Post-traumatic stress symptoms among former child soldiers in Sierra Leone: Follow-up study

Abstract

Background: Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. Aims: The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. Method: Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. Results: 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). Conclusions: 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.