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Posted September, 2010

Resilience and Psychopathology among
Former Ugandan Child Soldiers

Of the adverse conditions faced by children, one of the most appalling is the conscription of tens of thousands of children to serve in armed conflicts. In order to help former child soldiers, it is necessary to identify their particular problems and strengths, plus associated risk and protective factors. Although outcomes of very adverse experiences are often viewed through the lens of Posttraumatic Stress Disorder (PTSD), the variety of conditions experienced by child soldiers, as well as their developmental and other personal characteristics, argue for broader perspectives on outcomes. In a study that assessed resilience as well as psychopathology, the YSR, DSM diagnostic interviews, and measures of traumatic experiences, stressors, resilience, and social and spiritual support were administered by Ugandan interviewers to 330 former Ugandan soldiers at ages 11-17 (Klasen et al., 2010). Although Ugandan norms were not available for the YSR, the researchers used the YSR's Group 2 multicultural norms, because scores for the YSR normative sample from nearby Ethiopia qualified for the Group 2 norms. Based on multiple criteria, 27.6% of the 330 Ugandan youths were identified as having resilient outcomes, as defined by not manifesting PTSD nor other major psychopathology. Of the 72.4% who did not have resilient outcomes, 33% met DSM criteria for PTSD, an additional 17.9% met criteria for major depressive disorder, and most obtained YSR Total Problems scores in the clinical range. The mean YSR Total Problems score for the nonresilient youths was more than 2 standard deviations above the mean for the Group 2 multicultural norms and more than twice as high as the mean Total Problems score for the resilient youths, whose mean was close to the mean for the Group 2 norms. Compared to the nonresilient youths, the resilient youths had significantly less exposure to violence in their homes following their military experience, lower guilt cognitions, less motivation to seek revenge, higher family socioeconomic status, and more perceived spiritual support. As only 33% of the nonresilient youths actually met criteria for PTSD and many manifested psychopathology that did not correspond to PTSD criteria, the authors concluded that "the concept of PTSD does not fully capture the reaction to repeated and prolonged interpersonal trauma of child soldiers and may be better described by concepts such as developmental trauma disorder" (p. 1107).

Reference: Klasen, F., Oettingen, G., Daniels, J., Post, M., Hoyer, C., & Adam, H. (2010). Posttraumatic resilience in former Ugandan child soldiers. Child Development, 81, 1096-1113

Copyright © 2017 by Thomas Achenbach