Reinhart Koselleck-Projekt 'Psychobiologie menschlicher Gewalt- und Tötungsbereitschaft'

Institutions
  • FB Psychologie
Publications
    Crombach, Anselm; Elbert, Thomas(2015): Controlling Offensive Behavior Using Narrative Exposure Therapy : A Randomized Controlled Trial of Former Street Children Clinical Psychological Science ; 3 (2015), 2. - S. 270-282. - ISSN 2167-7026. - eISSN 2167-7034

Controlling Offensive Behavior Using Narrative Exposure Therapy : A Randomized Controlled Trial of Former Street Children

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Insecure and violent environments foster two different forms of aggressive behavior: reactive aggressive responding, such as fearful or angry impulsive behavior to perceived threats, and appetitive aggression, which encompasses violence-related feelings of power, excitement, and pleasure. We tested whether forensic offender rehabilitation narrative exposure therapy (FORNET; five sessions) would reduce involvement in everyday violence and produce beneficial effects for mental and physical health. In a Burundian residential center for former street children, we identified a subset of 32 male youths (mean age = 17 years) who scored highly in appetitive aggression. We conducted a randomized controlled trial by assigning matched pairs to receive either FORNET or treatment as usual. During the follow-up (4–7 months after completing treatment), the 16 youths who received FORNET reported having committed significantly fewer offenses (Hedges’s g = 0.62) and presented with fewer physical-health complaints (Hedges’s g = 0.56) than did their matched control participants.

Origin (projects)

    Hecker, Tobias; Hermenau, Katharin; Isele, Dorothea; Elbert, Thomas(2014): Corporal punishment and children’s externalizing problems : a cross-sectional study of Tanzanian primary school aged children Child Abuse & Neglect ; 38 (2014), 5. - S. 884-892. - ISSN 0145-2134. - eISSN 1873-7757

Corporal punishment and children’s externalizing problems : a cross-sectional study of Tanzanian primary school aged children

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The adverse effect of harsh corporal punishment on mental health and psychosocial func- tioning in children has been repeatedly suggested by studies in industrialized countries. Nevertheless, corporal punishment has remained common practice not only in many homes, but is also regularly practiced in schools, particularly in low-income countries, as a measure to maintain discipline. Proponents of corporal punishment have argued that the differences in culture and industrial development might also be reflected in a positive rela- tionship between the use of corporal punishment and improving behavioral problems in low-income nations. In the present study we assessed the occurrence of corporal punish- ment at home and in school in Tanzanian primary school students. We also examined the association between corporal punishment and externalizing problems. The 409 children (52% boys) from grade 2 to 7 had a mean age of 10.49 (SD = 1.89) years. Nearly all children had experienced corporal punishment at some point during their lifetime both in family and school contexts. Half of the respondents reported having experienced corporal punish- ment within the last year from a family member. A multiple sequential regression analysis revealed that corporal punishment by parents or by caregivers was positively related to children’s externalizing problems. The present study provides evidence that Tanzanian children of primary school age are frequently exposed to extreme levels of corporal punish- ment, with detrimental consequences for externalizing behavior. Our findings emphasize the need to inform parents, teachers and governmental organizations, especially in low- income countries, about the adverse consequences of using corporal punishment be it at home or at school.

Origin (projects)

    Crombach, Anselm; Elbert, Thomas(2014): The benefits of aggressive traits : a study with current and former street children in Burundi Child Abuse & Neglect ; 38 (2014), 6. - S. 1041-1050. - ISSN 0145-2134. - eISSN 1873-7757

The benefits of aggressive traits : a study with current and former street children in Burundi

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Aggressive behavior in children and youths is commonly associated with exposure to violence and maltreatment. Consequently, aggressive behavior has often been explained as a form of reactive behavior in response to violence-inflicted mental suffering. However, perpetrating violence can become appealing, fascinating and exciting, i.e., may acquire appetitive, self-rewarding aspects. We postulated that this appetitive form of aggression reduces the vulnerability for developing Posttraumatic Stress Disorder (PTSD) in insecure and violent environments. Furthermore we investigated the extent to which reactive aggression and appetitive aggression account for recent violent behavior in children and youths. We conducted semi-structured interviews in a sample of 112 children and youths (Mage=15.9 years) recruited from the streets, families and a residential center for vulnerable children in Burundi. We investigated the cumulative exposure to traumatic events and to domestic and community violence, assessed the recently committed offenses, the severity of PTSD symptoms, and the potential for reactive and appetitive aggression. Reactive aggression was positively related to PTSD, whilst appetitive aggression was negatively related to PTSD. Children higher in appetitive aggression were also more likely to display violent behavior. These results suggest that an appetitive perception of violence may be an useful adaption to insecure and violent living conditions reducing the vulnerability of children for trauma-related mental disorders. However, positive feelings experienced through violent or cruel behavior are also an important risk factor for ongoing aggressive behavior and therefore need to be considered in prevention strategies.

Origin (projects)

  Hermenau, Katharin(2014): Violent childhood experiences - Consequences on mental health and approaches to intervention

Violent childhood experiences - Consequences on mental health and approaches to intervention

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In order to develop in a healthy manner, a child requires a secure environment and a steady bond with a close caregiver (Johnson, Browne, & Hamilton-Giachritsis, 2006). However, experiences of violence may interfere with this process of healthy development. The present thesis examined the consequences of exposure to family, institutional and organized violence on the mental health of children in Sub-Saharan Africa, living either in institutional care or being associated with armed forces. Subsequently, intervention approaches to reduce psychological suffering and to prevent children from further exposure to violence were developed and evaluated.<br /><br /><br />Children in Sub-Saharan Africa are exposed to high rates of corporal punishment within their families and schools (UNICEF, 2010, 2011). Studies from other settings have found that family violence is strongly related to mental health problems, including trauma spectrum disorders as well as internalizing and externalizing psychological problems (e.g. Catani, Jacob, Schauer, Kohila, & Neuner, 2008; Elbert et al., 2009; Gámez-Guadix, Straus, Carrobles, Muñoz-Rivas, & Almendros, 2010). In Sub-Saharan Africa, institutional care is part of the support system for orphans and vulnerable children (McCall, 2013; Wolff & Fesseha, 1998). The few existing studies investigating these contexts have indicated that the quality of caregiving in such institutions is poor and that the caregivers are often undereducated and overburdened (e.g. Espié et al., 2011; Levin & Haines, 2007; Wolff & Fesseha, 1999). To date, little is known about the occurrence of violence toward children in institutional care in Sub-Saharan Africa. Interventions in institutional care worldwide have successfully improved the quality of caregiving (e.g. Levin & Haines, 2007; St. Petersburg-USA Orphanage Research Team, 2008; Wolff & Fesseha, 1999), yet none of them specifically targeted violence in institutional care. In regions of war and conflict, children are exposed to additional stressors in form of organized violence. This is especially true if they are recruited as child soldiers, during which time they experience and perpetrate massive amounts of violence (Schauer & Elbert, 2010) and suffer heavily from the consequences resulting in trauma spectrum disorders and aggressive behavior (Maclure & Denov, 2006; Schauer & Elbert, 2010; Stott, 2009). These mental health problems can pose challenges to the reintegration process (Betancourt et al., 2010; Boyden, 2003). It is therefore important to support the reintegration process by addressing individual psychological suffering (Stott, 2009).<br /><br /><br />The present thesis focused on family and institutional violence in Tanzania and on organized violence in the Democratic Republic of the Congo (DRC). The first article investigated corporal punishment and its consequences on Tanzanian primary school children and found alarmingly high rates: More than 95% of the children reported experiencing corporal punishment in the family and at school. More than half of the children reported incidents of corporal punishment in the family within the last year. Experiences of corporal punishment were related to externalizing problems, such as aggression and hyperactivity. The findings were in line with reports from UNICEF (2011) and research from other countries (Ani & Grantham-McGregor, 1998; Schilling, Aseltine, & Gore, 2007). The second and the third article revealed that corporal punishment and violence were equally common in institutional care. Experiences of violence in institutional care were more strongly related to mental health problems than were experiences in the family of origin. The most affected children were institutionalized at a very young age. Thus, adverse experiences in institutional care compounded with adverse experiences in the family of origin and distant and unresponsive caregiving in institutional care (Johnson et al., 2006; McCall, 2013). Subsequently, a two-component intervention was developed in the third article that addressed individual psychological suffering as well as prevention from further exposure to violence. Children suffering from traumatic stress were treated with KIDNET (Ruf et al., 2007). To reduce further exposure to violence and to improve caregiving all caregivers were trained in parenting skills and nonviolent discipline strategies. A six-month follow-up demonstrated this intervention’s feasibility and showed initial positive outcomes. Traumatic stress and experiences of violence in institutional care substantially decreased post treatment.<br /><br /><br />The fourth article shifted the focus from family violence to organized violence in the DRC and examined the experiences of violence and mental health of former child soldiers. Results revealed that child soldiers experienced and perpetrated higher amounts of violence compared to adult combatants. Additionally, they suffered more from the consequences of being both victim and perpetrator, resulting in higher rates of traumatic stress and aggression. In accordance with the literature (Betancourt et al., 2010), aggressive behavior was linked to failed integration attempts. Based on these findings, the fifth article described the development and evaluation of a two-component intervention, addressing mental health problems as well as aiming to reduce exposure to further violence by supporting the integration of former child soldiers into civil society. The intervention was embedded within a reintegration program offering vocational training and social support and was tested in a randomized-controlled trial against treatment as usual. An advanced version of NET (Schauer, Neuner, & Elbert, 2011) focusing on traumatic experiences as well as perpetrated violence was implemented. Individual sessions were followed by a group session, which dealt with the role change from combatant to civilian. A six-month follow-up confirmed feasibility and found initial positive outcomes. Traumatic stress decreased substantially in the treatment group, whereas aggression decreased in both groups. Closeness to combatants was used as an inverse index of integration and this index showed a specific decline as a result of the intervention.<br /><br /><br />The present thesis showed that exposure to violence, namely violence in families and institutions as well as organized and perpetrated violence in armed conflict, has detrimental consequences for children’s mental health. Consequently, the present thesis developed and successfully tested two interventions designed to reduce the children’s psychological suffering as well as to protect them from further exposure to violence. The interventions targeted children in institutional care and former child soldiers in reintegration programs. Thus, the present thesis showed that intervention approaches focusing on both individual psychological support and prevention of further exposure to violence promise to support affected children in overcoming their psychological suffering, providing them the opportunity to grow up in a secure and supportive environment.

Origin (projects)

    Hecker, Tobias; Hermenau, Katharin; Maedl, Anna; Hinkel, Harald; Schauer, Maggie; Elbert, Thomas(2013): Does Perpetrating Violence Damage Mental Health? : Differences Between Forcibly Recruited and Voluntary Combatants in DR Congo Journal of Traumatic Stress ; 26 (2013), 1. - S. 142-148. - ISSN 0894-9867. - eISSN 1573-6598

Does Perpetrating Violence Damage Mental Health? : Differences Between Forcibly Recruited and Voluntary Combatants in DR Congo

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As a consequence of the ongoing conflict in the Democratic Republic of the Congo (DRC), combatants are constantly involved in various forms of violence. Findings concerning the impact of perpetrating violence on mental health are contradictory, ranging from increasing to buffering the risk for mental ill health. The present study investigated the impact of perpetrating violence on mental health. In total, 204 forcibly recruited and voluntary male combatants (mean age = 24.61 years) from different armed groups in the eastern DRC took part in the study. In a semistructured interview, respondents were questioned about appetitive aggression and posttraumatic stress disorder (PTSD) as well as self-experienced violence and self-perpetrated violent offending. A multivariate analysis of variance (η2 = .23) revealed that voluntary combatants perpetrated more violent acts (η2 = .06) and showed higher appetitive aggression η2 = .03). A moderated multiple regression analysis (R2 = .20) showed that perpetrating violence was positively related to PTSD in forcibly recruited combatants, but not in voluntary combatants. Thus, perpetrating violence may not necessarily qualify as a traumatic stressor. Further studies might consider assessing the combatant’s perception of committing violent acts.

Origin (projects)

    Giebel, Gilda; Weierstall, Roland; Schauer, Maggie; Elbert, Thomas(2013): Female attraction to appetitive-aggressive men is modulated by women’s menstrual cycle and men’s vulnerability to traumatic stress Evolutionary Psychology ; 11 (2013), 1. - S. 248-262. - eISSN 1474-7049

Female attraction to appetitive-aggressive men is modulated by women’s menstrual cycle and men’s vulnerability to traumatic stress

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Many studies have reported that during high fertility points in the menstrual cycle, women demonstrate increased preference for men with masculinized faces and bodies. In this study, we analyzed whether appetitive aggression in men serves as an additional signal for a favored partner choice. Appetitive aggression describes the intrinsic motivation to act violently even when not being threatened. This study evaluated the responses of 1212 women to one of four descriptions regarding a soldier´s experience after returning from war. The four vignettes included trauma related symptoms with high or low appetitive aggression, or no trauma related symptoms with high or low appetitive aggression. Participants rated their desirability for the soldier in regards to potential long-term and short-term relationships. Results indicate that women preferred a soldier high in appetitive aggression as a short-term mate but not as a long-term relationship. This preference for the “warrior” was higher for women in their fertile window of the menstrual cycle. We conclude that women in their fertile window prefer men exhibiting higher appetitive aggression as a short-term partner, revealing appetitive aggression in men may serve as a signal for a higher genetic fitness.

Origin (projects)

  Crombach, Anselm(2013): Children and the Cycle of Violence in Post-Conflict Settings : Mental Health, Aggression, and Interventions in Burundi

Children and the Cycle of Violence in Post-Conflict Settings : Mental Health, Aggression, and Interventions in Burundi

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In this thesis I investigated the negative impact of maltreatment on the psychological wellbeing of children and adolescents who grew up in violent environments of the post-conflict country Burundi. Furthermore, the individual risk factors of these adolescents for engaging in everyday violence were assessed. Subsequently I evaluated the Forensic Offender Rehabilitation Narrative Exposure Therapy (FORNET) as a means of reducing violent behavior among adolescents.<br /><br />Research has demonstrated that trauma-related mental health disorders are common among war-affected populations. Children and adolescents growing up on the streets or in unstable family conditions in post-conflict settings are particularly vulnerable. Exposure to life-threatening situations, maltreatment and other forms of violence at early age most likely impede their development and exacerbate their risk to suffer from mental ill-health.<br /><br />Furthermore, violent environments also appear to foster aggressive behavior. A large number of studies have shown that posttraumatic stress disorder (PTSD) is associated with an increased likelihood of reactive aggressive responding. However, recent studies with serious offenders showed that violent behavior might also be perceived as appetitive, i.e., as exciting, fascinating and related to feelings of power. Appetitive aggression appears to be a useful adaption to adverse environments, which may also develop among children and adolescents. The mental health and the propensity to engage in violent behavior were investigated in 112 male children and adolescents. They were recruited from the streets (n = 15), families (n = 15), a residential center for former street children (n = 32) and other vulnerable children (n = 50) in Burundi. They were between 11 and 24 years old (mean = 15.9 years; SD = 3.0<br />years). PTSD symptom severity was assessed with the University of California at Los Angeles PTSD Reaction Index (UCLA PTSD Index; Steinberg, Brymer, Decker, & Pynoos, 2004). The Minnesota International Neuropsychiatric Interview for Children and Adolescents (MINI-KID; Sheehan et al., 2010) was used to screen for depression, alcohol and substance dependence as well as for suicidal risk. In addition, physical health complaints were examined with a checklist. Aggression was assessed with an offense checklist, the Reactive Proactive Aggression Questionnaire (Raine et al., 2006) and the Appetitive Aggression Scale for Children (AAS-C). Among the adolescents in residential care, the 32 scoring highest in appetitive aggression were chosen to participate in an intervention study. Half of them received FORNET, the remaining 16 received treatment as usual. The follow-up assessment was conducted 4-7 months after completing treatment.<br /><br />Results showed that current street children were most affected by mental disorders. The children living in the residential center suffered more from PTSD symptoms than children who still lived with their families. In residential care, the current exposure to minor violence and neglect was positively associated with increased PTSD symptom severity. The latter impeded progress in school. Appetitive aggression was negatively related to PTSD symptoms. This indicates that appetitive aggression improves resilience against mental illhealth of adolescents who grew up in precarious conditions. Furthermore, appetitive aggression was a serious risk factor for current offenses. FORNET proved to be effective in reducing the involvement in everyday violence among adolescents (Hedges g =.62). In addition, the physical health of the FORNET treated participants improved (Hedges g =.56). The results disentangled different aspects of the cycle of violence: (1) Being a victim of even minor violent acts impairs mental health, which in turn impedes progress in school. Hence providing adolescents with a violence free environment is essential for successful integration into society. (2) Children and adolescents may develop appetitive aggression as an adaption to violent environments. While this protects their mental health in precarious conditions, it also increases their involvement in everyday violence. The FORNET is a promising approach to reducing violent behavior and to improving resilience against ill-health.

Origin (projects)

  Hecker, Tobias(2013): Perpetual perpetration: How violence shapes the offender : The interplay between organized and family violence, appetitive aggression and mental health

Perpetual perpetration: How violence shapes the offender : The interplay between organized and family violence, appetitive aggression and mental health

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The present thesis explored how violence shapes the violent offender by investigating the interplay between exposure to and perpetration of organized and family violence and its impact on mental health and aggression. Violence and cruelty seem to be omnipresent in men. Nell (2006) suggested that an affectively positive, dopamine mediated and, therefore, rewarding perception of violence fosters violence among humans. Findings concerning the impact of perpetrating violence on mental health are, however, contradictory, ranging from increasing to buffering the risk for mental disorders. Elbert, Weierstall and Schauer (2010) suggested that an appetitive perception of violence may explain the contradictory findings and thus introduced the term ‘appetitive aggression’. Previous studies have shown that appetitive aggression buffers the risk of developing trauma-related suffering (Weierstall, Schaal, Schalinski, Dusingizemungu, & Elbert, 2011; Weierstall, Schalinski, Crombach, Hecker, & Elbert, 2012). Furthermore, the literature suggests a strong association between exposure to violence and mental health problems (Elbert & Schauer, 2002) as well as aggressive behavior (Weaver, Borkowski, & Thomas, 2008). The present thesis examined the phenomenon of appetitive aggression more closely in former combatants and child soldiers in the eastern provinces of the Democratic Republic of the Congo (DRC). Additionally, the interplay between organized and family violence, mental health, and aggression was investigated.<br /><br />The ‘cycle of violence’ hypothesis (Curtis, 1963; Elbert, Rockstroh, Kolassa, Schauer, & Neuner, 2006), which holds that violence breeds further violence, forms the underlying premise of the first article. This examined the association between exposure to family violence and aggressive behavior in primary school students in Tanzania. Results revealed that in line with the ‘cycle of violence’ hypothesis exposure to family violence, i.e. corporal punishment, was positively related to children’s aggressive behavior.<br /><br />The second article focused on appetitive forms of aggression in a sample of former combatants and child soldiers in the DRC. Results showed that combatants reporting high levels of appetitive aggression are characterized by the perpetration of a high number of violent acts, joining armed groups on their own accord and as children. Joining an armed group voluntarily may indicate an innate appetite for aggression. However, joining young and perpetrating violence on a regular basis seem to intensify the appetite for aggression.<br /><br />The third article examined the same sample, this time investigating whether the perpetration of violence damaged the perpetrator’s mental health. Results revealed that voluntary combatants differed significantly from forcibly recruited combatants, as they reported more perpetrated violence and higher levels of appetitive aggression. Furthermore, we found that perpetrating violence was positively related to posttraumatic stress disorder (PTSD) symptom severity in forcibly recruited combatants, but not in voluntary combatants. Thus, perpetrating violence does not necessarily damage mental health. The combatant’s perception of violence may determine whether perpetrating violence affects their mental health.<br /><br />Previous research suggests that appetitive aggression might buffer the risk of developing trauma related illnesses (Weierstall et al., 2011, 2012). In the fourth article, we investigated the relation between exposure to traumatic stressors, appetitive aggression, and PTSD symptom severity in voluntary combatants in the eastern DRC. The results showed that traumatic events were positively related to PTSD symptom severity and that appetitive aggression correlated negatively with PTSD symptom severity for participants with low to medium PTSD symptom severity. Thus, these findings provide further support for earlier findings that repeated exposure to traumatic stressors cumulatively heightens the risk of PTSD and revealed that appetitive aggression buffers the risk of developing PTSD symptoms under certain circumstances.<br /><br />The fifth article explored the relation between alcohol or drug consumption and the perpetration of violence in former combatants in the eastern DRC from a political science perspective. Prior research revealed a link between substance use and violent behavior. Substance consumption seems to decrease the threshold for using violence, i.e. it removes the learned constraints and thus facilitates aggressive behavior (Moore & Stuart, 2005; Reiss & Roth, 1993). At the same time, specific substances, particularly alcohol, seem to incite violence directly via aggression and rage (Hoaken & Stewart, 2003). Our analyses showed, after controlling for armed group-level and individual-level variables, that drug intake and alcohol consumption boost the amount of perpetrated violent actions by combatants.<br /><br />Earlier findings showed that former child soldiers or ex-combatants often form small groups of outlaws in civil life, performing violent and criminal acts (Elbert et al., 2010; Wessells & Monteiro, 2004). Based on these findings and the prior findings of the present thesis, the last article tested the efficacy of Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET) in a randomized controlled clinical trial. FORNET is a psychological intervention focusing on trauma-related suffering and appetitive forms of aggression to foster the integration of former combatants into civil society and break the cycle of violence. The treatment group reported reduced PTSD symptoms and less contact with combatants. Thus, the study presented for the first time evidence for the feasibility and efficacy of FORNET. We could show that addressing traumatic events and perpetrated violence foster the rehabilitation of violent offenders and thus may help to break the cycle of violence in violent environments.<br /><br /><br /><br />The present thesis has attained further knowledge about the appetitive perception of violence, the interrelation between the exposure to and the perpetration of organized and family violence as well as its impact on mental health and aggression. Clinical implications and directions for future research are discussed. The findings regarding appetitive aggression may provide one explanation at the level of the individual offender for why it is extremely difficult to pacify crisis regions or restrict the risk of violent recidivism in former offenders. However, the successful integration of violent offenders into civil society can help to break the cycle of violence. The findings of the present thesis increase the understanding of the needs and difficulties of violent offenders and can thus improve the rehabilitation process.

Origin (projects)

    Rieder, Heide; Elbert, Thomas(2013): The relationship between organized violence, family violence and mental health : findings from a community-based survey in Muhanga, Southern Rwanda European Journal of Psychotraumatology ; 4 (2013), 1. - 21329. - ISSN 2000-8198. - eISSN 2000-8066

The relationship between organized violence, family violence and mental health : findings from a community-based survey in Muhanga, Southern Rwanda

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Background: The relationship between organized violence and family violence, and their cumulative effect on mental health in post-conflict regions remains poorly understood.<br />Objective: The aim of the present study was to establish prevalence rates and predictors of family violence in post-conflict Rwanda. And to examine whether higher levels of war-related violence and its socio-economic<br />consequences would result in higher levels of violence within families and whether this would be related to an increase of psychological distress in descendants.<br />Method: One hundred and eighty-eight parent child pairs from four sectors of the district Muhanga, Southern Province of Rwanda, were randomly selected for participation in the study. Trained local psychologists<br />administered structured diagnostic interviews. A posttraumatic stress disorder (PTSD) diagnosis was established using the PTSD Symptom Scale Interview (PSS-I) and child maltreatment was assessed by means of<br />the Childhood Trauma Questionnaire (CTQ). Additionally, the Hopkins Symptom Checklist (HSCL-25) assessed symptoms of depression and anxiety in descendants.<br />Results: Prevalence rates of child abuse and neglect among descendants were below 10%. Ordinal regression analyses revealed that the level of child maltreatment in descendants was predicted by female sex, poverty,<br />loss of the mother, exposure to war and genocide as well as parents’ level of PTSD and reported child maltreatment. Poor physical health, exposure to war and genocide, parental PTSD symptoms, and reported childhood trauma were significantly associated with depressive and anxious symptoms, while only exposure to war and genocide and poor physical health predicted the level of PTSD.<br />Conclusion: The results indicate that cumulative stress such as exposure to organized violence and family violence in Rwandan descendants poses a risk factor for the development of depressive and anxious symptoms.<br />Besides the support for families to cope with stress, awareness-raising initiatives challenging the current discourse of discipline toward children in schools or at home need to be fostered.

Origin (projects)

    Hermenau, Katharin; Hecker, Tobias; Maedl, Anna; Schauer, Maggie; Elbert, Thomas(2013): Growing up in armed Groups : trauma and aggression among child soldiers in DR Congo European Journal of Psychotraumatology ; 4 (2013), 1. - 21408. - ISSN 2000-8198. - eISSN 2000-8066

Growing up in armed Groups : trauma and aggression among child soldiers in DR Congo

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Background:<br /><br />Child soldiers are often both victims and perpetrators of horrendous acts of violence. Research with former child soldiers has consistently shown that exposure to violence is linked to trauma-related disorders and that living in a violent environment is correlated with enhanced levels of aggression.<br /><br />Objective:<br /><br />To gain more insight into the experiences and the mental health status of former child soldiers, we conducted a survey with N=200 former child soldiers and adult combatants in the DR Congo.<br /><br /><br />Methods:<br /><br />We conducted semi-structured interviews concerning military experiences, experienced and perpetrated violence, and mental health.<br /><br />Results:<br /><br />Former child soldiers reported more experienced and perpetrated violence, a greater severity of trauma-related suffering, as well as higher appetitive aggression than adult ex-combatants. Appetitive aggression was related to more perpetrated violence, higher military ranks, voluntary recruitment and higher rates of reenlistments in former child soldiers.<br /><br /><br />Conclusions:<br /><br />Our results indicate that growing up in an armed group is related to higher levels of trauma- related disorders and aggressive behavior. This may explain the challenge of reintegrating former child soldiers. It is thus important to consider mental health problems, particularly trauma-related disorders and aggressive behavior, of former child soldiers for designing adequate reintegration programs.

Origin (projects)

    Hermenau, Katharin; Hecker, Tobias; Schaal, Susanne; Maedl, Anna; Elbert, Thomas(2013): Addressing Post-traumatic Stress and Aggression by Means of Narrative Exposure : A Randomized Controlled Trial with Ex-Combatants in the Eastern DRC Journal of Aggression, Maltreatment & Trauma ; 22 (2013), 8. - S. 916-934. - ISSN 1092-6771. - eISSN 1545-083X

Addressing Post-traumatic Stress and Aggression by Means of Narrative Exposure : A Randomized Controlled Trial with Ex-Combatants in the Eastern DRC

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Former child soldiers and ex-combatants are at high risk of developing trauma-related disorders and appetitive aggression, which reduce successful integration into peaceful societies. In a randomized controlled clinical trial, we offered Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET) to 15 ex-combatants with the goal of reducing traumatic stress and appetitive aggression compared to “treatment as usual.” Measures included the PTSD Symptom Scale-Interview and the Appetitive Aggression Scale assessed prior to treatment and 2 weeks and 6 months after the treatment. We also assessed closeness to combatants as an index of reintegration. The treatment group reported reduced PTSD symptoms and less contact with combatants. Appetitive aggression decreased substantially in both groups. The results indicate that it is feasible to add psychological treatment to facilitate the reintegration process.

Origin (projects)

    Hecker, Tobias; Hermenau, Katharin; Maedl, Anna; Elbert, Thomas; Schauer, Maggie(2012): Appetitive aggression in former combatants - Derived from the ongoing conflict in DR Congo International Journal of Law and Psychiatry ; 35 (2012), 3. - S. 244-249. - ISSN 0160-2527. - eISSN 1873-6386

Appetitive aggression in former combatants - Derived from the ongoing conflict in DR Congo

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Soldiers and combatants often report that committing violence can be appealing, fascinating and exciting (Elbert, Weierstall, & Schauer, 2010). This appetite for aggression was investigated in a sample of 224 former combatants from different armed groups and forces in eastern DRC. In a semistructured interview they were questioned about their military history, exposure to violence and perpetrated violence. Appetitive aggression was assessed with a 15-item-scale (Weierstall & Elbert, 2011), which was successfully implemented in comparable samples (Weierstall, Schalinski, Crombach, Hecker, & Elbert, submitted for publication). A sequential multiple regression was conducted to determine possible predictors of appetitive aggression. Perpetrated violence types, recruitment type, and joining as a child were significant predictors and explained 26% of the variability in appetitive aggression. Duration or military rank within the armed group and exposure to violence did not play a significant role. Thus, combatants reporting high levels of appetitive aggression are characterized by perpetrating a high number of violent acts, joining armed groups on their own accord and as children. Joining an armed group on one's own accord indicates pre-existing appetitive aggression. However, joining young and perpetrating violence on a regular basis seem to intensify the appetite for aggression.

Origin (projects)

Weierstall, Roland; Schauer, Maggie; Elbert, Thomas(2012): Der Krieger in uns Gehirn & Geist : das Magazin für Psychologie und Hirnforschung ; 2012, 11. - S. 28-33. - ISSN 1618-8519

Der Krieger in uns

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In vielen Krisenregionen der Erde geschehen schreckliche Gräuel. Was treibt ­Menschen dazu, ihre Mitmenschen zu quälen oder zu töten – und warum ­empfinden sie oft sogar Lust dabei? Psychologen der Universität Konstanz gingen dieser Frage in Feldstudien im Kongo nach.

Origin (projects)

Weierstall, Roland; Elbert, Thomas(2012): Multifaktorielle Genese und Pathologie der Aggression Interventionen bei Gewalt- und Sexualstraftätern : Risk-Management, Methoden und Konzepte der forensischen Therapie / Endrass, Jérôme et al. (Hrsg.). - Berlin : Med.- Wiss. Verl.-Ges, 2012. - S. 15-26. - ISBN 978-3-941468-70-2

Multifaktorielle Genese und Pathologie der Aggression

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Die multifaktorielle Genese und Pathologie von Aggression werden erörtert, um potentielle Kausalzusammenhänge, Motivation und Kontext sowie die individuelle Geschichte des aggressiven Verhaltens auch in verschiedenen Ebenen beurteilen zu können. Zunächst wird das biopsychosoziale Modell der Aggression erläutert. Anschließend wird der Zusammenhang von psychischen Erkrankungen und Aggression beleuchtet. Außerdem werden unter dem Aspekt der Psychopathologie der Aggression die Zusammenhänge zwischen erleichternder Aggression und pathologischem Verhalten sowie zwischen appetitiver Aggression und Psychopathologie aufgezeigt.

Origin (projects)

Weierstall, Roland; Elbert, Thomas(2012): Formen und Klassifikation menschlicher Aggression Interventionen bei Gewalt- und Sexualstraftätern : Risk-Management, Methoden und Konzepte der forensischen Therapie / Endrass, Jérôme et al. (Hrsg.). - Berlin : Med.- Wiss. Verl.-Ges, 2012. - S. 3-14. - ISBN 978-3-941468-70-2

Formen und Klassifikation menschlicher Aggression

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Verschiedene Ebenen der Klassifikation menschlicher Aggression sowie ihrer multifaktoriellen Genese werden beschrieben. Nach einer einleitenden Definition von menschlicher Gewalt werden folgende Einteilungskriterien erörtert: (1) instrumentell vs reaktiv, (2) impulsiv vs kontrolliert, (3) Emotionen und Motivationen als Motor aggressiven Verhaltens und (4) Valenz. Anschließend werden artverwandte Konstrukte menschlicher Aggression aufgeführt. Des Weiteren wird appetitive Aggression mit Blick auf evolutionspsychologische Grundlagen der Faszination von Gewalt sowie hinsichtlich ihrer Bedeutung in Kriegsgebieten gesondert betrachtet. Eine Skala zur Erfassung appetitiver Aggression, die Appetitive Aggressionsskala, wird vorgestellt.

Origin (projects)

    Mädl, Anna(2011): Rape as weapon of war in the eastern DRC? : The victims' perspective Human Rights Quarterly ; 33 (2011), 1. - S. 128-147

Rape as weapon of war in the eastern DRC? : The victims' perspective

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Rampant sexual violence is one of the most horrendous human rights abuses taking place within Democratic Republic of the Congo’s (DRC) armed conflict. The UN has called these abuses “strategic” and a “weapon of war.” Both labels carry specific implications within the human rights discourse. However, there is a lack of structured data exploring these concepts in the context of the DRC. To address this empirical gap, twenty-five rape survivors were interviewed. In the eyes of the victims the rapes served a multitude of different purposes and appear to be both endemic and indiscriminate. The rapes are the modus operandi of the war.

Origin (projects)

    Weierstall, Roland; Elbert, Thomas(2011): The Appetitive Aggression Scale : development of an instrument for the assessment of human’s attraction to violence European Journal of Psychotraumatology ; 2 (2011). - 8430. - ISSN 2000-8198. - eISSN 2000-8066

The Appetitive Aggression Scale : development of an instrument for the assessment of human’s attraction to violence

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Background: Several instruments, notably Buss and Perry’s Aggression Questionnaire, have been developed for the assessment of aggressive behavior. However, in these instruments, the focus has been on reactive rather than instrumental forms of aggression, even though men in particular may find aggressive behavior attractive. A questionnaire or structured interview for the systematic assessment of the attraction to violence is not yet available. Objective: We, therefore, developed a freely available short form for the assessment of a person’s attraction to violent and planned forms of aggression based on reports of former combatants on the attraction to violence and the characteristics of instrumental aggression described in the literature. Method: The Appetitive Aggression Scale (AAS) was administered to nine samples drawn from different populations, with a total of 1,632 former combatants and participants from war-affected regions (1,193 male and 439 female respondents). Results: From the initial set of 31 items, a selection of 15 items was extracted to improve the scale’s psychometric properties and assess the construct of appetitive aggression validly with respect to content. Cronbach’s Alpha coefficient of 0.85 was appropriate. All items loaded significantly on a single factor accounting for 32% of the total variance. Further analysis revealed that the scale measures a specific construct that can be distinguished from other concepts of human aggression. Conclusions: With the AAS, we present an easily administrable tool for the assessment of the attraction to violence

Origin (projects)

    Weierstall, Roland; Schaal, Susanne; Schalinski, Inga; Dusingizemungu, Jean-Pierre; Elbert, Thomas(2011): The thrill of being violent as an antidote to posttraumatic stress disorder in Rwandese genocide perpetrators European Journal of Psychotraumatology ; 2 (2011), 1. - 6345. - ISSN 2000-8198. - eISSN 2000-8066

The thrill of being violent as an antidote to posttraumatic stress disorder in Rwandese genocide perpetrators

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Background: The cumulative exposure to life-threatening events increases the risk for posttraumatic stress disorder (PTSD). However, over the course of evolutionary adaptation, intra-species killing may have also evolved as an inborn strategy leading to greater reproductive success. Assuming that homicide has evolved as a profitable strategy in humans, a protective mechanism must prevent the perpetrator from getting traumatised by self-initiated violent acts. Objective: We thus postulate an inverse relation between a person’s propensity toward violence and PTSD. Method: We surveyed a sample of 269 Rwandan prisoners who were accused or convicted for crimes related to the 1994 genocide. In structured interviews we assessed traumatic event types, types of crimes committed, the person’s appetitive violence experience with the Appetitive Aggression Scale (AAS) and PTSD symptom severity with the PSS-I. Results: Using path-analysis, we found a dose-response effect between the exposure to traumatic events and the PTSD symptom severity (PSS-I). Moreover, participants who had reported that they committed more types of crimes demonstrated a higher AAS score. In turn, higher AAS scores predicted lower PTSD symptom severity scores. Conclusions: This study provides first empirical support that the victim’s struggling can be an essential rewarding cue for perpetrators. The results also suggest that an appetitive aggression can inhibit PTSD and trauma-related symptoms in perpetrators and prevent perpetrators from getting traumatised by their own atrocities.

Origin (projects)

    Elbert, Thomas; Weierstall, Roland; Schauer, Maggie(2010): Fascination violence : on mind and brain of man hunters European Archives of Psychiatry and Clinical Neuroscience ; 260 (2010), S2. - S. 100-105. - ISSN 0940-1334. - eISSN 1433-8491

Fascination violence : on mind and brain of man hunters

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Why are savagery and violence so omnipresent among humans? We suggest that hunting behaviour is fascinating and attractive, a desire that makes temporary deprivation from physical needs, pain, sweat, blood, and ultimately the willingness to kill tolerable and even appetitive. Evolutionary development into the "perversion" of the urge to hunt humans, that is to say the transfer of this hunt to members of one's own species, has been nurtured by the resultant advantage of personal and social power and dominance. While breakdown of the inhibition towards intra-specific killing would endanger any animal species, controlled inhibition was enabled in humans in that higher regulatory systems, such as frontal lobe-based executive functions, prevent the involuntary derailment of hunting behaviour. If this control - such as in child soldiers for example - is not learnt, the brutality towards humans remains fascinating and appealing. Blood must flow in order to kill. It is hence an appetitive cue as is the struggling of the victim. Hunting for men, more rarely for women, is fascinating and emotionally arousing with the parallel release of testosterone, serotonin and endorphins, which can produce feelings of euphoria and alleviate pain. Bonding and social rites (e.g. initiation) set up the contraints for both hunting and violent disputes. Children learn which conditions legitimate aggressive behaviour and which not. Big game hunting as well as attack of other communities is more successful in groups - men also perceive it as more pleasurable. This may explain the fascination with gladiatorial combat, violent computer games but also ritualized forms like football.

Origin (projects)

Funding sources
NameProject no.DescriptionPeriod
Sachbeihilfe/Normalverfahren564/10no information
Further information
Period: 11.05.2010 – 10.05.2015