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Child Dev. 2013 Mar-Apr;84(2):455-70. doi: 10.1111/j.1467-8624.2012.01861.x. Epub 2012 Sep 24.

Trajectories of internalizing problems in war-affected Sierra Leonean youth: examining conflict and postconflict factors.

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Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA.


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.

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