title: Trajectories of internalizing problems in war-affected Sierra Leonean youth: examining conflict and postconflict factors.
abstract: Three waves of data from a prospective longitudinal study in Sierra Leone were used to examine internalizing trajectories in 529 war-affected youth (ages 10-17 at baseline; 25% female). Latent class growth analyses identified 4 trajectories: A large majority of youth maintained lower levels of internalizing problems (41.4%) or significantly improved over time (47.6%) despite very limited access to care, but smaller proportions continued to report severe difficulties 6 years postwar (4.5%) or their symptoms worsened (6.4%). Continued internalizing problems were associated with loss of a caregiver, family abuse and neglect, and community stigma. Despite the comparative resilience of most war-affected youth in the face of extreme adversity, there remains a compelling need for interventions that address family- and community-level stressors.
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA. theresa_betancourt@harvard.edu
authors.forename: Theresa S
authors.initials: TS
authors.lastname: Betancourt
authors.forename: Ryan
authors.initials: R
authors.lastname: McBain
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Newnham
authors.forename: Robert T
authors.initials: RT
authors.lastname: Brennan
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D012807:Sierra Leone; D014857:Warfare