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Can Child Soldiers Be Resilient Despite their Traumatic Experiences in War?

By: Selena M. Hengy


Model of Predispositions Affecting Mental Health Outcomes

Abstract
Currently, there are over 300,000 children who are fighting in
armed conflicts across 87 countries worldwide. The prevalence
of psychopathology in child soldiers has become increasingly
controversial regarding their ability to be resilient or suffer
from mental distress. The purpose of this paper is to identify
risk and protective factors associated with child soldiering and
determine how they influence a childs resilience or lack
thereof. Results reveal that children who are abducted and
forced to become soldiers experience negative psychopathology if they lack protective support, but others are resilient despite their traumatic experiences. The poster concludes with a
discussion of possible factors that could affect a child's ability
to display resilience in the face of war trauma.

Psychological Effects of War Trauma

Abduction
Risk
Factors

Exposure Length

Gender

- Out of 71 child soldiers, 69 (97%) had very high rates


of PTSD symptoms (Derluyn et al 2004).

Negative
Mental
Health

Stigma

- However, Betancourt et al. (2012) found little variation


in psychosocial distress levels between child soldiers and
a control group.

Child Soldier

Community
Acceptance

Protective
Factors

Education

Psychological Effects

Length & Severity of War Exposure


- Longer engagement with an armed group and severe
exposure both have negative consequences for the

Resilient
Outcome

mental health and social reintegration of youth soldiers


(Williams, 2007).

Family & Social Support

- In contrast, severe violence exposure alone, rather than


length of abduction, significantly predicted psychosocial adjustment over time Betancourt et al. (2010).

Research Objective

This poster will focus on the psychological effects of warrelated trauma on children based on their experiences as a
child soldier, with an overall goal to summarize literature
based on the following questions:
- What are the psychological effects of children directly
exposed to war-related trauma?

Risk Factors for Mental Illness

Protective Factors for Resilience

From my synthesis of the literature, I identified four factors that contribute to mental distress:

1. Abduction

- Parent availability decreases a childs likelihood of


developing negative stress reactions in adverse

Child Soldier
-Any person below 18 years of age who is or who has
been recruited by an armed force in any capacity,
including boys and girls, used as fighters, spies, or for
sexual purposes (United Nations International
Childrens Emergency Fund 2007).
- According to the United Nations Children's Fund
(UNICEF), 2 million children have been killed by
conflict over the last decade and there are at least
300,000 child soldiers operating in 30 different conflicts
across the globe.

- Support from a childs social environment predicted


lower levels of PTSD, depression, and functional

toxic environment can be damaging to a child


(Shonkoff & Phillips, 2000), however Klasen et
al. (2010) established younger kids exhibit lower
rates of PTSD than older children.

impairment (Kohrt et al. 2010).

2. Community Acceptance
- Greater community acceptance has demonstrated
increased prosocial attitudes & behaviors

2. Length of Conscription
- Extensive duration of war exposure is associated with
greater mental distress (Blattman et al. 2010).

- In contrast to negative psychological outcomes, Klasen


et al. (2010) demonstrated that more than 27% of the
children studied displayed a resilient mental health.

(Betancourt et al. 2010).

3. Education

3. Gender

- Educated former child soldiers displayed significant


improvement in their mental health and were 15% less
likely to be illiterate compared to civilians
(Betancourt et al. 2010).

- Female and male soldiers were, 6.8 & 3.8 respectfully,


times more likely to have PTSD than a comparison
group of civilian children (Kohrt et al. 2008).

4. Stigma
- Child soldiers are often stigmatized by their community
for the acts of cruelty they performed during
conscription (Derluyn et al. 2004).

- Risk factors place a child at greater risk of developing


psychological consequences following traumatic war
experiences.

(Rutter, 2006).
- Developing Resilience

- Direct us to think about resilience as more than


just an individual fight but rather one that involves
both internal and external protective factors to achieve
resilience.

- Returning to and staying in school was associated with


higher confidence levels and prosocial behaviors among
Sierra Leone youth (Betancourt & Khan, 2008).

- Betancourt et al (2010) described a resilience


perspective that provides a framework for thinking
about the adaptation of posttraumatic symptoms in
former child soldiers.
- Suggests that due to being continually exposed
to traumatic events, a child develops coping
strategies and when overly used, could
potentially suffer from mental distress.

Research Findings Comparing Psychopathology to Resilience Prevalences Among Child Soldiers


Reference
Country

Okello, Onen,
& Musisi
Uganda
(2007)

- Having the capacity to make realistic plans, manage


strong feelings, have a positive personal view, and be
confident in their own strength, are factors that help
a person develop resilience.
- Protective factors play a significant role in a childs
ability to be resilient despite war trauma.

Resilience Theories

1.) Stress Accumulation Theory: (Internal Strategy)

Resilience
- A relative resistance to environmental risk experiences,
or the overcoming of stress or adversity

Resiliency in Child Soldiers


- Increased confidence and positive attitudes were
associated with the sheer fact of surviving severe,
traumatic, war related events (Betancourt et al. 2010).

Prevalence of Psychopathology
- Psychological effects of warfare include depression,
anxiety, and PTSD.

Resiliency

situations (Derluyn et al. 2004).

- Age: Continuing development and being exposed to a

- Abductees exhibited a 49% increase in most distress


symptoms compared to non-abducted youth.

1.Family & Social Support


state and emotional impairment compared to
joining freely (Betancourt et al. 2010).

Clarification of Terms

Mental Health of Child Soldier vs. Civilian Child


- Kohrt et al. (2008) demonstrated that child soldiers
displayed a negative mental health outcome of greater
severity than non-conscripted children.

From my synthesis of the literature, I identified three factors that contribute to a resilient outcome:

- Entry: Forced abduction results in a harmful mental

- What factors promote resilience in child soldiers?

Betancourt
et al.
(2010)

Methodology
Subjects completed a set of
questionnaires that assessed
psychological disturbance,
SES factors, and trauma
events.

Interviewed soldiers from


June 2001 to Feb. 2002, with a
follow-up in 2004. Surveys
Sierra measured war experience, psyLeone chosocial adjustment, family/
community acceptance.

Sample Size
(Boy/Girl/Total)

Abducted:
54 / 28 / 82
Non-Abducted:
43 / 28 / 71

Time 1:
231 / 28 / 259
Time 2:
199 / 79 / 278

Associations with
War
Exposures
Killed Another:
93% (Ab), 8%(Non)
Witnessed Murder:
72%(Ab), 28%(Non)

Mental Health
Outcome

2.) Stress Adjustment Paradigm: (External Strategy)

Poor Mental Health:


PTSD: 27%(Ab), 13%(Non)

Depression: 20%(Ab), 4%(Non)

Anxiety: 13% (Ab), 4% (Non)

- Emphasizes the importance of family and


community support which helps a child achieve
positive psychological functioning despite severe
trauma exposure.

Beaten/Tortured:
71%(Ab), 29%(Non)
Killed Another: 28%
Witnessed Murder:
88%

References

Poor Mental Health:


PTSD: 63%(T1), 45%(T2)

Depression: 60%(T1), 55%(T2)

Beaten/Tortured: 37%

Anxiety: 60%(T1), 52% (T2)

Klasen et al.
(2010)

Uganda

Self-Report questionnaires
were given to formerly abducted children to assess trauma
severity PTSD & Depression
outcome, and Posttraumatic
Resilience.

Killed Another: 53%

170 / 160 / 330

Witnessed Murder:
88%

Poor Mental Health:


PTSD: 33%

Major Depression: 36%

Beaten/Tortured: 91% Resilience: 27.6%

Betancourt, T.S., Agnew-Blais, J., Gilman, S.E., Williams, D.R., & Ellis, B.H. (2010). Past horrors, present struggles: The role of stigma in the association between war experiences and psychosocial adjustment among former
child soldiers in Sierra Leone. Social Science and Medicine, 70, 17-26.
Betancourt, T.S., Borisova, I.I., Williams, T.P., Whitfield, T.H., Williamson, J. Brennan, R.T., Soudiere, M. , &
Gilman, S.E. (2010). Sierra Leones Former Child Soldiers: A Follow-Up Study of Psychosocial Adjustment an
Community Reintegration. Child Development, 81, 1077-1095.
Cortes, L. & Buchanan, M.J. (2007). The experience of Columbian child soldiers from a resilience perspective. International Journal for the Advancement of Counseling, 29, 43-55.
Derluyn, I., Broekaert, E., Schuyten,G., & Temmerman, E. (2004). Post-traumatic stress in former Ugandan child
soliders. The Lancet, 363, 861-863.
Klasen, F. , Daniels, J., Oettingen, G., Post, M., Hoyer, C., & Adam, H. (2010). Posttraumatic Resilience in Former Ugandan Child Soldiers. Child Development, 81, 1096-1113.
Kohrt, B.A., Jordans, M.J., Tol, W.A., Speckman, R.A., Maharjan, S.M., Worthman, C.M., & Komproe, I.H.
(2008). Comparision of mental health between former child soldiers and children never conscripted by armed
groups in Nepal. The Journal of the American Medical Association, 300, 691-702.
Okello, J., Onen, T.S., & Musisi (2007). Psychiatric disorders among war-abducted and non-abducted adolescents
in Gulu district, Uganda: a comparative study. African Journal of
Psychiatry, 225-231.
United Nations International Childrens Emergency Fund. (2007).
Paris principles: Principles and guidelines on children associated with
armed forces or armed conflict. New York.

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