Intergenerational / Longitudinal Study of War-Affected Youth and Families in Sierra Leone

Background and Aims of Study

During Sierra Leone’s 11-year civil war, it is estimated that there were: 2.6 million people displaced, 70,000 casualties, and upwards of 48,000 male and female children associated with armed groups (colloquially “child soldiers”). We will extend the first intergenerational study of war in Sub-Saharan Africa (R01HD073349) to focus on children born to war-affected parents. We will conduct assessments of behavioral and biological indicators of the Research Domain Criteria (RDoC)-linked constructs of self-regulation and stress reactivity, including autonomic nervous system reactivity, inflammation, and telomere length; and we will add sophisticated observations of parent-child interactions and synchrony. We will identify potentially modifiable risk and protective processes both to inform the development of screening tools to identify families at risk for poor child mental health and to be deployed as active ingredients of interventions to reduce transmission of mental health problems to children of war-affected parents. The proposed research is the first known effort in sub-Saharan Africa to examine long-term effects of children’s war experiences on their adult mental health and the intergenerational effects of parental war trauma on parenting and early child development in offspring. Despite the high global burden of conflict, we are limited in our knowledge about how adult health and functioning are affected by childhood war experiences. Further, the links between childhood war exposure, parenting, interpersonal relationships, and the physical and cognitive development of offspring have not been well explored in diverse populations. The proposed research aims to deepen our understanding of how previous war experiences have affected parental and early child development in a low-resource setting, and to investigate potential mechanisms of the intergenerational effects of violence. Findings will help identify potential leverage points for intervention development and global health initiatives aimed at improving family functioning and early child development among diverse groups. 

Aims of Study 

• Investigate the biological embedding and long-term mental health consequences of war- related trauma in a longitudinal sample of war-affected youth who have become parents (N=394).
• Examine associations between parental war-related trauma exposure, mental health and biological and physiological indicators of emotion, cognition and social functioning in offspring aged 0 and older (N=410).
• Identify and examine how modifiable risk and protective factors operate to identify priority intervention targets to improve physical and mental health of war-affected children and to develop screening tools to identify families at risk
• Investigate the long-term impact of childhood war experiences and post-conflict social and contextual factors on adult mental health and functioning in war-affected youth who are now adults. 
• Investigate how war experiences and post-war factors influence interpersonal relationships as adults, particularly with regard to parenting practices and parent-child relationships.
• Examine the intergenerational transmission of emotional/behavioural disruptions due to war trauma on the early childhood development of offspringIdentify and examine how modifiable risk and protective factors operate to inform the design of targeted parenting and early childhood interventions
  

Key Findings of Projects to Date

• LSWAY findings—drawn from four waves (T1:2002–T4:2016/17) of data collection and analysis—indicate that a healthy transition to adulthood was linked to engagement in prosocial behavior and community involvement, while problems with hostility, poor emotion regulation, and social withdrawal created barriers to achieving healthy and productive lives
• LSWAY findings – Significantly higher levels of violence-related and combat experiences characterized the group exposed to more traumatic events. The ‘higher war exposure’ group reported more PTSD symptoms at T2, more hyperarousal symptoms across all waves, and more difficulties in emotion regulation at T4. 
• Former child soldiers exposed to higher levels of war-related traumatic events and loss should be prioritized for mental health services immediately postconflict and as they transition into adulthood.
• Former child soldiers had elevated rates of mental health problems.
•  Postconflict risk and protective factors related to outcomes long after the end of conflict. 
• Targeted social inclusion and family interventions could benefit the long-term mental health of former child soldiers.
  

Additional research is currently underway for publication by 2026.