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Survivors of child trafficking exhibit symptoms of depression, anxiety, PTSD

About one-third of girls and boys who survived child trafficking experienced physical and/or sexual violence during their ordeal in a study of children receiving posttrafficking services in Cambodia, Thailand and Vietnam, according to an article published online by JAMA Pediatrics.

Many of these survivors of child trafficking in the Greater Mekong Subregion of Southeast Asia screened positive for depression, anxiety and posttraumatic stress disorder (PTSD), and mental health symptoms were associated with self-harm and suicide ideation, according to the article.

Millions of children each year experience extreme forms of exploitation and abuse in human trafficking.

Ligia Kiss, Ph.D., of the London School of Hygiene and Tropical Medicine, and coauthors describe experiences of abuse and exploitation, mental health outcomes and suicidal behavior among children and adolescents receiving posttrafficking services. The study was based on a survey with 387 children and adolescents between the ages of 10 and 17 who were receiving services such as health care, legal assistance, psychosocial rehabilitation and vocational training. Participants were identified by governmental and nongovernmental referral networks and posttrafficking service providers as having been trafficked.

Among the 387 children, 82 percent were female. Most of the children and adolescents in the study sample (52 percent) were exploited in sex work. Boys were most commonly trafficked for street begging (29 percent) and fishing (19 percent). Girls were trafficked primarily for forced sex work (63 percent). About 67 percent of the group reported that they left home because of economic concerns, while 5 percent said they were abducted and 4 percent left because of violence at home. Boys were predominantly from Cambodia (44 percent) and girls were mainly from Thailand (43 percent).

Results indicate that 12 percent of the children and adolescents tried to harm or kill themselves in the month before the survey interview, 56 screened positive for depression, 33 percent for an anxiety disorder and 26 percent for PTSD.

Other results include:

  • Nearly half of the boys (41 percent) and 19 percent of girls reported physical violence during trafficking.
  • Sexual violence was reported by 23 percent of girls and one boy.
  • During trafficking, children commonly worked seven days per week, with boys working an average of about 10 hours daily and girls about seven hours.
  • Children symptomatic for PTSD, depression and anxiety were more likely to report self-harm, as well as children reporting suicidal ideation.

The authors note that while the findings reflect the situation of children receiving posttrafficking services in the Greater Mekong Subregion, they believe the study can provide insights for other similarly vulnerable children.

“Despite potential limitations, these findings confirm what many service providers have witnessed so often: children in posttrafficking services have been exposed to traumatic events and are attempting to cope with haunting memories and deep distress as they try to forge ahead into an uncertain future,” the study concludes.

Editorial: Human Trafficking of Children and Adolescents

In a related editorial, Abigail English, J.D., of the Center for Adolescent Health & the Law, Chapel Hill, N.C., writes: “Kiss and colleagues concluded that ‘children in posttrafficking services have been exposed to traumatic events and are attempting to cope with haunting memories and deep distress as they try to forge ahead into an uncertain future.’ This eloquent description characterizes not only the trafficked children of the Mekong region, but trafficked young people everywhere. It should serve as a call to action to health care professionals, nongovernmental organizations, governmental agencies and policymakers to provide the essential responses for traumatized children and adolescents at risk for and experiencing human trafficking.”