Skip to main content
SpringerLink
Log in

Psychological Rehabilitation of Ex-combatants in Non-Western, Post-conflict Settings

  • Chapter
  • First Online:
Trauma Rehabilitation After War and Conflict

Abstract

Disarmament, demobilization, and reintegration (DDR) programs are part of most international peace-building efforts and post-conflict interventions in developing countries. Well over a million former combatants have participated in DDR programs in more than 20 countries, the vast majority of them in sub-Saharan Africa. The impact, however, has remained disappointing.

A significant portion of ex-combatants suffer from mental-health issues, caused by repeated exposure to severe psychological distress. Individuals with PTSD, depression, substance dependence, or psychotic conditions are heavily impaired in their daily functioning. It is often difficult for them to reintegrate into civilian society, and they are less able to support the process of reconciliation and peace-building within their communities and postwar areas at large. Others, who as child combatants adapted to a culture of violence and aggression, have never been taught the moral attitudes and the behavioral repertoire that are required in peaceful settings. These failures to adjust fuel cycles of violence that might reach across generations.

Psychological components of DDR programs are frequently neither sufficiently specific nor professional enough to address reintegration failure and the threat of continuing domestic or armed violence. This chapter presents examples from post-conflict settings, in which specific and targeted mental-health interventions and dissemination methods have been successfully evaluated, including Narrative Exposure Therapy and Interpersonal Therapy. It suggests a comprehensive, community-based, DDR program, which offers mental-health treatment for affected individuals, as well as community interventions to facilitate reintegration and lasting peace.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    While in Western countries, the term ‘readjustment’ is frequently used to describe this transition process, the term ‘reintegration’ is used in the international context.

  2. 2.

    To avoid stigmatization and the exclusion of children who might not have carried a weapon, the literature also refers to this group as ‘children associated with fighting forces’ or ‘formerly abducted children.’

References

  • Amone-P’Olak, K. (2005). Psychological impact of war and sexual abuse on adolescent girls in Northern Uganda. Intervention – International Journal of Mental Health, Psychosocial Work and Counselling in Areas of Armed Conflict, 1(3), 33.

    Google Scholar 

  • Annan, J., Blattman, C., & Horton, R. (2006). The state of youth and youth protection in Northern Uganda – Findings from the survey for war-affected youth (Report).

    Google Scholar 

  • Arnold, M., & Alden, C. (2007). ‘This gun is our food’: Disarming the white army militias of South Sudan. Conflict, Security and Development, 7(3), 361–385.

    Article  Google Scholar 

  • Ayalew, D., Dercon, S., & Kingma, K. (2000). ‘From the Gun to the Plough’: The macro- and micro-level impact of demobilizaton in Ethiopia. In K. Kingma (Ed.), Demobilization in Sub-Saharan Africa – The development and security impacts (pp. 132–172). London: Macmillan Press.

    Google Scholar 

  • Baingana, F., & Bannon, I. (2004). Integrating mental health and psychosocial interventions into world bank lending for conflict-affected populations: A toolkit (Report).

    Google Scholar 

  • Basoglu, M., Livanou, M., Crnobaric, C., Franciskovic, T., Suljic, E., Duric, D., et al. (2005). Psychiatric and cognitive effects of war in former Yugoslavia: Association of lack of redress for trauma and posttraumatic stress reactions. Journal of the American Medical Association, 294(5), 580–590.

    Article  Google Scholar 

  • Bayer, C., Klasen, F., & Adam, H. (2007). Association of trauma and PTSD symptoms with openness to reconciliation and feelings of revenge among former Ugandan and Congolese Child Soldiers. Journal of the American Medical Association, 298(5), 555–559.

    Article  Google Scholar 

  • Begic, D., & Jokic-Begic, N. (2001). Aggressive behavior in combat veterans with post-traumatic stress disorder. Military medicine, 166(8), 671–676.

    Google Scholar 

  • Berger, R., & Gelkopf, M. (2009). School-based intervention for the treatment of tsunami-related distress in children: A quasi-randomized controlled trial. Psychotherapy and Psychosomatics, 78(6), 364–371.

    Google Scholar 

  • Bhui, K., Abdi, A., Abdi, M., Pereira, S., Dualeh, M., Robertson, D., et al. (2003). Traumatic events, migration characteristics and psychiatric symptoms among Somali refugees – Preliminary communication. Social Psychiatry and Psychiatric Epidemiology, 38(1), 35–43.

    Article  Google Scholar 

  • Bichescu, D., Neuner, F., Schauer, M., & Elbert, T. (2007). Narrative exposure therapy of poli-tical imprisonment-related chronic trauma spectrum disorders: A randomized controlled trial. Behaviour Research and Therapy, 45(9), 2212–2220.

    Article  Google Scholar 

  • Bichescu, D., Schauer, M., Saleptsi, E., Neculau, A., Elbert, T., & Neuner, F. (2005). Long-term consequences of traumatic experiences: An assessment of former political detainees in Romania. Clinical Practice and Epidemiology in Mental Health, 1(17) doi: 10.1186/1745-0179-1-17.

    Google Scholar 

  • Bieber, B. (2002). Wie Kriege enden [How wars end]. Hamburg: Kovac.

    Google Scholar 

  • Biedermann, J. (2007). Untersuchungen zu psychologischen Prozessen im Lebenslauf von Kindersoldaten (Thesis). University of Konstanz, Konstanz.

    Google Scholar 

  • Bolton, P., Bass, J., Neugebauer, R., Verdeli, H., Clougherty, K. F., Wickramaratne, P., et al. (2003). Group interpersonal psychotherapy for depression in rural Uganda: A randomized controlled trial. Journal of the American Medical Association, 289(23), 3117–3124.

    Article  Google Scholar 

  • Boothby, N. (2006). What happens when child soldiers grow up? The Mozambique case study. Intervention – International Journal of Mental Health, Psychosocial Work and Counselling in Areas of Armed Conflict, 4(3), 244–259.

    Google Scholar 

  • Boscarino, J. A. (2006). Posttraumatic stress disorder and mortality among U.S. army veterans 30 years after military service. Annals of Epidemiology, 16(4), 248–256.

    Article  Google Scholar 

  • Byrne, C. A., & Riggs, D. S. (1996). The cycle of trauma; relationship: Aggression in male Vietnam veterans with symptoms of posttraumatic stress disorder. Violence and victims, 11(3), 213–225.

    Google Scholar 

  • Caramés, A., Fisas, V., & Luz, D. (2006). Analysis of disarmament, demobilisation and reintegration (DDR) existing in the world during 2005 (Report).

    Google Scholar 

  • Catani, C., Jacob, N., Schauer, E., Kohila, M., & Neuner, F. (2008). Family violence, war, and natural disasters: a study of the effect of extreme stress on children’s mental health in Sri Lanka. BMC Psychiatry, 8, 33.

    Article  Google Scholar 

  • Catani, C., Schauer, E., & Neuner, F. (2008). Beyond individual war trauma: Domestic violence against children in Afghanistan and Sri Lanka. Journal of Marital and Family Therapy, 34(2), 165–176.

    Article  Google Scholar 

  • Chilcoat, H. D., & Breslau, N. (1998). Investigations of causal pathways between PTSD and drug use disorders. Addictive Behaviors, 23(6), 827–840.

    Article  Google Scholar 

  • Colletta, N., Boutwell, J., & Clare, M. (2001). The world bank, demobilization, and social reconstruction. In J. Boutwell, M. Klare (Eds.), Light weapons and civil conflict – Controlling the tools of violence (pp. 203–216 ). New York: Rowman & Littlefield Publishers.

    Google Scholar 

  • Collier, P. (1994). Demobilization and insecurity: A study in the economics of the transition from war to peace. Journal of International Development, 6(3), 343–351.

    Article  Google Scholar 

  • Collier, P. (2003). The market for civil war. Foreign Policy, 136, 38–45.

    Article  Google Scholar 

  • Cox, B. S., Davies, D. R., Burlingame, G. M., Compbell, J. E., Layne, C., & Katzenbach, R. J. (2007). Effectiveness of a trauma/grief-focused group intervention: A qualitative study with war-exposed Bosnian adolescents. International Journal of Group Psychotherapy, 57(3), 319–345.

    Google Scholar 

  • Daud, A., Skoglund, E., & Rydelius, P.-A. (2005). Children in families of torture victims: Transgenerational transmission of parents’ traumatic experiences to their children. International Journal of Social Welfare, 14(1), 23.

    Article  Google Scholar 

  • Davidson, J. R., Hughes, D., Blazer, D. G., & George, L. K. (1991). Post-traumatic stress disorder in the community: An epidemiological study. Psychological Medicine, 21(3), 713–721.

    Article  Google Scholar 

  • De Jong, J. P., Komproe, I. H., Van Ommeren, M., El Masri, M., Araya, M., Khaled, N., et al. (2001). Lifetime events and posttraumatic stress disorder in 4 postconflict settings. Journal of the American Medical Association, 286(5), 555–562.

    Article  Google Scholar 

  • De Jong, J. P., Scholte, W. F., Koeter, M. W., & Hart, A. A. (2000). The prevalence of mental health problems in Rwandan and Burundese refugee camps. Acta Psychiatrica Scandinavica, 102(3), 171–177.

    Article  Google Scholar 

  • De Watteville, N. (2002). Addressing gender issues in demobilization and Reintegration programs (Report).

    Google Scholar 

  • Derluyn, I., Broekaert, E., Schuyten, G., & De Temmerman, E. (2004). Post-traumatic stress in former Ugandan child soldiers. Lancet, 363(9412), 861–863.

    Article  Google Scholar 

  • Dybdahl, R. (2001). Children and mothers in war: An outcome study of a psychosocial intervention program. Child development, 72(4), 1214–1230.

    Article  Google Scholar 

  • Ejigu, M., & Gedamu, T. (1996). Conversion in Africa: Past experiences and future outlook (Report No. 4).

    Google Scholar 

  • Elbert, T., Rockstroh, B., Kolassa, I.-T., Baltes, P. B., Reuter-Lorenz, P. A., & Rösler, F. (2006). The influence of organized violence and terror on brain and mind: A co-constructive perspective. In P. Baltes, P. Reuter-Lorenz, & F. Rösler (Eds.), Lifespan development and the brain: The perspective of biocultural co-constructivism (pp. 326–348). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Engdahl, B., de Silva, P., Solomon, Z., & Somasundaram, D. (2003). Former combatants. In B. Green, et al. (Eds.), Trauma and interventions in war and peace – Prevention, practice and policy (pp. 271–289). New York: Kluwer Academic/Plenum Publisher.

    Chapter  Google Scholar 

  • Ertl, V., Schauer, E., Onyut, L. P., Neuner, F., & Elbert, T. (2007). Narrative exposure therapy: Does it prevent the development of PTSD in former child soldiers? Paper presented at the 10th European Conference on Traumatic Stress (ECOTS), Opatija, Croatia.

    Google Scholar 

  • Fontana, A., & Rosenheck, R. (1994). Traumatic war stressors and psychiatric symptoms among World War II, Korean, and Vietnam War veterans. Psychology and Aging, 9(1), 27–33.

    Article  Google Scholar 

  • Gear, S. (2002). Wishing us away: Challenges facing ex-combatants in the ‘new’ South Africa. Violence and Transition Series(8).

    Google Scholar 

  • Glöckner, F. (2007). PTSD and collective identity in former Ugandan child soldiers. Unpublished Dissertation/Thesis, University of Konstanz.

    Google Scholar 

  • Hagman, L., & Nielsen, Z. (2002). A framework for lasting disarmament, demobilization, and reintegration of former combatants in crisis situations (Report). International Peace Academy.

    Google Scholar 

  • Harbom, L., Melander, E., & Wallensteen, P. (2008). Dyadic dimensions of armed conflict, 1946–2007. Journal of Peace Research, 45(5), 697–710.

    Article  Google Scholar 

  • Harbom, L., & Wallensteen, P. (2008). Appendix 2A. Patterns of major armed conflicts, 1998–2007. In SIPRI (Ed.), SPIRI yearbook 2008: Armaments, disarmament and international security (pp. 72–82). Oxford: Oxford University Press.

    Google Scholar 

  • Harlacher, T., Okot, F., Obonyo, C., Balthazard, M., & Atkinson, R. (2006). Traditional ways of coping in acholi: Cultural provisions for reconciliation and healing from war (Report). Kampala, Caritas Gulu Archdiocese.

    Google Scholar 

  • Hegre, H., & Sambanis, N. (2006). Sensitivity analysis of empirical results on civil war onset. Journal of Conflict Resolution, 50(4), 508–535.

    Article  Google Scholar 

  • Heinemann-Grüder, A., Pietz, T., & Duffy, S. (2003). Turning soldiers into a work force – Demobilization and reintegration in post-Dayton Bosnia and Herzegovina (Brief No. 27). Bonn International Center for Conversion.

    Google Scholar 

  • Hensel-Dittmann, D. (2007). Kontrollierte Therapieevaluation der Narrativen Expositionstherapie (NET) im Vergleich zu Stress-Impfungs-Training (SIT) bei posttraumatischer Belastungsstörung in Folge organisierter Gewalt [A controlled treatment evaluation of narrative exposure therapy (NET) in comparison with stress inoculation training (SIT) for post-traumatic stress disorder as a consequence of organized violence]. Thesis, University Konstanz, Konstanz.

    Google Scholar 

  • Human Rights Watch (2003). Struggling through peace: Return and resettlement in Angola (Report Vol. 15, No. 16). New York.

    Google Scholar 

  • Humphreys, M., & Weinstein, J. (2005). Disentangling the determinants of successful disarmament, demobilization (Report No. 69). Washington, DC: Center for Global Development.

    Google Scholar 

  • Humphreys, M., & Weinstein, J. (2007). Demobilization and reintegration. Journal of Conflict Resolution, 51(4), 531–567.

    Article  Google Scholar 

  • Jacob, N. (2007). Traumatisierung durch häusliche Gewalt, Krieg und Tsunami: Eine Untersuchung zur mentalen Gesundheit von Kindern in Sri Lankas Norden [Traumatization by domestic violence, war and Tsunami: An investigation of mental health of children in Sri Lankas North ]. Thesis, University of Konstanz, Konstanz.

    Google Scholar 

  • Jacob, N., Neuner, F., Schaal, S., Mädl, A., & Elbert, T. (in preparation). Dissemination of psychotherapy for trauma-spectrum disorders in resource-poor post-conflict societies: A randomized partly controlled trial in Rwanda.

    Google Scholar 

  • Jakupcak, M., Conybeare, D., Phelps, L., Hunt, S., Holmes, H. A., Felker, B., et al. (2007). Anger, hostility, and aggression among Iraq and Afghanistan war veterans reporting PTSD and subthreshold PTSD. Journal of traumatic stress, 20(6), 945–954.

    Article  Google Scholar 

  • Janoff-Bulman, R., Berg, M., & Harvey, J. H. (1998). Disillusionment and the creation of values: From traumatic losses to existential gains. In J. H. Harvey (Ed.), Perspectives on loss – A sourcebook (pp. 35–47). Philadelphia, Pa.: Brunner/Mazel.

    Google Scholar 

  • Johnson, D. R., Lubin, H., Rosenheck, R., Fontana, A., Southwick, S., & Charney, D. (1997). The impact of the homecoming reception on the development of posttraumatic stress disorder. The West Haven homecoming stress scale (WHHSS). Journal of Traumatic Stress, 10(2), 259–277.

    Google Scholar 

  • Johnson, K., Asher, J., Rosborough, S., Raja, A., Panjabi, R., Beadling, C., et al. (2008). Association of combatant status and sexual violence with health and mental health outcomes in postconflict Liberia. Journal of the American Medical Association, 300(6), 676–690.

    Article  Google Scholar 

  • Kaldor, M. (2004). New and old wars: Organized violence in a global era. Cambridge: Polity Press.

    Google Scholar 

  • Karunakara, U. K., Neuner, F., Schauer, M., Singh, K., Hill, K., Elbert, T., et al. (2004). Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese nationals, refugees and Ugandans in the West Nile. African health sciences, 4(2), 83–93.

    Google Scholar 

  • Keane, T. M., & Kaloupek, D.G. (1997). Comorbid psychiatric disorders in PTSD: Implications for research. Annals of the New York Academy of Sciences, 821, 24–34.

    Google Scholar 

  • Keen, D. (2008). Complex emergencies. Cambridge: Polity Press.

    Google Scholar 

  • Kellermann, N. P. (2001). Transmission of holocaust trauma – An integrative view. Psychiatry, 64(3), 256–267.

    Google Scholar 

  • Kingma, K. (2000a). Demobilization in Sub-Saharan Africa. London: Macmillan Press.

    Google Scholar 

  • Kingma, K. (2000b). The impact of demobilization. In K. Kingma (Ed.), Demobilization in Sub-Saharan Africa (pp. 215–243). London: Macmillan Press.

    Google Scholar 

  • Knight, M., & Ozerdem, A. (2004). Guns, camps and cash: Disarmament, demobilization and reinsertation of former combatants in transition from war to peace. Journal of Peace Research, 41(4), 499–516.

    Article  Google Scholar 

  • Kolassa, I.-T., Ertl, V., Eckart, C., Gloeckner, F., Kolassa, S., & Papassotiropoulos, A., et al. (2010). Association study of trauma load and SLC6A4 promoter polymorphism in PTSD: Evidence from survivors of the Rwandan genocide. Journal of Clinical Psychiatry, Early online.

    Google Scholar 

  • Kulka, R., Schlenger, W., Fairbank, J., Hough, R., Jordan, K., & Marmar, C., et al. (1990). Trauma and the Vietnam war generation – Report of the findings from the National Vietnam Veterans Readjustment Study. Levittown: Brunner/Mazel.

    Google Scholar 

  • Lapierre, C. B., Schwegler, A. F., & Labauve, B. J. (2007). Posttraumatic stress and depression symptoms in soldiers returning from combat operations in Iraq and Afghanistan. Journal of traumatic stress, 20(6), 933–943.

    Google Scholar 

  • Layne, C. M., Pynoos, R. S., & Saltzman, W. R. (2001). Trauma/grief-focused group psychotherapy: School-based postwar intervention with traumatized Bosnian adolescents. Group dynamics, 5(4), 277–290.

    Article  Google Scholar 

  • Layne, C., Saltzman, W.R., Poppleton, L., Burlingame, G.M., Pasalic, A., Durakovic, E., et al. (2008). Effectiveness of a school-based group psychotherpay program for war-exposed adolescents: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 47(9), 1048–1062.

    Google Scholar 

  • Lee, K. A., Vaillant, G. E., Torrey, W. C., & Elder, G. H. (1995). A 50-year prospective study of the psychological sequelae of World War II combat. The American Journal of Psychiatry, 152(4), 516–522.

    Google Scholar 

  • Lindy, J. D. (1985). The trauma membrane and other clinical concepts derived from psychotherapeutic work with survivors of natural disasters. Psychiatric Annals, 15(3), 153–155, 159–160.

    Google Scholar 

  • Lindy, J. D., & Wilson, J. P. (2001). Respecting the trauma membrane: Above all, do no harm. In J. P. Wilson, M. J. Friedman, & J. D. Lindy (Eds.), Treating psychological trauma and PTSD (pp. 423–445). New York: Guildford Press.

    Google Scholar 

  • Magambo, C., & Lett, R. (2004). Post-traumatic stress in former Ugandan child soldiers. Lancet, 363(9421), 1647–1648.

    Article  Google Scholar 

  • Maslen, S. (1997). The reintegration of war affected youth: The experience of Mozambique. ILO action programme on skills and entrepreneurship training for countries emerging from armed conflict: International Labor Organization.

    Google Scholar 

  • Meany, M., & Moshe, S. (2005). Maternal care as a model for experience-dependent chromatin plasticity. TRENDS in Neuroscience, 28(9), 456–463.

    Article  Google Scholar 

  • Mehreteab, A. (2002). Veteran combatants do not fade away: A comparative study on two demobilization and reintegration exercises in Eritrea: Bonn International Center for Conversion.

    Google Scholar 

  • Mogapi, N. (2004). Reintegration of soldiers: The missing piece. International Journal of Mental Health, Psychosocial Work and Counselling in Areas of Armed Conflict, 2(3), 221–225.

    Google Scholar 

  • Molina, V. (2007). Sondages sur la Réinsertion des ex-combattant – République Démocratique du Congo (Report).

    Google Scholar 

  • Mollica, R. F., McInnes, K., Poole, C., & Tor, S. (1998). Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. The British journal of psychiatry: The journal of mental science, 173, 482–488.

    Article  Google Scholar 

  • Multi-Country Demobilization and Reintegration Program (2008). Psychosocial issues in the demobilization and reintegration of ex-combatants. MDRP Dissemination Note, June–July.

    Google Scholar 

  • Neuner, F., & Elbert, T. (2007). The mental health disaster in conflict settings: Can scientific research help? BMC Public Health, 7, 275.

    Article  Google Scholar 

  • Neuner, F., Kurreck, S., Ruf, M., Odenwald, M., Elbert, T., & Schauer, M. (2009). Can asylum seekers with posttraumatic stress disorder be successfully treated? A randomized controlled pilot study. Cognitive Behaviour Therapy, 34(3), 1–11.

    Google Scholar 

  • Neuner, F., Onyut, P. L., Ertl, V., Odenwald, M., Schauer, E., & Elbert, T. (2008). Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: A randomized controlled trial. Journal of consulting and clinical psychology, 76(4), 686–694.

    Article  Google Scholar 

  • Neuner, F., Schauer, E., Catani, C., Ruf, M., & Elbert, T. (2006). Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka. Journal of traumatic stress, 19(3), 339–347.

    Article  Google Scholar 

  • Neuner, F., Schauer, M., Karunakara, U., Klaschik, C., Robert, C., & Elbert, T. (2004). Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC psychiatry, 4, 34.

    Article  Google Scholar 

  • Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004). A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Journal of consulting and clinical psychology, 72(4), 579–587.

    Article  Google Scholar 

  • Neuner, F., Schauer, M., Roth, W., & Elbert, T. (2002). A narrative exposure treatment as intervention in a refugee camp: A case report. Behavioural and Cognitive Psychotherapy, 30(2), 205–209.

    Google Scholar 

  • Odenwald, M., Hinkel, H., Schauer, E., Neuner, F., Schauer, M., Elbert, T. R., et al. (2007). The consumption of khat and other drugs in Somali combatants: A cross-sectional study. PLoS medicine, 4(12), e341.

    Article  Google Scholar 

  • Odenwald, M., Hinkel, H., Schauer, E., Schauer, M., Elbert, T., & Neuner, F. (2009). Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: A study of Somali combatants. Social Science and Medicine, 69, 1040–1048.

    Google Scholar 

  • Odenwald, M., Lingenfelder, B., Schauer, M., Neuner, F., Rockstroh, B., Hinkel, H., et al. (2007). Screening for posttraumatic stress disorder among Somali ex-combatants: A validation study. Conflict and Health, 1, 10.

    Article  Google Scholar 

  • Odenwald, M., Neuner, F., Schauer, M., Elbert, T., Catani, C., Lingenfelder, B., et al. (2005). Khat use as risk factor for psychotic disorders: A cross-sectional and case-control study in Somalia. BMC medicine, 3, 5.

    Article  Google Scholar 

  • Odenwald, M., Schauer, M., Neuner, F., Lingenfelder, B., Horn, R., Catani, C., et al. (2002). War-trauma, khat abuse and psychosis: Mental health in the demobilization and reintegration program Somaliland. Unpublished manuscript, Nairobi.

    Google Scholar 

  • Okulate, G. T., & Jones, O. B. (2006). Post-traumatic stress disorder, survivor guilt and substance use – A study of hospitalised Nigerian army veterans. South African medical journal – Suid-Afrikaanse tydskrif vir geneeskunde, 96(2), 144–146.

    Google Scholar 

  • Onyut, P., Neuner, F., Schauer, E., Ertl, V., Odenwald, M., Schauer, M., et al. (2005). Narrative exposure therapy as a treatment for child war survivors with posttraumatic stress disorder: Two case reports and a pilot study in an African refugee settlement. BMC psychiatry, 5, 7.

    Article  Google Scholar 

  • Pham, P., Weinstein, H., & Longman, T. (2004). Trauma and PTSD symptoms in Rwanda: Implications for attitudes toward justice and reconciliation. Journal of the American Medical Association, 292(5), 602–612.

    Article  Google Scholar 

  • Porto, J., Parsons, I., & Alden, C. (2007). From soldiers to citizens – The social, economic and political integration of UNITA ex-combatants. Institute for security studies, Tshwane, South Africa.

    Google Scholar 

  • Prigerson, H. G., Maciejewski, P. K., & Rosenheck, R. A. (2002). Population attributable fractions of psychiatric disorders and behavioral outcomes associated with combat exposure among US men. American Journal of Public Health, 92(1), 59–63.

    Article  Google Scholar 

  • Pugel, J. (2007). What the fighters say: A survey of ex-combatants in Liberia (Report).

    Google Scholar 

  • Ramsbotham, O., & Woodhouse, T. (1999). Encyclopedia of international peacekeeping operations. Oxford: ABC-Clio.

    Google Scholar 

  • Rowland-Klein, D., & Dunlop, R. (1998). The transmission of trauma across generations: Identification with parental trauma in children of Holocaust survivors. The Australian and New Zealand Journal of Psychiatry, 32(3), 358–369.

    Article  Google Scholar 

  • Ruf, M. (2008). Traumatisierte Flüchtlingskinder in Deutschland: Epidemiologie, Therapie sowie neurokognitive und neurophysiologische Korrelate [Traumatised refugee children in Germany: An epidemiology, treatment and neurocognitive as well as neurophysiological changes]. Thesis, University Konstanz, Konstanz.

    Google Scholar 

  • Savarese, V. W., Suvak, M. K., King, L. A., & King, D. W. (2001). Relationships among alcohol use, hyperarousal, and marital abuse and violence in Vietnam veterans. Journal of traumatic stress, 14(4), 717–732.

    Article  Google Scholar 

  • Savoca, E., & Rosenheck, R. (2000). The civilian labor market experiences of Vietnam-era veterans: The influence of psychiatric disorders. The journal of mental health policy and economics, 3(4), 199–207.

    Article  Google Scholar 

  • Schaal, S., & Elbert, T. (2006). Ten years after the genocide: Trauma confrontation and posttraumatic stress in Rwandan adolescents. Journal of Traumatic Stress, 19(1), 95–105.

    Article  Google Scholar 

  • Schaal, S., Elbert, T., & Neuner, F. (2009). Narrative exposure therapy versus interpersonal psychotherapy: A pilot randomized controlled trial with Rwandan genocide orphans. Psychotherapy and Psychosomatics, 78(5), 298–306.

    Google Scholar 

  • Schauer, E. (2008). Trauma Treatment for Children in War : Build-up of an evidence-based large-scale Mental Health Intervention in North-Eastern Sri Lanka. Thesis, University Konstanz, Konstanz.

    Google Scholar 

  • Schauer, E., Neuner, F., Elbert, T., Ertl, V., Onyut, P. L., Odenwald, M., et al. (2004). Narrative exposure therapy in children – A case study. Intervention – International Journal of Mental Health, Psychosocial Work and Counselling in Areas of Armed Conflict, 2(1), 18–32.

    Google Scholar 

  • Schauer, M., Elbert, T., Neuner, F., Elbert, T., Engel, A. K., Hellhammer, D., et al. (2007). Interaktion von neurowissenschaftlichen Erkenntnissen und psychotherapeutischen Einsichten am Beispiel von traumatischem Stress und dessen Behandlung mittels narrativer Expositionstherapie. [Interaction of findings from neuro-science and insights from psychotherapy – The example of traumatic stress and its treatment with narrative exposure therapy] In R. Becker & H. -P. Wunderlich (Ed.), Wie wirkt Psychotherapie? [How does psychotherapy affect change?] (pp. 87–108). Stuttgart: Thieme.

    Google Scholar 

  • Schauer, M., Neuner, F., & Elbert, T. (2005). Narrative exposure therapy. Toronto: Hogrefe & Huber.

    Google Scholar 

  • Schauer, M., Neuner, F., Karunakara, U. K., Klaschik, C., Robert, C., & Elbert, T. (2003). PTSD and the ‘building block’ effect of psychological trauma among West Nile Africans. ESTSS Bulletin, 10(2), 5–6.

    Google Scholar 

  • Schauer, M., Thomas, E., Gotthardt, S., Rockstroh, B., Odenwald, M., & Neuner, F. (2006). Wiedererfahrung durch Psychotherapie modifiziert Geist und Gehirn. [Reliving through psychotherapy modifies the mind and brain.] Verhaltenstherapie, 16, 96–103.

    Article  Google Scholar 

  • Scholte, W. F., Olff, M., Ventevogel, P., de Vries, G. J., Jansveld, E., Cardozo, B. L., et al. (2004). Mental health symptoms following war and repression in eastern Afghanistan. Journal of the American Medical Association, 292(5), 585–593.

    Article  Google Scholar 

  • Seedat, S., le Roux, C., & Stein, D. J. (2003). Prevalence and characteristics of trauma and post-traumatic stress symptoms in operational members of the South African national defence force. Military medicine, 168(1), 71–75.

    Google Scholar 

  • Shipherd, J. C., Stafford, J., & Tanner, L. R. (2005). Predicting alcohol and drug abuse in Persian Gulf War veterans: What role do PTSD symptoms play? Addictive Behaviors, 30(3), 595–599.

    Article  Google Scholar 

  • Shmotkin, D., Blumstein, T., & Modan, B. (2003). Tracing long-term effects of early trauma: A broad-scope view of Holocaust survivors in late life. Journal of consulting and clinical psychology, 71(2), 223–234.

    Article  Google Scholar 

  • Sigal, J. J., & Weinfeld, M. (1987). Mutual involvement and alienation in families of Holocaust survivors. Psychiatry, 50(3), 280–288.

    Google Scholar 

  • Silva, J. A., Derecho, D. V., Leong, G. B., Weinstock, R., & Ferrari, M. M. (2001). A classification of psychological factors leading to violent behavior in posttraumatic stress disorder. Journal of forensic sciences, 46(2), 309–316.

    Google Scholar 

  • Somasundaram, D. J., van de Put, W. A., Eisenbruch, M., & de Jong, J. T. (1999). Starting mental health services in Cambodia. Social Science and Medicine, 48(8), 1029–1046.

    Article  Google Scholar 

  • Sorscher, N., & Cohen, L. J. (1997). Trauma in children of Holocaust survivors: Transgenerational effects. American journal of orthopsychiatry, 67(3), 493.

    Article  Google Scholar 

  • Stark, L. (2006). Cleansing the wounds of war: An examination of traditional healing, psychosocial health and reintegration in Sierra Leone. Intervention – International Journal of Mental Health, Psychosocial Work and Counselling in Areas of Armed Conflict, 4(3), 206–216.

    Google Scholar 

  • Stavrou, A., Vincent, J., Peters, K., & Johnson, S. (2003). Tracer study and follow-up assessment of the reintegration component of Sierra Leone’s disarmament, demobilization, and reintegration program. Cork: University of Ireland, Centre for Sustainable Livelihoods.

    Google Scholar 

  • Steel, Z., Silove, D., Phan, T., & Bauman, A. (2002). Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. Lancet, 360(9339), 1056–1062.

    Article  Google Scholar 

  • Tol, W. A., Komproe, I. H., & Susanty, D., et al. (2008). School-based mental health intervention for children affected by political violence in Indonesia: A cluster randomized trial. Journal of the American Medical Association, 300(6), 655–662.

    Google Scholar 

  • UN (2001). Comprehensive review of the whole question of peacekeeping operations in all their aspects – Implementation of the recommendations of the special committee on peacekeeping operations and the panel on United Nations peace operations [Brahimi Report] (Report).

    Google Scholar 

  • UN (2007). The principles and guidelines on children associated with armed forces or armed groups – Paris principles (Report).

    Google Scholar 

  • UNICEF (2008). Fact sheet: Child soldiers (Report).

    Google Scholar 

  • UNDP & UNFPA (2006). Post-conflict peace building in Africa: The role of UNDP and UNFPA in Angola and the Democratic Republic of the Congo – The DRC case study – Background Note – Sexual and gender-based violence – prevention and response/Disarmament, demobilization and reintegration (Report).

    Google Scholar 

  • UNHCR (2008). 2007 Global Trends: Refugees, asylum-seekers, returnees, internally displaced and stateless persons (Report).

    Google Scholar 

  • UNODCCP (1999). The drug nexus in Africa. Vienna: UNODCCP.

    Google Scholar 

  • Uvin, P. (2007). Ex-Combatants in Burundi: Why the joined, how they left, why they fared (Report No. 3).

    Google Scholar 

  • Van Ijzendoorn, M. H., Bakermans-Kranenburg, M. J., & Sagi-Schwartz, A. (2003). Are children of Holocaust survivors less well-adapted? A meta-analytic investigation of secondary traumatization. Journal of traumatic stress, 16(5), 459–469.

    Article  Google Scholar 

  • Verdeli, H., Clougherty, K., Bolton, P., Speelman, L., Lincoln, N., Bass, J., et al. (2003). Adapting group interpersonal psychotherapy for a developing country: Experience in rural Uganda. World psychiatry: Official journal of the World Psychiatric Association (WPA), 2(2), 114–120.

    Google Scholar 

  • Verhey, B. (2001). Child soldiers: Preventing, demobilizing and reintegrating (Report No. 23).

    Google Scholar 

  • Weissman, M., Markowitz, J., & Klerman, G. (2000). Comprehensive guide to interpersonal psychotherapy. New York: Basic Books.

    Google Scholar 

  • Yehuda, R., Bell, A., Bierer, L. M., & Schmeidler, J. (2008). Maternal, not paternal, PTSD is related to increased risk for PTSD in offspring of Holocaust survivors. Journal of psychiatric research, 42(13), 1104–1111.

    Google Scholar 

  • Yule, W. (2000). From programs to "ethnic cleansing": Meeting the needs of war affected children. Journal of child psychology and psychiatry, and allied disciplines, 41(6), 695–702.

    Article  Google Scholar 

  • Yule, W. (2002). Alleviating the effects of war and displacement on children. Traumatology, 8, 160.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Konstanz, Konstanz, Germany

    Anna Maedl, Michael Odenwald & Thomas Elbert

  2. Department of Psychology, University of Konstanz, Konstanz, Germany

    Elisabeth Schauer

  3. vivo International, Konstanz, Germany

    Elisabeth Schauer & Thomas Elbert

Authors
  1. Anna Maedl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elisabeth Schauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Odenwald
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Elbert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anna Maedl .

Editor information

Editors and Affiliations

  1. SW Neptune Terrace 7420, Beaverton, 97007, USA

    Erin Martz

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Maedl, A., Schauer, E., Odenwald, M., Elbert, T. (2010). Psychological Rehabilitation of Ex-combatants in Non-Western, Post-conflict Settings. In: Martz, E. (eds) Trauma Rehabilitation After War and Conflict. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5722-1_9

Download citation

Publish with us

Policies and ethics

Search

Navigation