Post-traumatic Stress Disorder among child perpetrators and victims of violence from the Northern Uganda civil war: Findings from the WAYS study

War experiences are known risk factors for post-traumatic stress disorder (PTSD) and other poor psychosocial outcomes. This study aimed to assess the extent to which perpetrating violence (operationalised as intentional and unintentional killing or mutilation) and being a victim of violence (operationalised as being a victim of violence, e. g., witnessing violence, injuries, torture) predict PTSD and other psychosocial outcomes independently in war-affected youth of Northern Uganda. Data on war experiences, PTSD, psychosocial problems, and socio-demographic characteristics were collected from the youth formerly abducted by the Ugandan Lord's Resistance Army (LRA) at baseline (mean age = 22.39 years; SD = 10.47) and at follow-up (mean age = 23.52 years; SD = 9.28) using self-report questionnaires. On average, the participants spent 3.13 years in captivity (SD = 2.99) and were abducted at 14.14 years of age (SD = 4.21). Regression models were fitted to predict PTSD and psychosocial outcomes from perpetrating violence controlling for being a victim of violence and demographic characteristics. Thirty-seven percent (n = 168) reported killing or being responsible for killing while in rebel captivity. After adjusting for being a victim of violence, perpetrating violence remained a statistically significant predictor of PTSD and poor psychosocial outcomes such as depression, anxiety, somatic complaints, psychotic symptoms, and conduct problems. Among war-affected youth returning from LRA captivity, perpetrating violence may just be as toxic a risk factor for PTSD and other psychosocial outcomes as being a victim of violence. Mental health workers should consider both the effects of being a victim of violence and perpetrating violence in treatment planning.