Original article
Sierra Leone's Child Soldiers: War Exposures and Mental Health Problems by Gender

https://doi.org/10.1016/j.jadohealth.2010.09.021Get rights and content

Abstract

Purpose

To examine associations between war experiences, mental health, and gender in a sample of male and female Sierra Leonean former child soldiers.

Methods

A total of 273 former child soldiers (29% females) were assessed for depression and anxiety by using the Hopkins Symptoms Checklist, and for hostility, confidence, and prosocial attitudes by using an instrument developed for use with Sierra Leonean child soldiers.

Results

The former child soldiers had witnessed and perpetrated violence at largely comparable rates, although females experienced higher rates of rape (p < .0001). More females scored within clinical ranges for depression (p = .008) and anxiety (p < .0001). In multiple regression analyses, female gender was a significant predictor of lower levels of confidence but not of mental health problems. Children who perpetrated injury or killing reported greater levels of depression (p < .0001), anxiety (p < .0001), and hostility (p < .0001). Surviving rape was associated with increased anxiety (p < .05) and hostility (p < .05), in males. Surviving rape was also related to higher confidence levels (p < .05) and prosocial attitudes (p < .05). Male former child soldiers who lost caregivers were also more vulnerable to depression (p < .05) and anxiety (p < .05), strong and significant effects noted among male child soldiers.

Conclusions

In our sample, female and male child soldiers experienced comparable levels of most war exposures. Female soldiers reported higher rates of rape and lower levels of adaptive outcomes. Toxic forms of violence (killing or injuring; rape) were associated with particularly poor outcomes. Although all boys and girls who experience rape and loss of caregivers are generally at risk for mental health problems, boys in our sample demonstrated increased vulnerability; these findings indicate a need for more inclusive mental health services.

Section snippets

Study cohort and procedures

This study presents a cross-sectional analysis of data collected in 2004 as part of a larger longitudinal study of Sierra Leonean war-affected youth. This longitudinal study was launched in 2002 by the first author in collaboration with the International Rescue Committee (IRC). In 2002, 260 former child soldiers (11% females and 89% males) completed baseline interviews. Participants were selected from pooled registries of all young people processed through the IRC Interim Care Center (ICC) in

Results

Table 1 shows the sample's demographic and socioeconomic characteristics by gender. Females constituted 29% (N = 79) of the sample. In all, 81% (N = 64) of female participants and 32% (N = 63) of male participants self-reintegrated without formal assistance; 53% of the total (N = 146) received NGO assistance through ICCs. The average age of abduction was comparable among males (mean = 10.68, SD = 2.86) and females (mean = 10.39, SD = 2.89). Males and females reported comparable family

Discussion

This study's findings challenge the common perception of “child soldiering” as a male-only phenomenon. Girls and boys in our sample experienced comparable levels of exposure to most violent events, including participation in front-line fighting. At the same time, females reported significantly more instances of rape and sexual abuse, and far more limited access to protective resources such as education. Ethnographic and qualitative reports from postconflict settings confirm the challenges

Conclusion

The present study contributes to a growing body of literature examining the experience of child soldiers by gender. In particular, it provides quantitative data on rates of war experiences among male and female CAAFAG to shed light on important differences and similarities. This study emphasizes that children's psychosocial adjustment must be considered in light of war experiences, post-conflict resources, and gender.

Our findings have important programmatic and policy implications. They suggest

Acknowledgments

The authors thank Sidney Atwood for his assistance in data management and analysis. This study was funded by the United States Institute of Peace, USAID/DCOF, Grant # 1K01MH077246-01A2 from the National Institute of Mental Health, the International Rescue Committee, and the François-Xavier Bagnoud Center for Health and Human Rights.

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