[Dimensions of Empathy in Ex-Combatants of the Colombian Armed Conflict Using a Standardized Scale]

Mental health outcomes in communities exposed to Armed Conflict Experiences

Background

Populations exposed to Armed Conflict Experiences (ACE) show different levels of impact in their mental health (i.e. clinical and positive components); however, there is limited evidence related to mental health of general population (civilians not classified as victims) exposed to ACE. Government guided mental health assessments exclude this population. The use of a newly validated Extreme Experiences Scale (EX²) seems appropriate to classify victims, ex-combatants, and civilians for their mental health assessment.

Methods

Here, we propose a novel approach to identify relationships between individuals classified with different levels of ACE exposure—independent of their legal role in the armed conflict, and mental health outcomes. According to the cut-off points derived from the scores of EX², we classified the sample in low and high exposure to ACE.

Results

The high-level ACE group (scores > 2.5) included 119 subjects, and the low-level ACE was constituted by 66 subjects. Our results evidence that people with high exposure to ACE experiment higher odds to present anxiety disorders, risk of suicide, or post-traumatic stress disorder, as well as increased cognitive empathy (i.e., fantasy dimension).

Conclusion

These findings allowed us to identify the influence of ACE on mental health outcomes beyond the conventional frame (victim or ex-combatant), and to discuss effective interventions and implementation of mental health strategies in these communities. We expect to help the health system to focus on key vulnerable subjects by including civilians not recognized as victims, which are neglected from most of the public health screening, assessment, and interventions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00626-2.

Is There Really a Relationship Between Empathy and Aggression? Evidence From Physiological and Self-Report Measures

A strong relationship between empathy and aggression has traditionally been argued, but a recent meta-analysis showed that this relationship is surprisingly weak. However, none of the studies that were analyzed in the meta-analysis used physiological measures of empathy to assess differences between aggressive and nonaggressive subjects. The present study evaluated the activity of the corrugator and zygomatic muscles, galvanic skin response, and heart rate response to pictures with different social content in 30 aggressive and 30 nonaggressive subjects. Self-report measures of emotion and empathy were also evaluated. The results did not show significant differences in any of the physiological measures of affective empathy or subjective measures of emotion. Significant differences were found only in cognitive empathy, in which nonaggressive subjects had higher scores than aggressive subjects. These results suggest that intervention programs should focus on increasing cognitive empathy and exploring other variables, such as emotional self-regulation and callous-unemotional traits. We also suggest exploring other ways of understanding affective empathy.

Validation of the Extreme Experiences Scale (EX2) for Armed Conflict Contexts

Psychological approaches to the study of armed conflict have focused on analyzing post-traumatic stress outcomes, and on evaluating the intensity of exposure to violent confrontation. Nevertheless, psychometrically valid tools required for measuring these traumatic experiences are scarce To validate the Extreme Experiences scale (EX²) for armed conflict contexts for its use in Colombia, and to provide a framework for validation in conflict contexts around the world This Cross-sectional aims to validate the scale with 187 participants, study of validate with 187 participants, comprising population with high exposure to conflict (former combatants and a set of armed conflict victims) and low conflict-exposed individuals (control group). Structures of two domains and 18 items were confirmed: Direct Extreme Experiences (dEX²) and Indirect Extreme Experiences (iEX²); these dimensions were also validated by expert judgment, producing 14-item version. Good levels of internal consistency were found, with a KR-20 of 0.80 for the 18-item version, and 0.77 for the 14-item. The scale differentiates between population with 'high exposure to conflict' from population with 'low exposure' (d_np > 0.5 and area under the ROC >0.90). The scale scores have significant correlation with some mental health constructs. The EX² scale has good internal consistency, as well as structural validity with regard to exposed groups. This scale can be potentially validated for its use in countries with armed confrontation history. In future versions, the scale may include additional items in order to improve content validity.

Efecto de la empatía afectiva sobre el procesamiento cortical de emojis

Objetivo. Identificar las diferencias en el procesamiento cortical de emojis en personas con alta y baja empatía afectiva. Método. El estudio se llevó a cabo con 69 participantes, distribuidos en dos grupos –baja y alta empatía afectiva–, según su puntaje en el Índice de Reactividad Interpersonal. Cada participante observó emojis con expresiones de alegría, ira y neutros. Se registraron los potenciales relacionados a eventos (PRE) P100, N170 y LPP. Resultados. Se encontró una mayor amplitud del N170 en el grupo de personas con alta empatía afectiva y, en general, mayor magnitud del LPP ante emojis de ira. Conclusión. Los resultados sugieren que los emojis son procesados corticalmente de forma similar al rostro humano y que la empatía afectiva modula la codificación del emoji, pero no la atención temprana y el enganche atencional hacia estos estímulos.

Social Cognitive Training Improves Emotional Processing and Reduces Aggressive Attitudes in Ex-combatants

Emotional processing (EP) is a complex cognitive function necessary to successfully adjust to social environments where we need to interpret and respond to cues that convey threat or reward signals. Ex-combatants have consistently shown atypical EP as well as poor social interactions. Available reintegration programs aim to facilitate the re-adaptation of ex-combatants to their communities. However, they do not incorporate actions to improve EP and to enhance cognitive-emotional regulation. The present study was aimed at evaluating the usefulness of an intervention focused on Social Cognitive Training (SCT), which was designed to equip ex-combatants enrolled in the Social Reintegration Route with EP and social cognition skills. A group of 31 ex-combatants (mean age of 37.2, 29 men) from Colombian illegal armed groups were recruited into this study. Of these, 16 were invited to take part in a SCT and the other continued with the conventional reintegration intervention. Both groups underwent 12 training sessions in a period 12–14 weeks. They were assessed with a comprehensive protocol which included Psychosocial, Behavioral, and Emotion Processing instruments. The scores on these instruments prior to and after the intervention were compared within and between groups. Both groups were matched at baseline. Ex-combatants receiving the SCT experienced significant improvements in EP and a reduction in aggressive attitudes, effects not observed in those continuing the conventional reintegration intervention. This is the first study that achieves such outcomes in such a population using SCT intervention. We discuss the implications of such results toward better social reintegration strategies.

[Psychiatric, Cognitive and Emotional Profile in Ex-combatants of Illegal Armed Groups in Colombia]

INTRODUCTION

Exposure to armed conflict produces biological adaptations oriented to handle the highly stressful conditions in war environments. The special features of The Colombian armed create a special scenario to evaluate the human behavior.

OBJECTIVE

In this study, psychiatric, cognitive and emotional processing characteristics of a group of Colombian armed illegal forces of ex-combatants are described.

METHODS

Sixty-three ex combatants and 22 controls were assessed with WAIS (IQ), INECO frontal screening (executive functions), Interpersonal Reactivity Index (empathy), emotional features recognition and MINI (psychiatric profile).

RESULTS

When compared to the control group, ex-combatants showed higher frequency of antisocial personality disorder (P=.031) and behavioral dissocial disorder (P=.017). In cognitive profile, the ex-combatants showed a lower score in the executive function test (Me=18.50; RQ=4.00), control (Me=23.00; RQ=5.25), with a poor personal distress in emphatic profile (Me=10.00; RQ=5.00) compared to control group (Me=37.00; RQ=7.25).

CONCLUSIONS

We found differences in cognitive and psychiatric profile in ex-combatants in comparison with controls.