Declaration of interest
Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined.
The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated.
Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed.
Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later (P<0.05). Symptoms of PTSD at baseline were significantly associated with war experiences (P<0.01) and post-conflict family abuse (P<0.001). Reliable improvement in symptoms was reported by 30%. In growth models examining symptom change, worsening of symptoms was associated with death of a parent (P<0.05) and post-conflict stigma (P<0.001). Protective effects were observed for increases in family acceptance (P<0.001).
The findings indicated improvement in PTSD symptoms among former child soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.
We acknowledge support from the US Institutes for Peace, the American Psychological Foundation, the François-Xavier Bagnoud Center for Health and Human Rights, grant 1K01MH07724601A2 from the National Institute of Mental Health, grant P60 MD002261 from the National Center for Minority Health and Disparities, and the Displaced Children's and Orphans' Fund of USAID, who helped to fund this work. E.A.N. was supported by a Morgan Stanley Pediatrics Fellowship through the American Australian Association and an Early Career Fellowship through the National Health and Medical Research Council.
- Royal College of Psychiatrists