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Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research.

ABSTRACT: This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18?years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers.PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the systematic assessment of quality in observational research (SAQOR).According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment.Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring.

SUBMITTER: Betancourt TS

PROVIDER: S-EPMC4167714 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research.

Betancourt Theresa S TS Borisova Ivelina I Williams Timothy P TP Meyers-Ohki Sarah E SE Rubin-Smith Julia E JE Annan Jeannie J Kohrt Brandon A BA

Journal of child psychology and psychiatry, and allied disciplines 20121012 1

<h4>Aims and scope</h4>This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers.<h4>Methods</h4>PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries ...[more]

PMID: 23061830

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Project description:Internationally, the mental health of children and adolescents is undoubtedly an important construct of theoretical, clinical, and policy level concern. Worldwide, five mental disorders (depression, alcohol misuse, bipolar affective disorder, schizophrenia, and obsessive-compulsive disorder) represent half of the 10 leading causes of disability and premature death; with mental disorders accounting for 15-30% of disability adjusted life years in the first three decades of life. This provides a solid rational founded in implications for population health as to why reducing and preventing mental health problems in children and adolescents deserves attention. Past research has indicated interventions focussed on building resilience through strengthening protective factors may offer the potential to address mental health problems in children and adolescents, and in particular aid in reducing such problems during times of increased risk or adversity. With childhood and adolescence being critical periods of development, there is a need to reflect on the strengths and limitations of resilience-focussed interventions and anticipated future needs of the world's youth. This conceptual analysis identifies a number of future research directions that may meaningfully add to the evidence base and improve implementation, evaluation, and impact of resilience-focussed interventions. These largely relate to refining the understanding of how resilience protective factors relate to mental health problems in children and adolescents. Important issues and potential opportunities to improve the related research field include improved reporting of intervention content; improved measurement of resilience protective factors in intervention trials; continued reporting and review of evidence of association between protective factors and mental health outcomes; and incorporation of mediation analysis within intervention trials. There is a need for further intervention studies in this space to be conducted as rigorous trials of resilience-focussed approaches based on such evidence of association, with clearly posited mechanisms of change, and inclusive of analysis of differential intervention effects. The suggested implications for research made in this conceptual analysis will aid in improving the quality of the evidence base relevant to the fostering of resilience and prevention of mental health problems in children and adolescents.

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Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research.

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Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research.

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