DNA methylation changes following narrative exposure therapy in a randomized controlled trial with female former child soldiers

The aftermath of traumatization lives on in the neural and epigenetic traces creating a momentum of affliction in the psychological and social realm. Can psychotherapy reorganise these memories through changes in DNA methylation signatures? Using a randomised controlled parallel group design, we examined methylome-wide changes in saliva samples of 84 female former child soldiers from Eastern DR Congo before and six months after Narrative Exposure Therapy. Treatment predicted differentially methylated positions (DMPs) related to ALCAM, RIPOR2, AFAP1 and MOCOS. In addition, treatment associations overlapped at gene level with baseline clinical and social outcomes. Treatment related DMPs are involved in memory formation—the key agent in trauma focused treatments—and enriched for molecular pathways commonly affected by trauma related disorders. Results were partially replicated in an independent sample of 53 female former child soldiers from Northern Uganda. Our results suggest a molecular impact of psychological treatment in women with war-related childhood trauma.Trial registration: Addressing Heightened Levels of Aggression in Traumatized Offenders With Psychotherapeutic Means (ClinicalTrials.gov Identifier: NCT02992561, 14/12/2016).

Child and adolescent mental health services in Uganda

Introduction Worldwide, one in five children and adolescents suffer from mental health disorders, while facing limited opportunities for treatment and recovery. Growing up, they face multiple challenges that might contribute to the development of mental disorders. Uganda is a developing country with a history of prolonged civil and regional wars associated with child soldiers, large numbers of refugees and internally displaced people due to natural disasters and unrests, and a large infectious disease burden mainly due to acute respiratory tract infections, malaria and HIV/AIDS. Objective This paper aims to examine the current status of child and adolescent mental health services in Uganda. Methodology A scoping review approach was used to select studies on child and adolescent mental health services (CAMHS) in Uganda. A search of MEDLINE, Wiley and PubMed databases was conducted using eligibility criteria. The papers were summarized in tables and then synthesized using the Frameworks for monitoring health systems performance designed by the World Health Organisation (WHO). This was done according to the Preferred Reporting Items for Systematic Review and M-Analyses Extension for Scoping Review (PRISMA-ScR) guidelines. Results Twelve studies were identified; five of them used qualitative methods and focused mostly on the current limitations and strengths of CAMHS in Uganda, while six quantitative studies investigated the effects of new interventions. One study used a mixed-methods approach. In summary, the papers outlined a need for collaboration with the primary health sector and traditional healers to ensure additional human resources, as well as the need to focus on groups such as orphans, HIV/AIDS-affected youth, former child soldiers and refugees. Conclusion Relatively few studies have been conducted on CAMHS in Uganda, and most of those that exist are part of larger studies involving multiple countries. CAMHS in Uganda require improvement and needs to focus especially on vulnerable groups such as orphans, HIV/AIDS-affected youth and former child soldiers.

Congolese Child Soldier Narratives for Global and Local Audiences

The article examines narratives by and about former child soldiers in the Democratic Republic of the Congo, a hitherto neglected corpus despite the topicality of child soldiering in African literatures after 2000. Critical readings of three testimonial texts that have been published in France are juxtaposed with the analysis of one testimonial narrative and one youth novel that have been published in Kinshasa. The editorial framing and narrative strategies that speak to different audiences located in different literary fields are identified. The popularity of testimonial narratives in the West relies on the depiction of violence and the iconic function of the child soldier in medial and human rights discourses. By contrast, narratives about the reconciliation and the reintegration of child soldiers prevail in the DRC. Thus, the different functions of global and local narratives on the sensitive issue of children at war are exposed.

Looking for the child soldier

This article follows a criminal investigation for recruitment of child soldiers, by asking the following questions: how does one find child soldiers? How does one bring them onto the judicial stage? The article explores the different moments that marked the investigation by the Office of the Prosecutor in the first case brought before the International Criminal Court in The Hague, that of Thomas Lubanga Dyilo. After describing the successive stages of the investigation, the article analyses the conditions under which former child soldiers testified before the ICC. None of their nine testimonies was judged credible by the ICC Trial Chamber I. The different moments that marked these legal proceedings bring to light the instability of the category of child soldier and the uncertainty that regularly threatens the labour of judicial elucidation.

Children in Armed Conflict

This chapter addresses a particularly vulnerable population of children, namely, children associated with armed forces or armed groups. These children are colloquially known as child soldiers. This chapter begins by surveying the prevalence of child soldiering globally. It then sets out the considerable amount of international law that addresses children in armed conflict, in particular, the law that allocates responsibility for child soldiering and the law that sets out the responsibility of child soldiers for their conduct. The chapter identifies significant gaps between the law and the securing of positive outcomes for former child soldiers, notably when it comes to post-conflict reintegration. The protective impulse that envisions militarized youth as faultless passive victims may not always reflect how youthful fighters see themselves nor necessarily support an emancipatory and empowering vision of how international law should promote the rights of children.

Can Duress Exclude Criminal Responsibility of Former Child Soldiers? The Case of Dominic Ongwen Before the International Criminal Court

The phenomenon of child soldiers encompasses up to half a million of adolescents around the world and is – without a doubt – one of the most pressing humanitarian problems of contemporary armed conflicts. This article aims at addressing this issue by examining an ongoing trial of Dominic Ongwen before the International Criminal Court. The first part is dedicated to the description of Dominic Ongwen’s life through the prism of the ‘victim’ and ‘perpetrator’ labels. In this respect I try to prove that in many situations these two labels do not fit the social reality which they are supposed to classify or categorize. In the second part, I refer to the taxonomy of defences, justifications, excuses and grounds for excluding criminal responsibility in domestic and international criminal law. I also analyse concepts of duress and necessity as they are codified in the Rome Statute of the International Criminal Court. On these basis, I give a negative answer to the question if Dominic Ongwen will be able to effectively invoke one of these defences in order to limit or exclude his criminal responsibility, while in conclusions I also provide a short assessment of ‘the law as it is’.