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Past horrors, present struggles: The role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone


  • Betancourt, Theresa S.
  • Agnew-Blais, Jessica
  • Gilman, Stephen E.
  • Williams, David R.
  • Ellis, B. Heidi


Upon returning to their communities, children formerly associated with armed forces and armed groups--commonly referred to as child soldiers--often confront significant community stigma. Much research on the reintegration and rehabilitation of child soldiers has focused on exposure to past war-related violence and mental health outcomes, yet no empirical work has yet examined the role that post-conflict stigma plays in shaping long-term psychosocial adjustment. Two waves of data are used in this paper from the first prospective study of male and female former child soldiers in Sierra Leone. We examined the role of stigma (manifest in discrimination as well as lower levels of community and family acceptance) in the relationship between war-related experiences and psychosocial adjustment (depression, anxiety, hostility and adaptive behaviors). Former child soldiers differ from one another with regard to their post-war experiences, and these differences profoundly shape their psychosocial adjustment over time. Consistent with social stress theory, we observed that post-conflict factors such as stigma can play an important role in shaping psychosocial adjustment in former child soldiers. We found that discrimination was inversely associated with family and community acceptance. Additionally, higher levels of family acceptance were associated with decreased hostility, while improvements in community acceptance were associated with adaptive attitudes and behaviors. We found that post-conflict experiences of discrimination largely explained the relationship between past involvement in wounding/killing others and subsequent increases in hostility. Stigma similarly mediated the relationship between surviving rape and depression. However, surviving rape continued to demonstrate independent effects on increases in anxiety, hostility and adaptive/prosocial behaviors after adjusting for other variables. These findings point to the complexity of psychosocial adjustment and community reintegration in these youth and have a number of programmatic and policy implications.

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  • Betancourt, Theresa S. & Agnew-Blais, Jessica & Gilman, Stephen E. & Williams, David R. & Ellis, B. Heidi, 2010. "Past horrors, present struggles: The role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone," Social Science & Medicine, Elsevier, vol. 70(1), pages 17-26, January.
  • Handle: RePEc:eee:socmed:v:70:y:2010:i:1:p:17-26

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    References listed on IDEAS

    1. Macartan Humphreys & Jeremy M. Weinstein, 2007. "Demobilization and Reintegration," Journal of Conflict Resolution, Peace Science Society (International), vol. 51(4), pages 531-567, August.
    2. Meyer, Ilan H. & Schwartz, Sharon & Frost, David M., 2008. "Social patterning of stress and coping: Does disadvantaged social statuses confer more stress and fewer coping resources?," Social Science & Medicine, Elsevier, vol. 67(3), pages 368-379, August.
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    7. Link, Bruce & Castille, Dorothy M. & Stuber, Jennifer, 2008. "Stigma and coercion in the context of outpatient treatment for people with mental illnesses," Social Science & Medicine, Elsevier, vol. 67(3), pages 409-419, August.
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    Cited by:

    1. Havari, Enkelejda & Peracchi, Franco, 2017. "Growing up in wartime: Evidence from the era of two world wars," Economics & Human Biology, Elsevier, vol. 25(C), pages 9-32.
    2. T.S. Betancourt & A. Ettien, 2010. "Transitional Justice and Youth Formerly Associated with Armed Forces and Armed Groups: Acceptance, marginalization and psychosocial adjustment," Papers inwopa614, Innocenti Working Papers.
    3. Foster, Holly & Brooks-Gunn, Jeanne, 2015. "Children's exposure to community and war violence and mental health in four African countries," Social Science & Medicine, Elsevier, vol. 146(C), pages 292-299.
    4. Trani, Jean-François & Cannings, Tim I., 2013. "Child Poverty in an Emergency and Conflict Context: A Multidimensional Profile and an Identification of the Poorest Children in Western Darfur," World Development, Elsevier, vol. 48(C), pages 48-70.
    5. Barber, Brian K. & McNeely, Clea & Olsen, Joseph A. & Belli, Robert F. & Doty, Samuel Benjamin, 2016. "Long-term exposure to political violence: The particular injury of persistent humiliation," Social Science & Medicine, Elsevier, vol. 156(C), pages 154-166.
    6. Trani, Jean-Francois & Ballard, Ellis & Peña, Juan B., 2016. "Stigma of persons with disabilities in Afghanistan: Examining the pathways from stereotyping to mental distress," Social Science & Medicine, Elsevier, vol. 153(C), pages 258-265.
    7. Tay, Alvin Kuowei & Rees, Susan & Chan, Jack & Kareth, Moses & Silove, Derrick, 2015. "Examining the broader psychosocial effects of mass conflict on PTSD symptoms and functional impairment amongst West Papuan refugees resettled in Papua New Guinea (PNG)," Social Science & Medicine, Elsevier, vol. 132(C), pages 70-78.


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