Protective and risk factors of psychosocial wellbeing related to the reintegration of former child soldiers in Nepal

Adhikari, Ramesh P.; Kohrt, Brandon A.; Luitel, Nagendra P.; Upadhaya, Nawaraj; Gurung, Dristy; Jordans, Mark J. D.

doi:10.1097/wtf.0000000000000056

Cited by 11 publications

(8 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is not surprising that reintegration programs for former child soldiers across many world regions have focused on economic support. However, studies in Burundi and Nepal have shown that economic programs have limited mental health benefit compared to social support services (Adhikari et al, 2014; Jordans et al, 2012), but these studies did not compare outcomes by gender, which would be suggested based on our current study’s outcomes.…”

Section: Discussionmentioning

confidence: 67%

Recruitment of child soldiers in Nepal: Mental health status and risk factors for voluntary participation of youth in armed groups.

Kohrt¹,

Yang²,

Rai³

et al. 2016

Peace and Conflict: Journal of Peace Psychology

Self Cite

View full text Add to dashboard Cite

Preventing involuntary conscription and voluntary recruitment of youth into armed groups are global human rights priorities. Pathways for self-reported voluntary recruitment and the impact of voluntary recruitment on mental health have received limited attention. The objective of this study was to identify risk factors for voluntarily joining armed groups, as well as the association of conscription status and mental health. In Nepal, interviews were conducted with 258 former child soldiers who participated in a communist (Maoist) revolution. Eighty percent of child soldiers joined ‘voluntarily’. Girls were 2.07 times as likely to join voluntarily (95% CI, 1.03–4.16, p=0.04). Among girls, 51% reported joining voluntarily because of personal connections to people who were members of the armed group, compared to 22% of boys. Other reasons included escaping difficult life situations (36%), inability to achieve other goals in life (28%), and an appealing philosophy of the armed group (32%). Poor economic conditions were more frequently endorsed among boys (22%) than girls (10%). Voluntary conscription was associated with decreased risk for PTSD among boys but not for girls. Interventions to prevent voluntary association with armed groups could benefit from attending to difficulties in daily life, identifying non-violent paths to achieve life goals, and challenging the political philosophy of armed groups. Among boys, addressing economic risk factors may prevent recruitment, and prevention efforts for girls will need to address personal connections to armed groups, as it has important implications for preventing recruitment through new methods, such as social media.

show abstract

Section: Discussionmentioning

confidence: 67%

Recruitment of child soldiers in Nepal: Mental health status and risk factors for voluntary participation of youth in armed groups.

Kohrt¹,

Yang²,

Rai³

et al. 2016

Peace and Conflict: Journal of Peace Psychology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Maltreatment by mothers-in-law and inter-case marriage have also been identified as risk factors for mental health distress in Nepal (Adhikari et al, 2014; Kohrt & Worthman, 2009). Elements of physical, emotional, and psychological violence were also found, suggesting utility of a manual designed specifically for female victims of domestic violence.…”

Section: Resultsmentioning

confidence: 99%

A Cultural Adaptation of Dialectical Behavior Therapy in Nepal

Ramaiya¹,

Fiorillo

Regmi³

et al. 2017

Cognitive and Behavioral Practice

Self Cite

View full text Add to dashboard Cite

Growing evidence exists on the potential for adapting evidence-based interventions for low- and-middle-income countries (LMIC). One opportunity that has received limited attention is the adaptation of psychotherapies developed in high-income countries (HIC) based on principles from LMIC cultural groups. Dialectical behavior therapy (DBT) is one such treatment with significant potential for acceptability in South Asian settings with high suicide rates. We describe a tri-phasic approach to adapt DBT in Nepal that consists of qualitative interviews with major Nepali mental health stakeholders (Study 1), an adaptation workshop with 15 Nepali counselors (Study 2), and a small-scale treatment pilot with eligible clients in one rural district (Study 3). Due to low literacy levels, distinct conceptualizations of mind and body, and program adherence barriers, numerous adaptations were required. DBT concepts attributable to Asian belief systems were least comprehensible to clients. However, the 82% program completion rate suggests utility of a structured, skills-based treatment. This adaptation process informs future research regarding the effectiveness of culturally adapted DBT in South Asia.

show abstract

“…Child soldiers were enrolled prior to participating in nongovernmental reintegration services provided by UNICEF, and a cohort of 258 civilian children matched on demographics were enrolled in the study but did not receive intervention services. All child soldiers were given the opportunity to participate in reintegration programs through UNICEF partners, the main packages of which were education, vocational training, apprenticeship and income-generating activities (Adhikari et al 2014 ; Kohrt et al 2015 a , b ). After enrollment in 2007, participants were followed for 1 year then re-interviewed in 2008, at which time 222 of the former child soldiers (86% of original sample) and 234 of the matched civilians (91%) participated.…”

Section: Methodsmentioning

confidence: 99%

Interpersonal violence and suicidality among former child soldiers and war-exposed civilian children in Nepal

et al. 2018

Self Cite

View full text Add to dashboard Cite

Background.Suicide risk reduction is crucial for 15–29-year-old youth, who account for 46% of suicide deaths in low- and middle-income countries. Suicide predictors in high-resource settings, specifically depression, do not adequately predict suicidality in these settings. We explored if interpersonal violence (IPV) was associated with suicidality, independent of depression, in Nepal.Methods.A longitudinal cohort of child soldiers and matched civilian children, enrolled in 2007 after the People's War in Nepal, were re-interviewed in 2012. The Depression Self-Rating Scale and Composite International Diagnostic Interview assessed depression and suicidality, respectively. Non-verbal response cards were used to capture experiences of sexual and physical IPV.Results.One of five participants (19%) reported any lifetime suicidal ideation, which was associated with sexual IPV, female gender, former child soldier status and lack of support from teachers. Among young men, the relationship between sexual IPV and suicidality was explained by depression, and teacher support reduced suicidality. Among young women, sexual IPV was associated with suicidality, independent of depression; child soldier status increased suicidality, and teacher support decreased suicidality. Suicide plans were associated with sexual IPV but not with depression. One of 11 female former child soldiers (9%) had attempted suicide.Conclusion.Sexual IPV is associated with suicidal ideation and plans among conflict-affected young women, independent of depression. Reducing suicide risk among women should include screening, care, and prevention programs for sexual IPV. Programs involving teachers may be particularly impactful for reducing suicidality among IPV survivors.

show abstract

Protective and risk factors of psychosocial wellbeing related to the reintegration of former child soldiers in Nepal

Cited by 11 publications

References 13 publications

Recruitment of child soldiers in Nepal: Mental health status and risk factors for voluntary participation of youth in armed groups.

Recruitment of child soldiers in Nepal: Mental health status and risk factors for voluntary participation of youth in armed groups.

A Cultural Adaptation of Dialectical Behavior Therapy in Nepal

Interpersonal violence and suicidality among former child soldiers and war-exposed civilian children in Nepal

Contact Info

Product

Resources

About