Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study.

BACKGROUND Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. AIMS The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. METHOD Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. RESULTS Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later (P<0.05). Symptoms of PTSD at baseline were significantly associated with war experiences (P<0.01) and post-conflict family abuse (P<0.001). Reliable improvement in symptoms was reported by 30%. In growth models examining symptom change, worsening of symptoms was associated with death of a parent (P<0.05) and post-conflict stigma (P<0.001). Protective effects were observed for increases in family acceptance (P<0.001). CONCLUSIONS The findings indicated improvement in PTSD symptoms among former child soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.