Project Summary

Children, adolescents, and youth that are exposed to violence are associated with psychological distress in the form of depression, anxiety, PTSD, and difficulty with regulating anger and emotions. This project works to address the mental health consequences of war. 


Interventions in war affected groups may target a singular condition, such as depression, few cost effective trans diagnostic interventions exist to address multi symptomatic presentations that can cause major impairments in school and community functioning. This project is a stabilization and skills focused intervention that integrates elements from cognitive-behavioral therapy and group interpersonal therapy to address co-occurring mental health symptoms that these youth experience. 

Measurement & Metrics

Sixteen Internalizing and 12 externalizing elements from the Oxford Measure of Psychosocial Adjustment were used. Additionally, a sub-scale measuring prosocial attitudes/behaviors was used as a key outcome measure. Capacity for emotional regulation was assessed using 23 items from the Difficulties in Emotion Regulation Scale. The World Health Organization Disability Adjustment Scale, Inventory of Socially Supportive Behaviors, Classroom Performance Scale, and University of California, Los Angeles Post-Traumatic Stress Disorder Reaction Index were also utilized. 

Key Findings

  • YRI participants reported significantly greater improvements in emotion regulation and prosocial attitudes/behaviors compared to controls. 
  • YRI participants also reported significantly greater reductions infunctional impairment and greater improvements in social support.
  • At 6-month follow-up, the difference in symptom improvement between conditions was no longer greatly significant, as both treatment and control groups showed similar improvement relative to the elevated levels of symptoms on the initial screening.
  • YRI participants also had better school attendance and classroom behavior compared to controls.

Facts & Figures


An estimated 20,000 children and adolescents in Sierra Leon were involved with armed groups in the 1991-2002 civil war.


of YRI participants were in school, compared to the 4.7% of non-YRI controls.

Principal Investigator

Project Support

This study was supported by the United States Institute of Peace, the UBS Optimus Foundation, the National Institute for Mental Health, the National Institute on Aging, Harvard Catalyst, the Julie Henry Junior Faculty Development Fund, the Australian Psychological Society, and the Australian National Health and Medical Research Council.


Carolyn Schafer
Program Manager