Betancourt Theresa S, Keegan Katrina, Farrar Jordan, Brennan Robert T
Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, MA USA.
Women's Studies Research Center, Brandeis University, Waltham, MA USA.
Confl Health. 2020 Sep 1;14:62. doi: 10.1186/s13031-020-00308-7. eCollection 2020.
Globally, one in four children lives in a country affected by armed conflict or disaster often accompanied by exposure to a range of adversities including violent trauma and loss. Children involved with armed groups (often referred to as "child soldiers") typically exhibit high levels of mental health needs linked to their experiences. The Longitudinal Study of War-Affected Youth (LSWAY) in Sierra Leone is a seventeen-year prospective longitudinal study of the long-term effects of children's experiences in the country's eleven-year (1991-2002) civil war on their adult mental health and functioning in addition to exploring the potential mechanisms by which intergenerational transmission of emotional and behavioral disruptions due to war trauma may operate. LSWAY illuminates how war-related and post-conflict experiences shape long-term adult functioning, family dynamics, and developmental outcomes in offspring.
The LSWAY study utilizes mixed methodologies that incorporate qualitative and quantitative data to unpack risk and protective factors involved in social reintegration, psychosocial adjustment, parenting, and interpersonal relationships. To date, study findings demonstrate striking levels of persistent mental health problems among former child soldiers as adults with consequences for their families, but also risk and protective patterns that involve family- and community-level factors. This case study examines the course of LSWAY from inception through implementation and dissemination, including building on the study results to design and evaluate several intervention models.
The case study offers a unique perspective on challenges and field realities of health research in a fragile, post-conflict setting common in the context of humanitarian emergencies. LSWAY findings along with lessons learned from the field can inform future research as well as intervention research and implementation science to address the mental health and development of war-affected young people. With four waves of data collection and a planned fifth wave, LSWAY also provides rare insights into the intergenerational effects of humanitarian crises on children, youth, and families across generations.
在全球范围内，四分之一的儿童生活在受武装冲突或灾难影响的国家，这些国家往往还伴随着一系列逆境，包括暴力创伤和亲人离世。与武装组织有关联的儿童（通常被称为“儿童兵”）通常因其经历而表现出高度的心理健康需求。塞拉利昂的受战争影响青年纵向研究（LSWAY）是一项为期17年的前瞻性纵向研究，旨在探究该国11年（1991 - 2002年）内战期间儿童的经历对其成年后的心理健康和功能的长期影响，此外还探索战争创伤导致的情绪和行为障碍的代际传播可能发挥作用的潜在机制。LSWAY阐明了与战争相关及冲突后的经历如何塑造成年人的长期功能、家庭动态以及后代的发展结果。
LSWAY研究采用了混合方法，将定性和定量数据结合起来，以剖析社会重新融入、心理社会适应、养育子女和人际关系中涉及的风险和保护因素。迄今为止，研究结果表明，成年后的前儿童兵存在显著程度的持续性心理健康问题，这对他们的家庭产生了影响，但同时也发现了涉及家庭和社区层面因素的风险和保护模式。本案例研究考察了LSWAY从启动到实施及传播的过程，包括基于研究结果设计和评估几种干预模型。
该案例研究为在人道主义紧急情况下常见的脆弱冲突后环境中进行健康研究的挑战和实地现实提供了独特视角。LSWAY的研究结果以及从实地获得的经验教训可为未来研究以及干预研究和实施科学提供参考，以解决受战争影响的年轻人的心理健康和发展问题。通过四轮数据收集以及计划中的第五轮收集，LSWAY还提供了关于人道主义危机对跨代儿童、青年和家庭的代际影响的罕见见解。
