The treatment of posttraumatic stress symptoms and aggression in female former child soldiers using adapted Narrative Exposure therapy – a RCT in Eastern Democratic Republic of Congo

Robjant, Katy; Koebach, Anke; Schmitt, Sabine; Chibashimba, Amani; Carleial, Samuel; Elbert, Thomas

doi:10.1016/j.brat.2019.103482

Cited by 44 publications

(99 citation statements)

References 52 publications

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“…Some children have not only been the victims of human rights abuses, but have also perpetrated them. Robjant et al describe the treatment of 100 female former child soldiers abducted during the M23 war in Eastern DRC (38). This case was typical of those seen.…”

Section: Child Soldiermentioning

confidence: 89%

“…NET was used to treat a series of child soldiers in the Democratic Republic of Congo (DRC) (38). Some children have not only been the victims of human rights abuses, but have also perpetrated them.…”

Section: Child Soldiermentioning

confidence: 99%

“…At night, unlike the other girls who were afforded the title of "wife of soldier" and regularly raped by one person, she was "unassigned" and thus visited frequently by different men and groups of men. This afforded her a lower social status, as well as a likely increased trauma exposure, and as such she attempted to increase her status (and life expectancy) by being a better "fighter" using increasingly violent and deadly means (38).…”

Section: Child Soldiermentioning

confidence: 99%

“…The treatment of this case involved an adaption of NET for perpetrators (FORNET) (38,42), for example by marking acts of perpetration on the lifeline with "sticks." Other adaptations include holding group sessions as part of the treatment which include: learning skills to manage affect regulation especially targeting anger; motivational work in avoiding violence; problem solving to help manage stigma and prejudice from community members (who often feared the returning abductees and sought to isolate and reject them); and active peer support through a buddying system (38).…”

Section: Child Soldiermentioning

confidence: 99%

“…These sessions had a focus on re-processing traumatic events in which the traumatized individual had played different roles, at times as a perpetrator of events and other times not. Typically the lifeline showed large numbers of traumatic events, many of which also included perpetration of violence, and so in order to fit with the context (requiring low resource input) priority was afforded to events which were of different types, in differing contexts and which were related to symptoms (38). As was typical of the wider treatment cohort in the RCT, PTSD and depressive symptoms were reduced to the extent that she no longer met criteria for a diagnosis of either condition, appetitive aggression was reduced, but more importantly she had fewer episodes of actual violent behavior.…”

Section: Child Soldiermentioning

confidence: 99%

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Five Applications of Narrative Exposure Therapy for Children and Adolescents Presenting With Post-Traumatic Stress Disorders

et al. 2020

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Narrative exposure therapy (NET) is an individual therapeutic approach that has an emerging evidence base for children. It was initially trialed with refugee and asylum seeking populations, in low, middle and high-income settings, utilizing either lay or professional therapists. The results of treatment trials for PTSD in refugee children with NET (or the child "KIDNET" adaptation) demonstrates how this is an effective intervention, is scalable and culturally dexterous. This paper describes, in five cases from clinical practice settings, the applicability of NET into broader, routine practice. The cases outlined describe the use of NET with adolescents with: autism spectrum disorders, psychotic symptoms, and intellectual disabilities; histories of forced abduction into child soldiering; complex physical health problems needing multiple interventions; and victims of childhood sexual abuse. The cases are discussed with regards to how the NET lifeline facilitated engagement in treatment, practical adaptations for those with intellectual disabilities and how NET, with its relatively short training for health professionals, can be modified to different contexts and presentations. The importance of improving access to care is discussed to ensure that young people are supported with their most complex and disruptive memories.

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Section: Child Soldiermentioning

confidence: 89%

Section: Child Soldiermentioning

confidence: 99%

Section: Child Soldiermentioning

confidence: 99%

Section: Child Soldiermentioning

confidence: 99%

Section: Child Soldiermentioning

confidence: 99%

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Five Applications of Narrative Exposure Therapy for Children and Adolescents Presenting With Post-Traumatic Stress Disorders

et al. 2020

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A combination of combat experience, early abduction, and severe traumatization fuels appetitive aggression and violence among abductees of rebel war in Northern Uganda

Zeller

Conrad

Schneider

et al. 2020

Aggressive Behavior

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Individuals who perpetrate violence may likely perceive violence as appealing and infliction of violence to derive pleasure is termed as appetitive aggression. Individuals who were abducted as children into an armed group often experience a higher number of traumatic event types, that is traumatic load and are usually socialized in a violence-endorsing environment. This study aims to investigate the interaction between age at initial abduction with that of traumatic load, and their influence on appetitive aggression along with perpetration of violent acts by former members of an armed rebel group of both sexes. Semi-structured interviews were conducted among a target group of formerly abducted rebel-war survivors (including participants with and without combat experience) from Northern Uganda. Participants included 596 women and 570 men with N = 1,166 (M age = 32.58, SD age = 9.76, range: 18-80 years). We conducted robust linear regression models to investigate the influence of age at initial abduction, traumatic load, combat experience, and biological sex on appetitive aggression as well as their perpetrated violent acts. Our study shows, appetitive aggression and the number of perpetrated violent acts were specifically increased in individuals who were abducted young, experienced several traumatic events in their lifetime, and with previous combat experience. For perpetrated violence men showed increased levels whereas for appetitive aggression the association was independent of biological sex. Therefore, early abducted individuals with a higher traumatic load, who have combat experience, need to be given special intervention to prevent any further violence.

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When reintegration fails: Stigmatization drives the ongoing violence of ex‐combatants in Eastern Democratic Republic of the Congo

2021

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The treatment of posttraumatic stress symptoms and aggression in female former child soldiers using adapted Narrative Exposure therapy – a RCT in Eastern Democratic Republic of Congo

Cited by 44 publications

References 52 publications

Five Applications of Narrative Exposure Therapy for Children and Adolescents Presenting With Post-Traumatic Stress Disorders

Five Applications of Narrative Exposure Therapy for Children and Adolescents Presenting With Post-Traumatic Stress Disorders

A combination of combat experience, early abduction, and severe traumatization fuels appetitive aggression and violence among abductees of rebel war in Northern Uganda

When reintegration fails: Stigmatization drives the ongoing violence of ex‐combatants in Eastern Democratic Republic of the Congo

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