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We were interested in examining the trajectory of sexual behaviors and practices that have yet to be examined among a sample of adolescents affected by war. This study explored sexual behaviors among a sample of adolescent males whose childhoods were affected by war (N = 169) in postconflict Sierra Leone. Results indicated that age of sexual debut was significantly associated with condom use. Specifically, those who had a sexual debut as midadolescents (15–17 years old) were less likely to have used a condom, compared to those who had a sexual debut as adults (18 or older). Furthermore, age was also significantly associated with having multiple partners in the last year. Older respondents indicated higher odds of having multiple partners. Findings suggest that this population may benefit from health education campaigns that include early intervention that focus on healthy sexual behaviors. Public Significance Statement: We were interested in examining the different paths regarding sexual behaviors and practices taken by adolescent males affected by war in postconflict Sierra Leonne. We focused on the sexual behaviors and practices of this population because this has not been explored in other studies. We found that the age when males first began having sex determined if they used condoms or not with younger males being less likely to use condoms than older males. We also found that older males were more likely to have multiple partners than were younger males. We conclude that early supports and services that teach about condoms, make condoms accessible, and lessen the stigma associated with sexual intercourse and condom use may benefit male youth affected by war in adopting healthy sexual behaviors. [ABSTRACT FROM AUTHOR]

Exposure to war is associated with poor psychosocial outcomes. Yet the effects of different types of war events on various psychosocial outcomes such as conduct problems remain unknown. This study aims to assess whether various war events differ in predicting conduct problems. Using data from an on-going longitudinal research project, the WAYS study, the current article examined the relationship between specific war events and conduct problems in war-affected youth in Northern Uganda (N=539, baseline age=22.39; SD=2.03, range 18–25). Regression analyses were conducted to relate each type of war experience to conduct problems. War categories of “witnessing violence”, “deaths”, “threat to loved ones” and “sexual abuse” were associated with reporting conduct problems. Multivariable models yielded independent effects of ‘‘witnessing violence’’ (β=0.09, 95% CI: 0.01, 0.18) and ‘‘Sexual abuse’’ (β=0.09, 95% CI: 0.02, 0.19) on conduct problems while “duration in captivity” independently and negatively predicted conduct problems (β=−0.14, 95% CI: −0.23, −0.06). Types of war events vary in predicting conduct problems and should be considered when designing interventions to alleviate negative consequences of exposure to war. Moreover, longer duration in captivity appear to protect war-affected youth from conduct problems. [ABSTRACT FROM AUTHOR]

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Resilience research with war-affected populations has long conceptualized resilience as the absence of psychopathology and operationalized it by use of standardized measures. However, literature on resilience increasingly highlights the importance of also including indicators of positively valued functioning as well as contextually sensitive indicators of resilience. This study used a participatory approach to examine the contextual conceptualization of youth resilience in the aftermath of war in northern Uganda, as defined by groups of stakeholders (youths, parents, elders, leaders, teachers) in four communities. The results identify 40 indicators covering a multiplicity of domains of functioning. The rationales behind these indicators were clustered into the broad themes: progress, self-reliance, social connectedness, morality, health, and comfort. The findings suggest that positively and negatively valued aspects of functioning are both key to conceptualizing resilience, and indicate the importance of including contextually distinguished indicators. The findings further point to the role of individual and collective processes in the construction of resilience, and to the need to take into account the contexts wherein resilience is conceptualized and observed. This study generated contextually sensitive indicators of young people’s resilience, which can be used, complementary to existing measures of functioning, to provide a more comprehensive and culturally sensitive view of youths’ resilience in the wake of war adversity. [ABSTRACT FROM PUBLISHER]

Purpose – This study aims to direct war-affected youth’s self-identity towards microcredit. Youth is an important life stage for individuals’ self-identity formation. Features, labels and meanings associated with products can influence youth’s self-identity development. Design/methodology/approach – A quantitative-survey method was used for data collection. The sample comprised 1,160 youth microcredit users aged between 18 and 24 years selected from the Northern Province of Sri Lanka. Analysis was conducted mainly in three steps, testing measurement model, hypotheses testing and testing for moderation effects. Findings – The findings revealed that positive affect directed the youth’s self-identity towards microcredit, whereas perceived deterrents played a negative role. Knowledge of microcredit enhanced these attitudes. Also, entrepreneurial desire enhanced the association between positive affect and self-identity, and weakened the negative association between perceived deterrents and self-identity. Research limitations/implications – The data were cross-sectional and this study was conducted in one country. So, the model needs replication amongst youth in other war-affected countries and with longitudinal data. Additionally, this study is open for expansion by incorporating other constructs that can draw vulnerable youth’s self-identity around products. Practical implications – This research suggests how war-affected youth’s self-identity can be drawn around microcredit. Originality/value – This study proposes a unique conceptual model to draw vulnerable youth’s self-identity closer to products beneficial for their well-being, in this case, microcredit. [ABSTRACT FROM AUTHOR]

The bottom of the pyramid (BOP) market comprises a huge customer size of approximately 4 billion globally; hence, segmentation is necessary within this market. The BOP market refers to an aggregate of customers who survive on relatively low-income levels. In this respect, youth in war-affected regions can be considered to be a segment of the BOP market. However, there is scant research on customers' attitudes and purchase behaviours in the BOP markets or segments therein. Hence, the purpose of this research is to investigate war-affected youth's attitudes towards microcredit and the related drivers of these attitudes. The literature revealed four types of attitudes towards microcredit: positive affect, perceived benefits, perceived deterrents and default risk perceptions. Also, knowledge of microcredit and entrepreneurial desire were considered to be the drivers of these attitudes. A total of 795 valid completed surveys were collected from youth aged 18 and above who live in the Northern Province of Sri Lanka. The findings revealed that positive affect enhanced intentions to obtain microcredit, whereas perceived deterrents reduced them. Knowledge of microcredit enhanced attitudes towards microcredit. Also, entrepreneurial desire enhanced the association between positive affect and intentions to obtain microcredit and it decreased the negative association between perceived deterrents and intentions to obtain microcredit. The implications to theory and practice have been discussed which will go a long way in enhancing the attitudes towards microcredit among war-affected youth and possibly those in the other segments of the BOP market. [ABSTRACT FROM AUTHOR]

Background: Trained local screeners assessed the mental-health status of male and female students in Northern Ugandan schools. The study aimed to disclose potential differences in mental health-related impairment in two groups, former child soldiers (n =354) and other war-affected youth (n=489), as well as to separate factors predicting mental suffering in learners. Methods: Participants were randomly selected. We used the Post-Traumatic Diagnostic Scale to assess symptoms of post-traumatic stress disorder (PTSD) and for potential depression the respective section of the Hopkins Symptom Checklist with a locally validated cut-off. Results: Almost all respondents had been displaced at least once in their life. 30% of girls and 50% of the boys in the study reported past abduction history. Trauma exposure was notably higher in the group of abductees. In former child soldiers, a PTSD rate of 32% was remarkably higher than that for non-abductees (12%). Especially in girls rates of potential depression were double those in the group of former abductees (17%) than in the group of non-abductees (8%). In all groups, trauma exposure increased the risk of developing PTSD. A path-analytic model for developing PTSD and potential depression revealed both previous trauma exposure as well as duration of abduction to have significant influences on trauma-related mental suffering. Findings also suggest that in Northern Ugandan schools trauma spectrum disorders are common among war-affected learners. Conclusions: Therefore, it is suggested the school context should be used to provide mental-health support structures within the education system for war-affected youth at likely risk of developing war-related mental distress. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: This article explores resources that help formerly recruited young people in dealing with war-related adversity and subsequent challenges, hence fostering their resilience. Methods: Self-reports on pertinent resources were collected from 1,008 northern Ugandan youth, of whom 330 had formerly been recruited by the Lord's Resistance Army. Based on the conceptual framework developed by the Psychosocial Working Group, the reported resources were thematically clustered and quantitatively analyzed. Results: This study identified a range of human, social, and cultural resources, with little difference between groups. Religious beliefs, social support, and mental health resources were most frequently reported by former child soldiers. Conclusions: These results reveal a multitude of resources and suggest that it is important to build on these resources in interventions that aim to support former child soldiers in the aftermath of armed conflict. [Copyright &y& Elsevier]

Background: Research is needed to understand the effects of violence and armed conflict in low- and middle-income countries, though there are logistical and ethical concerns that should be taken prior to study design. Objective: This paper provides commentary on some of the challenges inherent in conducting research with youth affected by war in low- and middle-income countries. Method: A practical discussion of the need of psychosocial research with youth from low-and middle-income countries, determining priorities for research on violence using a mental health needs assessment, and the importance of service linked to research in low-resource countries. Results and Conclusion: Understanding the practical and ethical concerns of conducting research for youth exposed to violence and armed conflict can assist in producing studies that are powerful tools to advocate for those affected by trauma in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess trauma-related symptoms and mental health among war-exposed Ugandan adolescents (n = 81) as a basis for planning their re-attendance at school. Self-reports of exposure to traumatic events, trauma-related symptoms, and indicators of mental health were collected. While about half of the youths (51.9%) reported having been abducted by rebels and were former child soldiers, no differences were found in their mental health functioning compared to the remaining sample. Of the youths, 78% reported post-traumatic stress reactions of clinical significance. However, scores were within the normal range on conduct problems, hyperactivity, pro-social behavior, and self-efficacy. Even though the sample was clearly suffering from trauma-related symptoms, there were also marked areas of adaptive functioning and resilience. Whether the students are ready for education is discussed and implications for adapting educational programs for war-affected adolescents are indicated. [ABSTRACT FROM PUBLISHER]

Abstract: Families migrating out of a war zone are often perceived as the lucky ones because they escape at least some of the devastating consequences of war. Nevertheless, we know little about the relative developmental effects of war for refugees and domestic survivors. This inquiry addresses that gap by focusing on how two groups of young people sharing a traditional culture used narrating as a tool to make sense of the circumstances of their post-war environments. The analysis presented in this paper draws on narratives by 64 young people whose experiences with war began when they were babies and children in Bosnia & Herzegovina (BiH), 38 youth whose families remained in BiH and 26 who migrated to the United States. Analyses based cultural–historical activity theory reveal major differences in how these Bosnian Muslim youth growing up in diverse post-war circumstances narrated conflicts. The pattern of results indicates, for example, that the U.S. participants focused on how things work in society and an orientation to other people more than themselves, while BiH participants focused critically on adults in their society and on their own personal identity clarifications. Such uses of narrating to mediate self-society relations differ from those expected in research assuming universal orientations, such as an adolescent emphasis on identity, or assuming that traditional cultural mores organize experience. The study underscores the need for ongoing research to examine the context-sensitive nature of development. Implications for future research in normative and problematic situations are discussed. [ABSTRACT FROM AUTHOR]

It is 10 years since the adoption of the Cape Town Principles and Best Practices on the Prevention of Recruitment of Children into the Armed Forces and on Demobilization and Social Reintegration of Child Soldiers in Africa. The field of programming for the reintegration of children associated with armed forces and armed groups has made significant strides in this period. However, important gaps in the knowledge base remain. This paper examines empirical evidence that supports lessons learned from work with children formerly connected with fighting forces. It evaluates what is known, where promising practice exists, and lacunae in five programming areas: psychosocial support and care; community acceptance; education, training and livelihoods; inclusive programming for all war-affected children; and follow-up and monitoring. While the 2007 Paris Commitments to Protect Children from Unlawful Recruitment or Use by Armed Forces or Groups mark an emerging consensus on many issues, there is still a critical need for more systematic studies to develop the evidence base supporting intervention in this area. [ABSTRACT FROM AUTHOR]

This report discusses the relationship between mental health care and post- conflict rehabilitation in Sierra Leone and Liberia. Data were collected during the author's involvement in mental health programmes for extremely distressed so called `child soldiers' in both countries, as well as involvement in co-ordinating and supporting professionals in charge of the war-affected population. Analysis suggested that mental health was neglected. However consideration of mental health is crucial to rehabilitation efforts because it facilitates understanding and appropriate responses to the difficulties encountered by both professionals and demobilized youth, and needs to be incorporated into designing policy, training and interventions. [ABSTRACT FROM AUTHOR]

The pathways from war experiences to mental health problems are poorly understood. The current study aims to assess the role of interpersonal sensitivity in the relations between war experiences and mental health problems based on data from the W ar- A ffected Y outh S urvey cohort study. The W ar- A ffected Y outh S urvey is an ongoing research project of formerly abducted children in Northern Uganda assessing their war experiences and the risk and protective factors in the development of mental health problems. Mediation of the relations between war experiences and mental health problems by interpersonal sensitivity was analyzed using structural equation modeling. War experiences were related to posttraumatic stress disorder through interpersonal sensitivity accounting for 55% of the variance in their relations, to depression/anxiety through interpersonal sensitivity accounting for 89% of the variance in their relations (i.e., near complete mediation), and to psychotic symptoms through interpersonal sensitivity accounting for 53% of the variance in their relations. The direct relation between war experiences, on the one hand, and posttraumatic stress disorder and psychotic symptoms, on the other hand, attenuated but remained statistically significant. For depression/anxiety, the direct relationship ceased to be significant after including interpersonal sensitivity in the model. Interpersonal sensitivity is an important determinant of long-term mental health problems in war-affected youth. Interventions to improve mental health should target youth with high scores on interpersonal sensitivity. Cognitive-behavioral therapy to recognize and change cognitive schemas in youth prone to interpersonal sensitivity is recommended.

War creates a multifaceted web of inequities that encompass most levels of the ecology of youth development. These include psychosocial inequities bearing on war-exposed youth's limited access to medical and educational services and job-training and employment opportunities, as well as some of the unique psychological sequelae of trauma exposure. In this chapter we put forth a twofold argument. First, we argue that the protracted hardships of war also create enduring psychological inequities that go beyond the well-documented psychosocial needs and psychological trauma, and encompass other aspects of youths' healthy development; these are inequities inasmuch as they represent profound alterations of the developmental pathways available to war-affected youth. Second, we maintain that the psychological sciences must strive to understand such longstanding developmental inequities even if we do not, at this time, have the tools to fully address them., (© 2016 Elsevier Inc. All rights reserved.)

This article outlines the impact of conflict and war-related sexual exploitation on young people's mental health and explores some of the predisposing factors which contribute to this psychological distress. It then outlines how a lack of valid measures of psychological distress, limited research, diverse services, treatments and cultural practices, previous trauma, and a multitude of competing agencies can hamper mental health delivery in war-affected countries before explaining how using non-Western measures of distress, extensive preresearch preparation, cultural respect tinged with scepticism, a duty of care, and involving stakeholders in decision-making can mitigate these problems. Lastly, this article outlines one study that overcame the logistical, security, and educational challenges of service delivery and calls for further research on psychosocial interventions, dismantling studies of cognitive behavioral therapy (CBT) interventions, and hybrid inventions which target both mental health and psychosocial need and fruitful partnerships between academic institutions and civil society organizations.

Background Children and adolescents exposed to armed conflict are at high risk of developing mental health problems. To date, a range of psychosocial approaches and clinical/psychiatric interventions has been used to address mental health needs in these groups. Aims To provide an overview of peer-reviewed psychosocial and mental health interventions designed to address mental health needs of conflict-affected children, and to highlight areas in which policy and research need strengthening. Methods We used standard review methodology to identify interventions aimed at improving or treating mental health problems in conflict-affected youth. An ecological lens was used to organize studies according to the individual, family, peer/school, and community factors targeted by each intervention. Interventions were also evaluated for their orientation toward prevention, treatment, or maintenance, and for the strength of the scientific evidence of reported effects. Results Of 2305 studies returned from online searches of the literature and 21 sources identified through bibliography mining, 58 qualified for full review, with 40 peer-reviewed studies included in the final narrative synthesis. Overall, the peer-reviewed literature focused largely on school-based interventions. Very few family and community-based interventions have been empirically evaluated. Only two studies assessed multilevel or stepped-care packages. Conclusions The evidence base on effective and efficacious interventions for conflict-affected youth requires strengthening. Postconflict development agendas must be retooled to target the vulnerabilities characterizing conflict-affected youth, and these approaches must be collaborative across bodies responsible for the care of youth and families.