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
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DOI：
10.1016/j.jaac.2010.03.008
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发表时间：
2010-06-01
影响因子：
13.3
通讯作者：
Gilman, Stephen E.
中科院分区：
文献类型：
--
作者：
Betancourt, Theresa S.;Brennan, Robert T.;Gilman, Stephen E.
目标：调查塞拉利昂前儿童兵内在化和外在化问题和适应性/亲社会行为的纵向过程，以及冲突后因素是否会导致不良或有弹性的心理健康结果。方法：男性和女性前儿童兵（N = 260，基线年龄为10至17岁）从科诺区非政府组织（NGO）经营的临时护理中心的名册中招募，并于2002年，2004年和2008年进行了采访。留存率为69%。线性增长模型被用来调查与战争和冲突后经历有关的趋势。结果如下：前儿童兵的长期心理健康与战争经历和冲突后风险因素有关，冲突后保护因素部分减轻了这些因素。外化行为的增加与战争期间杀害/伤害他人和冲突后的耻辱有关，而社区接受度的增加与外化问题的减少有关（B = -1.09）。内化问题的高基线水平与被强奸有关，而增加则与年轻人参与武装团体以及社会和经济困难有关。内化问题的改善与更高水平的社区接受度和社区接受度的增加有关（B = -0.86）。适应性/亲社会行为的减少与战争期间和冲突后的耻辱杀害/伤害他人有关，但部分减轻了社会支持，在学校和增加社区接受（B = 1.93）。结论：对前儿童兵的心理社会干预如果除了战争暴露之外还考虑到冲突后因素，可能会更有效。应确定具有累积风险因素、缺乏保护因素和持续痛苦的青年。建议提供可持续的服务，以促进社区接受，减少耻辱，扩大社会支持和教育机会。J. Am. Acad.儿童青少年。精神病学，2010;49（6）：606-615.
Objective: To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. Method: Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (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 postconflict experiences. Results: The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems (b = -1.09). High baseline levels of internalizing problems were associated with being raped, whereas 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 postconflict 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 postconflict 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. J. Am. Acad. Child Adolesc. Psychiatry, 2010;49(6):606-615.