This is the first prospective study to investigate psychosocial adjustment in male and female former child soldiers (n=156, 12% female). The study began in Sierra Leone in 2002 and was designed to examine both risk and protective factors in psychosocial adjustment. Over the twoyear period of follow up, youth who had wounded or killed others during the war demonstrated increases in hostility. Youth who survived rape had higher levels of anxiety and hostility, but also demonstrated greater confidence and prosocial attitudes at follow up. Of the potential protective resources examined, improved community acceptance was associated with reduced depression at follow up and improved confidence and prosocial attitudes regardless of levels of violence exposure. Retention in school was also associated with greater prosocial attitudes.At present, Sierra Leone is still contending with the legacy of the 1991-2002 civil conflict involving the Revolutionary United Front (RUF), the Sierra Leonean Armed Forces Revolutionary Council (AFRC), the Sierra Leone Army (SLA), and local groups like the Civil Defense Forces (CDF). This bloody civil war led to human rights abuses, including mass mutilations and the pervasive use of children in armed conflict. Thousands of children, some as young as seven years old, were conscripted into fighting forces and paramilitary groups (Betancourt, Simmons et al., 2008; The World Revolution, 2001). Many young boys and girls were brutalized into submission, drugged and then forced to fight on the frontlines of combat; others who did not fight served as porters, cooks, guards, messengers, servants,
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript human shields or bush "wives." While most point to abduction as their point of entry into their role as child soldiers (Mazurana & Khristopher, 2004), some children may have assumed a more active role in their decision to participate in armed conflict. The breakdown of family and community systems, coupled with insufficient educational opportunities, left many children with limited viable options for the future (Ashby, 2002). Consequently, a militia group's promise of adventure, security, and camaraderie led some to turn to conscription into armed conflict as their 'best among the worst' of options (Machel, 2001;Peters & Richards, 1998;Shepler, 2005). As a result of their involvement with armed forces and armed groups, many youth were witnesses and/or perpetrators of intense physical violence, including summary executions and death-squad killings, torture, detention, rape, bombings, forced displacement, destruction of homes, and massacres of family members. They were deprived of their rights to the care and protection of their families, and denied education and other developmental opportunities.The Sierra Leone conflict involved direct attempts by rebel groups to destroy relations between young abductees and their families and communities. This was done by forcing many young people to commit atrocities (killings, assault) aga...