title: Social ecology of child soldiers: child, family, and community determinants of mental health, psychosocial well-being, and reintegration in Nepal.
abstract: This study employed a social ecology framework to evaluate psychosocial well-being in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Disorder Symptom Scale (CPSS), and locally developed measures of functional impairment and reintegration. Hierarchical linear modeling was used to examine the contribution of factors at multiple levels. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted lack of reintegration supports. Ultimately, social ecology is well suited to identify intervention foci across ecological levels based on community differences in vulnerability and protective factors.
authors.affiliation: Department of Anthropology, Emory University, 1557 Dickey Drive, Atlanta, GA 30322, USA. brandonkohrt@gmail.com
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Kohrt
authors.forename: Mark J D
authors.initials: MJ
authors.lastname: Jordans
authors.forename: Wietse A
authors.initials: WA
authors.lastname: Tol
authors.forename: Em
authors.initials: E
authors.lastname: Perera
authors.forename: Rohit
authors.initials: R
authors.lastname: Karki
authors.forename: Suraj
authors.initials: S
authors.lastname: Koirala
authors.forename: Nawaraj
authors.initials: N
authors.lastname: Upadhaya
mesh_terms: D000293:Adolescent; D002648:Child; D003866:Depressive Disorder / Q000208:ethnology / Q000523:psychology / Q000534:rehabilitation; D003906:Developing Countries; D005190:Family / Q000523:psychology*; D018596:Hinduism / Q000523:psychology; D006801:Humans; D007206:Individuality; D008016:Life Change Events; D001523:Mental Disorders / Q000208:ethnology* / Q000523:psychology* / Q000534:rehabilitation; D008889:Military Personnel / Q000523:psychology*; D009390:Nepal; D010552:Personality Assessment; D011379:Prognosis; D012069:Religion and Psychology; D012111:Residence Characteristics; D012307:Risk Factors; D012931:Social Environment; D012944:Social Support; D012951:Socialization; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology / Q000523:psychology / Q000534:rehabilitation; D014104:Torture / Q000523:psychology