@article{ref1,
title="Stigma and acceptance of Sierra Leone's child soldiers: a prospective longitudinal study of adult mental health and social functioning",
journal="Journal of the American Academy of Child and Adolescent Psychiatry",
year="2019",
author="Betancourt, Theresa S. and Thomson, Dana L. and Brennan, Robert T. and Antonaccio, Cara M. and Gilman, Stephen E. and Vanderweele, Tyler J.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To investigate the associations of war and post-conflict factors with mental health among Sierra Leone's former child soldiers as adults. <br><br>METHOD: In 2002, we recruited former child soldiers from lists of soldiers (aged 10-17) served by Disarmament, Demobilization, Reintegration centers and from a random door-to-door sample in five districts of Sierra Leone. In 2004, self-reintegrated child soldiers were recruited in an additional district. At 2016/17, 323 of the sample of 491 former child soldiers were reassessed. Subjects reported on war exposures and post-conflict stigma, family support, community support, anxiety/depression, and post-traumatic stress symptoms. <br><br>RESULTS: 72% of subjects were male; mean age, 28. 26% reported killing or injuring others; 67% reported being victims of life-threatening violence; 45% of female, 5% of male subjects, reported being raped; 32% reported death of a parent. In 2016/17 (Wave 4), 47% exceeded the threshold for anxiety/depression; 28% exceeded the likely post-traumatic stress disorder threshold. Latent class growth analysis yielded three trajectory groups based on changes in stigma and family/community acceptance; &quot;Improving Social Integration&quot; (n = 77) fared nearly as well as the &quot;Socially Protected&quot; (n = 213). The &quot;Socially Vulnerable&quot; group (n = 33) had increased risk of anxiety/depression above the clinical threshold and possible PTSD and were around three times more likely to attempt suicide. <br><br>CONCLUSION: Former child soldiers had elevated rates of mental health problems. Post-conflict risk and protective factors related to outcomes long after the end of conflict. Targeted social inclusion interventions could benefit long-term mental health of former child soldiers.<br><br>Copyright © 2019. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0890-8567",
doi="10.1016/j.jaac.2019.05.026",
url="http://dx.doi.org/10.1016/j.jaac.2019.05.026"
}