Department of Global Health and Population, François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
J Adolesc Health. 2011 Jul;49(1):21-8. doi: 10.1016/j.jadohealth.2010.09.021. Epub 2010 Dec 24.
To examine associations between war experiences, mental health, and gender in a sample of male and female Sierra Leonean former child soldiers.
A total of 273 former child soldiers (29% females) were assessed for depression and anxiety by using the Hopkins Symptoms Checklist, and for hostility, confidence, and prosocial attitudes by using an instrument developed for use with Sierra Leonean child soldiers.
The former child soldiers had witnessed and perpetrated violence at largely comparable rates, although females experienced higher rates of rape (p < .0001). More females scored within clinical ranges for depression (p = .008) and anxiety (p < .0001). In multiple regression analyses, female gender was a significant predictor of lower levels of confidence but not of mental health problems. Children who perpetrated injury or killing reported greater levels of depression (p < .0001), anxiety (p < .0001), and hostility (p < .0001). Surviving rape was associated with increased anxiety (p < .05) and hostility (p < .05), in males. Surviving rape was also related to higher confidence levels (p < .05) and prosocial attitudes (p < .05). Male former child soldiers who lost caregivers were also more vulnerable to depression (p < .05) and anxiety (p < .05), strong and significant effects noted among male child soldiers.
In our sample, female and male child soldiers experienced comparable levels of most war exposures. Female soldiers reported higher rates of rape and lower levels of adaptive outcomes. Toxic forms of violence (killing or injuring; rape) were associated with particularly poor outcomes. Although all boys and girls who experience rape and loss of caregivers are generally at risk for mental health problems, boys in our sample demonstrated increased vulnerability; these findings indicate a need for more inclusive mental health services.
在塞拉利昂前儿童兵样本中，调查战争经历、心理健康和性别之间的关系。
共有 273 名前儿童兵（29%为女性）接受了 Hopkins 症状清单的抑郁和焦虑评估，并使用专为塞拉利昂儿童兵开发的工具评估了敌意、信心和亲社会态度。
前儿童兵目睹和实施暴力的比率大致相当，尽管女性遭受强奸的比率更高（p <.0001）。更多的女性在抑郁（p =.008）和焦虑（p <.0001）的临床范围内得分。在多元回归分析中，女性性别是信心水平较低的重要预测因素，但不是心理健康问题的预测因素。实施伤害或杀害的儿童报告了更高水平的抑郁（p <.0001）、焦虑（p <.0001）和敌意（p <.0001）。男性幸存者遭受强奸与焦虑增加（p <.05）和敌意增加（p <.05）有关。幸存的强奸也与更高的信心水平（p <.05）和亲社会态度（p <.05）有关。失去照顾者的男性前儿童兵也更容易出现抑郁（p <.05）和焦虑（p <.05），这些影响在男性儿童兵中尤为明显。
在我们的样本中，女性和男性儿童兵经历了大多数战争经历的水平相当。女兵报告了更高的强奸率和较低的适应结果。有毒形式的暴力（杀害或伤害；强奸）与特别差的结果有关。尽管经历过强奸和失去照顾者的所有男孩和女孩通常都面临心理健康问题的风险，但我们样本中的男孩表现出更大的脆弱性；这些发现表明需要更具包容性的心理健康服务。
