An Intergenerational Analysis of the Impact of War on Child Soldiers

War has long-lasting political and socioeconomic repercussions, as well as substantial implications for interpersonal relationships. Experts argue that war undermines family dynamics by weakening adults’ capacity to provide care for young children. The Security Council of the United Nations has established complex peacekeeping task forces in several African countries affected by war, including Sierra Leone. This country’s civil war, which lasted from 1991 to 2002, resulted in 70,000 causalities and 2.6 million displaced people, and was characterized by brutal violence perpetrated against civilians, including the kidnapping of children and systemic rape.

A new study by Theresa S. Betancourt, Ryan K. McBain, Elizabeth A. Newnham, and Robert T. Brennan, explores the intergenerational impact of war on mental health in post-conflict Sierra Leone. In particular, the authors examine the association between the mental health of a child’s caregiver and youth internalizing symptoms of anxiety and depression over a four-year period (2004-2008).

The scholars invited several groups of children, ages 10 to 17, and their caregivers, to participate in the study, and 118 pairs of children and caregivers were ultimately used in the sample. The sample included former child soldiers and those associated with armed groups in Sierra Leone who had and had not received reintegration services, as well as those who self-reintegrated. The study began in 2002, and in 2008 the authors re-contacted 85 percent of the original participants.

It is important to note that many former child soldiers are without family members or caregivers—this group is unrepresented here, which is one limitation of the study in terms of accurately representing the subpopulation of former child soldiers. However, the focus of this study is how mental health can be improved among youth who have been greatly affected by war.

Through several interviews, the scholars assessed caregivers’ and children’s mental health symptoms. Youth were assessed using the Oxford Measure of Psychosocial Adjustment (OMPA), while caregivers were assessed using an adapted version of the 25-item Hopkins Symptom Checklist (HSCL). In addition, the study also measured youths’ acceptance by their families, community stigma, toxic war exposures (such as rape or the perpetration of violence through injury or killings), and other daily hardships (hunger, economic insecurity, and interpersonal adversities).

The results of the study reveal that an improvement in a caregiver’s mental health is associated with an improvement in a youth’s treatment using xanax symptoms of anxiety and depression, after controlling for all other factors that predict mental health. This implies that, over a four-year post-conflict horizon, a one-standard deviation change in the depression and anxiety levels of caregivers is associated with a corresponding 0.43-standard deviation change in the mental health of children in their care. However, the researchers clarify that it is not possible to determine direct causality since children’s mental health might influence the caregivers’ as well.

Of the other factors analyzed, community stigma (measured by youths’ perception of their own discrimination for being a former child soldier) was positively associated with symptoms of anxiety and depression. Additionally, an increase in family acceptance during the time of the study (measured by youths’ perception of their families’ support and respect) has a negative relationship with youths’ poor mental health.

Interpretations of these results should consider the limitations of the study. The authors explain that the youth who participated in the study might not be broadly representative of the country, or of all war-affected youth. They also warn about potential reporting biases, since anxiety was assessed by self-reporting symptoms of depression. Furthermore, there might be a common method bias since youth reported community stigma and family acceptance in the same surveys, using similar techniques. Lastly, the study does not specify other possible unobserved factors that influence both the caregivers’ and youths’ mental health.

Nonetheless, the researchers suggest that, in a war setting, there is a robust relationship between caregivers’ and youths’ mental health for youth who may have been involved in combat. Although further research is necessary to identify causal relationships, a comprehensive health policy that considers caregivers’ mental state might offer a more suitable option for helping and treating war-affected children.

Acknowledging the importance of a supportive social environment, particularly among family and peers, can open the door to broader interventions that facilitate psychological recovery for former child soldiers. It is important to note that many former child soldiers do not have family structures in place. In these cases, building supportive relationships with caregiver-type individuals becomes even more necessary.

Article Source: Betancourt, Theresa S., Ryan K. McBain, Elizabeth A. Newnham, and Robert T. Brennan, “The Intergenerational Impact of War: Longitudinal Relationships between Caregiver and Child Mental Health in Post-Conflict Sierra Leone,” Journal of Child Psychology and Psychiatry, Vol. 10, 56 October (2015): 1101-7.

Featured Photo: cc/(AdrianHillman, photo ID: 26239379, from iStock by Getty Images)