Editorial: When Child Soldiers Grow Up: A Longitudinal Analysis of Postwar Adult Mental Health and Social Functioning

Abstract

In 2017, approximately 420 million children-nearly one in five-were living in conflict-affected areas, an increase of 30 million from the previous year.¹ In contexts of war, children are killed, injured, orphaned, separated from family, and sexually assaulted. Vast numbers of boys and girls are also recruited into armed groups as child soldiers. Exposed to brutal forms of violence as witnesses, victims, and participants - most often simultaneously - child soldiers take on a multiplicity of roles as fighters, porters, messengers, spies, caregivers to younger children, domestic workers, and are frequently sexually exploited. Exposure to war is a known risk factor for long-term mental health problems and psychosocial distress,² with child soldiers reporting higher levels of anxiety, posttraumatic stress, depressive, and somatic symptoms than control groups.³ Yet research has also demonstrated the resilience of former child soldiers and their ability to cope well despite wartime adversity and individual, familial, and structural stressors.⁴ The post-war context has an important influence on the social functioning and mental health outcomes of child soldiers,⁵ with community and family stigma being identified as significant barriers to acceptance, belonging, and well-being.^6,7 This growing body of research has helped to uncover and illuminate the immediate and short-term effects of war on former child soldiers. However, knowledge of the long-term effects remains poorly understood. The study by Betancourt et al.⁸ provides insight into the long-term adult mental health and social functioning of former child soldiers in Sierra Leone. The study offers nuance regarding why some former child soldiers may, over time, fare better than others. Betancourt et al.⁸ show that adult mental health and social functioning in Sierra Leone's former child soldiers were related to (1) wartime experiences, and (2) post-conflict risk and protective factors. Although previous literature has demonstrated this when considering the lives of former child soldiers over the short-term, this study reaffirms these realities over the long term.