seven-factor first-order correlated model. Furthermore, individuals who met the criteria for CPTSD reported higher levels of war experiences, symptoms of anxiety and depression, and somatic problems than those with PTSD only and no diagnosis. There was also a much larger proportion of former child soldiers that met the criteria for a CPTSD diagnosis. In conclusion, these results partly support the factorial validity of the ICD-11 proposals for PTSD and CPTSD in a non-Western culture exposed to mass violence. These findings highlight that more research is required across different cultural backgrounds before firm conclusions can be made regarding the factor structure of CPTSD using the ITQ.

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“…Kim argues that a credible commitment by the state, anchored in a 43 See for example Barenbaum, Ruchkin, and Schwab Stone 2004;Bayer, Klasen, and Adam 2007;Blattman and Annan 2010;Boyden 2003;Kohrt et al 2010;Özerdem and Podder 2011;Wessells 2006;Zack-Williams 2006. 44 Rubio 1997.…”

Section: Institutional Theoriesmentioning

confidence: 99%

Trusting the Enemy: Confidence in the State Among Ex-Combatants

Nussio

Oppenheim

2013

SSRN Journal

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Association of Trauma and PTSD Symptoms With Openness to Reconciliation and Feelings of Revenge Among Former Ugandan and Congolese Child Soldiers

Cited by 252 publications

References 15 publications

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

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

Testing competing factor models of the latent structure of post-traumatic stress disorder and complex post-traumatic stress disorder according to ICD-11

Trusting the Enemy: Confidence in the State Among Ex-Combatants

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