Abstract
Background: There is a paucity of
evidence for effective interventions to improve the mental health
of child soldiers returning home after war. Most approaches
emphasize family support and vocational rehabilitation. As war
effectively distorts and creates profound change in children's
socioecology, this change can affect normal child development,
putting them at greater risk psychologically. Many children who
participate in conflict often return to their homes only to find
new struggles with problematic reintegration and psychological
trauma. Research has demonstrated, however, that when a child is
provided family and social support, they build greater resilience
and show more positive reintegration outcomes, as opposed to those
child soldiers with limited to no support.
Objectives: Using multiple theories
in a mixed methods approach, we examined how socioecological
support affects the psychosocial wellbeing and function of former
child soldiers in Nepal.
Methods: We performed thematic
analysis of 8 key informant interviews of former child soldiers
which then guided bivariate and hierarchical linear regression
analyses on a dataset of former child soldiers (n = 142) from 10
districts in Nepal.
Results: Several
overarching themes emerged from the interviews, including
socioecological impact on how a child soldier manages during
reintegration post-conflict, the link between hope and education,
and the relationship a child has with his or her peers and daily
function. Quantitative measures showed that a child's
social ecology accounted for a significant proportion of the
variance in hope, function, and PTSD above that accounted for by
demographic variables. Specifically, a higher degree of community
support was associated with a greater sense of hope, a lower level
of peer support was associated with greater levels of functional
impairment, and lower levels of community support were associated
with higher levels of PTSD.
Conclusions: As the mental health of
child soldiers and other children affected by armed conflict are
influenced significantly by the degree of social support,
especially from peers and family members, post-conflict
interventions should consider that fostering peer support,
minimizing discrimination, and emphasizing educational programming
can have dramatic effects on promoting resilience of reintegrating
child soldiers.
Table of Contents
Table of Contents
Figures & Tables
Introduction 1
Research, Reintegration, & Rehabilitation
3
Theoretical Underpinning 4
Research Hypotheses 9
Literature Review 10
An Overview of Child Soldiers 10
Case Examples Demonstrating Considerations for Child
Soldiers Around the World 11
Nepal and The People's War 14
Nepali CAAFAG Pilot Study 15
CAAFAG Mental Health 16
Reintegration 17
The Future of CAAFAG: Where Research Is Going
17
Methods 18
Institutional Review 18
Design 18
Participants 18
Study Instruments 20
Procedure 23
Data Analysis 24
Results 27
Discussion 51
Limitations 55
Recommendations 56
Conclusion 58
References 59
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