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Çetin S, Gedikbaş M, Gedikbaş ŞS. Evaluation of foreign national cases applied to Tokat Gaziosmanpasa University Hospital Forensic Medicine Department, 2014-2022. Int J Legal Med 2024; 138:2015-2020. [PMID: 38775815 PMCID: PMC11306730 DOI: 10.1007/s00414-024-03246-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/27/2024] [Indexed: 08/09/2024]
Abstract
INTRODUCTION/AIM Turkey has experienced a heavy migration burden in recent years due to its location and benevolent policies. This study aimed to retrospectively examine and discuss the reports prepared for foreign nationals who requested assistance at the Forensic Medicine Department of Tokat Gaziosmanpaşa University Hospital in Tokat, which is located in the Middle Black Sea Region of Turkey, between 2014 and 2022. MATERIALS AND METHODS This study retrospectively evaluated reports prepared between 2014 and 2022 in the outpatient clinics of Forensic Medicine at Tokat Gaziosmanpaşa University Hospital. RESULTS Based on the files reviewed, 219 cases were included in the study, of which 70.8% (n = 155) were male and 29.2% (n = 64) were female. Among the 75 cases referred by judicial authorities, 34.6% (n = 26) involved assault, 28% (n = 21) involved determination of the ability to understand the legal significance and consequences of the act, 16% (n = 12) involved traffic accidents, 8% (n = 6) involved poisoning, 9.3% (n = 7) involved abuse, and 4% (n = 3) involved age determinations. DISCUSSION Problems with immigrants, which have always been a reality due to Turkey's location on migration routes, have increased significantly in recent years. For this reason, we believe that studies with multicenter and larger series should be conducted to determine the current situation that foreigners create for themselves and Turkey to facilitate necessary arrangements, determine proposed solutions, increase the quality of services offered, and develop plans for the future.
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Affiliation(s)
- Selçuk Çetin
- Department of Forensic Medicine, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkiye, Turkey.
| | - Mete Gedikbaş
- Department of Orthopedics and Traumatology, Turhal State Hospital, Tokat, Turkiye, Turkey
| | - Şule Sinem Gedikbaş
- Department of Forensic Medicine, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkiye, Turkey
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Prod'hom D, Rosselet Amoussou J, Plessen KJ, Cuissart de Grelle N, Gaultier S. Adaptative Skills and Global Functioning of Unaccompanied Migrant Minors in Europe: A Systematised Review. Int J Public Health 2024; 69:1606625. [PMID: 38988503 PMCID: PMC11233468 DOI: 10.3389/ijph.2024.1606625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 06/10/2024] [Indexed: 07/12/2024] Open
Abstract
Objectives This systematised review aimed to examine European literature reporting data about adaptative skills and global external functioning of unaccompanied minors (UAMs). Methods We conducted a systematised screening of four databases (APA PsycINFO Ovid, Medline Ovid ALL, Embase.com and Web Of Science Core Collection) using a research strategy including social, scholarly and behavioural abilities as well as externalising problems associated with the target population of UAMs. Thirty articles were included using pre-defined inclusion and exclusion criteria. Results Our review showed that despite high levels of internalising disorders, socio-behavioural and educational adjustment of UAMs remained positive. It demonstrated how this population displays a strong desire for academic success and prosocial behaviours instead of aggressivity in everyday life. Nevertheless, our review drew attention to the strong tendency of UAMs to internalise their disorders and display chronic distress and problematic behaviours which increased with time spent in the host country. Conclusion Our study draws attention to the risk of underestimating the real mental health needs of refugees, due to preserved external functioning combined with significant settlement pressures.
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Affiliation(s)
- Dimitri Prod'hom
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | | | - Kerstin Jessica Plessen
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Division of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Sydney Gaultier
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Division of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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3
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Oberg C, Sharma H. Post-Traumatic Stress Disorder in Unaccompanied Refugee Minors: Prevalence, Contributing and Protective Factors, and Effective Interventions: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:941. [PMID: 37371174 DOI: 10.3390/children10060941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
In 2021, there were close to 37 million children displaced worldwide. There were 13.7 million refugees and an additional 22.8 million internally displaced. In Europe, this included 23,255 unaccompanied minors seeking asylum, up 72% compared with 2020 (13,550). The objective was to review the current literature regarding PTSD in unaccompanied refugee minors (URM). The authors searched Ovid Medline, Embase, and Cochrane Library from 1 January 2008 through 15 January 2019. Thirty full texts were chosen that specifically studied unaccompanied refugee minors (URM). The results showed that URM had a prevalence of post-traumatic stress disorder (PTSD of 17-85% across the studies reviewed. There were numerous factors that contributed to PTSD, including cumulative stress and trauma, guilt, shame, and uncertainty about legal status. Protective factors included resilience, a trusted mentor, belonging to a social network, religion, having an adult mentor, and having a family (even if far away). Immigrant youth can thrive most easily in multiculturally affirming countries. Five interventions demonstrated effectiveness, comprising trauma-focused cognitive behavioral therapy (TF-CBT); "Mein Weg", a TF-CBT combined with a group-processing mixed therapy approach; teaching recovery techniques (TRT), narrative exposure therapy for children (KIDNET), and expressive arts intervention (EXIT). The significant mental health conditions include depression, anxiety, internalizing and externalizing behaviors, and frequently PTSD. It is fair to conclude that the high levels of mental health problems experienced in URM are due to exposure to traumatic experiences, separation from parents, and lack of social support.
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Affiliation(s)
- Charles Oberg
- Global Pediatrics Program, Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Hayley Sharma
- Department of Internal Medicine and Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Zaverdinou E, Katimertzi M, Chrousos GP, Darviri C, Vlachakis D, Kanaka-Gantenbein C, Bacopoulou F. Post-traumatic Stress Disorder as a Risk Factor for the Development of Risky Behavior Among Adolescent Offenders: A Systematic Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:119-129. [PMID: 37581786 DOI: 10.1007/978-3-031-31986-0_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
The purpose of this research study was to obtain greater insight into the associations of post-traumatic stress disorder (PTSD) and trauma-exposed experiences with the development of offending behavior in adolescents. Using the PubMed and Scopus databases, we performed a systematic review of recent cross-sectional studies between 2016 and 2022, investigating the associations of PTSD and trauma with the social and mental behavior of adolescents. Fifty-three articles were initially identified. Due to duplication, eight articles were excluded, leaving 45 remaining articles. In addition, 34 articles were excluded due to year of publication, review, abstract, or irrelevant title. Seven articles were included in this systematic review after excluding the remaining due to different study types or samples. Included studies primarily examined the associations of PTSD symptomatology and expression of externalizing symptoms with risky behavior and the commission of a crime. The strongest outcomes were increased levels of violent behavior, violent delinquency, and total risk in correlation with PTSD symptoms, emotional numbing, use of drugs, and in some cases maltreatment. The results of the systematic review suggest that PTSD symptoms and risky behavior, which can be also fueled by maltreatment activities in the family circle, are associated with criminal behavior. Future research is needed to confirm these findings.
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Affiliation(s)
- Eleni Zaverdinou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Katimertzi
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair in Adolescent Health Care, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Darviri
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, School of Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, School of Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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5
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Grillo L. A Possible Anti-anxiety Effect of Appetitive Aggression and a Possible Link to the Work of Donald Winnicott. Scand J Child Adolesc Psychiatr Psychol 2022; 10:102-113. [PMID: 36133733 PMCID: PMC9454322 DOI: 10.2478/sjcapp-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Various pleasant sensations that give a particularly intense pleasure are able to improve anxiety. In the present study I consider the possibility that their anti-anxiety action depends on the strong pleasure they provide, and I propose a possible mechanism of this action. According to some studies, also appetitive aggression (an aggression that provokes a strong pleasure and that is performed only for the pleasure it provides) can improve anxiety, and in this article I consider the possibility that the pleasure of appetitive aggression is able to reduce anxiety by the same mechanism I have proposed for other intense pleasurable sensations. The aggression performed by a child against the mother or against a substitute for the mother in the first period of life (a period in which this aggression is not dangerous) is a recurring theme throughout the work of of Donald Winnicott. Winnicott stresses that this aggression is necessary for the normal development of the child, and that the child must be free to practise it. According to Winnicott, this aggression is highly pleasurable and is not a response to unpleasant or hostile external situations. For these characteristics it seems to correspond to appetitive aggression in the adult that has been found to be able to reduce anxiety. Consequently, aggression performed by the child in the first period of life may also relieve anxiety, in the same way that appetitive aggression helps against anxiety in the adult. In his writings, Winnicott returns several times to an unthinkable or archaic anxiety that children experience when they feel abandoned by their mother for a period that is too long for them, and all children, according to Winnicott, live on the brink of this anxiety. In this study I propose the hypothesis that aggression in the early period of life may be necessary for children because the intense pleasure it provides may help them against this continuously impending anxiety.
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Affiliation(s)
- Luigi Grillo
- San Giorgio su Legnano via Ragazzi del 99Milano MI, Italy
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Höhne E, van der Meer AS, Kamp-Becker I, Christiansen H. A systematic review of risk and protective factors of mental health in unaccompanied minor refugees. Eur Child Adolesc Psychiatry 2022; 31:1-15. [PMID: 33169230 PMCID: PMC9343263 DOI: 10.1007/s00787-020-01678-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/25/2020] [Indexed: 11/28/2022]
Abstract
In recent years, there has been a rising interest in the mental health of unaccompanied minor refugees (UMR), who are a high-risk group for mental disorders. Especially the investigation of predictive factors of the mental health of young refugees has received increasing attention. However, there has been no review on this current issue for the specific group of UMR so far. We aimed to summarize and evaluate the existing findings of specific risk and protective factors to identify the most verified influences on the mental health of UMR. Therefore, we conducted a systematic literature search. Study designs were limited to quantitative cross-sectional and longitudinal designs. Eight databases were searched in four different languages and article reference lists of relevant papers were screened. 27 studies were included (N = 4753). Qualitative synthesis revealed the number of stressful life events to be the most evaluated and verified risk factor for mental health of UMR. A stable environment and social support, on the other hand, can protect UMR from developing poor mental health. Besides that, several other influencing factors could be pointed out, such as type of accommodation, family contact, gender and cultural competences. Because of the large heterogeneity of outcome measures, quantitative synthesis was not possible. This review helps to improve our understanding of determinants of UMRs mental health and thus to provide more targeted treatment. Furthermore, it provides information on how to prevent the development of mental health problems by specifying factors that can be modified by different health and immigration sectors in advance. Further research is needed focusing on the interaction between the various predictive factors.
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Affiliation(s)
- Edgar Höhne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Human Medicine, Philipps-University Marburg, Schützenstraße 49, 35039, Marburg, Germany.
| | - Anna Swantje van der Meer
- Department of Clinical Child and Adolescent Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstraße 18, 35037 Marburg, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Human Medicine, Philipps-University Marburg, Schützenstraße 49, 35039 Marburg, Germany
| | - Hanna Christiansen
- Department of Clinical Child and Adolescent Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstraße 18, 35037 Marburg, Germany
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Höhne E, Banaschewski T, Bajbouj M, Böge K, Sukale T, Kamp-Becker I. Prevalences of mental distress and its associated factors in unaccompanied refugee minors in Germany. Eur Child Adolesc Psychiatry 2021:10.1007/s00787-021-01926-z. [PMID: 34919189 DOI: 10.1007/s00787-021-01926-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/05/2021] [Indexed: 11/28/2022]
Abstract
Prevalences for mental disorders within minor refugees are comparatively high and heterogeneous. To reduce heterogeneity and identify high-risk subgroups, we compared unaccompanied refugee minors (URM) to accompanied refugee minors (ARM) regarding depressive symptoms and mental distress. Furthermore, we examined associative factors of mental distress in URM on a broad scale. We conducted a survey with a cross-sectional design in four German University hospitals. The sample consisted of n = 172 URM and n = 52 ARM aged 14-21. Depressive symptoms were assessed via the Patient Health Questionnaire (PHQ-9). Mental distress was assessed by the Refugee Health Screener (RHS-15). Mann-Whitney test was used to examine differences between URM and ARM. Associated factors of mental distress were evaluated via a stepwise multiple regression analysis. URM showed significantly higher mean scores for PHQ-9 (p < .001) and RHS-15 (p < .001) compared to ARM indicating medium effect sizes. Furthermore, URM were significantly more likely to surpass the cut-off for depression (61.6% vs. 30.8%) and overall mental distress (81.4% vs. 53.8%) compared to ARM. The factors Number of stressful life events (SLE), Female gender, and Fear of deportation were found to be associated with an increased mental distress in URM, whereas Weekly contact to a family member, School attendance, and German language skills were accompanied with lower distress scores. All six factors accounted for 32% of the variance of mental distress in URM (p < .001). Within minor refugees, URM are a highly vulnerable subgroup, which should receive particular attention and more targeted measures by health authorities. Our results indicate that these measures should comprise a rapid promotion of family contact, school attendance, language acquisition, and the fast processing of asylum applications. However, the cross-sectional design limits the interpretability of the results.
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Affiliation(s)
- E Höhne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Human Medicine, University Hospital of Marburg and Philipps-University Marburg, Marburg, Germany.
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - M Bajbouj
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - K Böge
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - T Sukale
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - I Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Human Medicine, University Hospital of Marburg and Philipps-University Marburg, Marburg, Germany
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8
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Inofuentes RA, Fuente LDL, Ortega E, García-García J. Victimización y Problemas de Conducta Externalizante y Antisocial en Menores Extranjeros no Acompañados en Europa: Revisión Sistemática. ANUARIO DE PSICOLOGÍA JURÍDICA 2021. [DOI: 10.5093/apj2021a24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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9
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Inofuentes RA, Fuente LDL, Ortega E, García-García J. Victimización y Problemas de Conducta Externalizante y Antisocial en Menores Extranjeros no Acompañados en Europa: Revisión Sistemática. ANUARIO DE PSICOLOGÍA JURÍDICA 2021. [DOI: 10.5093/apj2021a27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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10
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Scharpf F, Mkinga G, Masath FB, Hecker T. A socio-ecological analysis of risk, protective and promotive factors for the mental health of Burundian refugee children living in refugee camps. Eur Child Adolesc Psychiatry 2021; 30:1651-1662. [PMID: 32959157 PMCID: PMC8505296 DOI: 10.1007/s00787-020-01649-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/13/2020] [Indexed: 11/30/2022]
Abstract
Children and adolescents' mental health risk and resilience arise from a complex interplay of factors on several socio-ecological levels. However, little is known about the factors that shape the mental health of refugee youth living in refugee camps close to ongoing conflict. We conducted a cross-sectional study with a representative sample of 217 Burundian refugee children aged 7-15 and their mothers residing in refugee camps in Tanzania to investigate associations between risk, protective and promotive factors from various ecological levels (individual, microsystem, exosystem), and children's post-traumatic stress disorder (PTSD) symptoms, internalizing and externalizing problems, and prosocial behavior. Data were collected using structured clinical interviews and analyzed using multiple regression models. Exposure to violence across all contexts and engagement coping were risk factors for PTSD symptoms and internalizing problems, while only violence by mothers seemed to increase children's vulnerability for externalizing problems. A differential impact of violence exposures on prosocial behavior was observed. Higher-quality friendships appeared to protect youth from PTSD symptoms and externalizing problems, while they also promoted children's prosocial behavior, just as mothers' social support networks. Prevention and intervention approaches should integrate risk, protective and promotive factors for refugee youth's mental health across multiple ecological contexts and take into account context-specific and adaptive responses to war and displacement.
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Affiliation(s)
- Florian Scharpf
- Department of Psychology, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany.
| | - Getrude Mkinga
- Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, Dar es Salaam, Tanzania
| | - Faustine Bwire Masath
- Department of Psychology, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany
- Vivo International, Konstanz, Germany
| | - Tobias Hecker
- Department of Psychology, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany
- Department of Psychology, University of Zurich, Zurich, Switzerland
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11
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Di Pietro ML, Zaçe D, Sisti LG, Frisicale EM, Corsaro A, Gentili A, Giraldi L, Bruno S, Boccia S. Development and validation of a questionnaire to assess Unaccompanied Migrant Minors' needs (AEGIS-Q). Eur J Public Health 2021; 31:313-320. [PMID: 33176357 DOI: 10.1093/eurpub/ckaa184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While many studies focus on specific aspects of Unaccompanied Migrant Minors' (UMMs) health, especially mental well-being, there is a lack of tools comprehensively assessing their needs. To fill this gap, we developed and validated a questionnaire to thoroughly assess unAccompaniEd miGrant mInorS' physical, psychological, legal, spiritual, social and educational needs (AEGIS-Q). METHODS This work consisted of three stages. The first one involved an extensive literature review. Given the results of the review, a first draft of the questionnaire was developed and submitted to a panel of experts for validation (Delphi method-second stage). During the third stage, the final version of the questionnaire was pilot-tested in a sample of 18 UMMs. RESULTS The questionnaire, drafted based on the results of the review, consisted of sections covering personal data, migration profile, physical health needs and access to healthcare, psychological needs, legal needs, spiritual needs and educational and social needs of UMMs. After two Delphi rounds, the final version of the questionnaire, consisting of 83 questions, was structured. The pilot study had a response rate of 89-100%. We found substantial reliability for most of the sections in the questionnaire, including physical health (α=0.652), legal (α=0.781), and educational and social (α=0.614) needs. The questions regarding psychological needs had very high reliability (α=0.860). CONCLUSIONS The questionnaire offers a useful sharable tool to assess and monitor UMMs' needs, helping the reception system to better know and meet their needs and implement the taking in charge.
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Affiliation(s)
- Maria Luisa Di Pietro
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Drieda Zaçe
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Leuconoe Grazia Sisti
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Emanuela Maria Frisicale
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.,Azienda Sanitaria Locale (ASL), Roma, Italia
| | | | - Andrea Gentili
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Luca Giraldi
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Stefania Bruno
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Stefania Boccia
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
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12
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Xulu KR, Womersley JS, Sommer J, Hinsberger M, Elbert T, Weierstall R, Kaminer D, Malan-Müller S, Seedat S, Hemmings SMJ. DNA methylation and psychotherapy response in trauma-exposed men with appetitive aggression. Psychiatry Res 2021; 295:113608. [PMID: 33290938 DOI: 10.1016/j.psychres.2020.113608] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
Exposure to violence can lead to appetitive aggression (AA), the positive feeling and fascination associated with violence, and posttraumatic stress disorder (PTSD), characterised by hyperarousal, reexperience and feelings of ongoing threat. Psychotherapeutic interventions may act via DNA methylation, an environmentally sensitive epigenetic mechanism that can influence gene expression. We investigated epigenetic signatures of psychotherapy for PTSD and AA symptoms in South African men with chronic trauma exposure. Participants were assigned to one of three groups: narrative exposure therapy for forensic offender rehabilitation (FORNET), cognitive behavioural therapy or waiting list control (n = 9-10/group). Participants provided saliva and completed the Appetitive Aggression Scale and PTSD Symptom Severity Index at baseline, 8-month and 16-month follow-up. The relationship, over time, between methylation in 22 gene promoter region sites, symptom scores, and treatment was assessed using linear mixed models. Compared to baseline, PTSD and AA symptom severity were significantly reduced at 8 and 16 months, respectively, in the FORNET group. Increased methylation of genes implicated in dopaminergic neurotransmission (NR4A2) and synaptic plasticity (AUTS2) was associated with reduced PTSD symptom severity in participants receiving FORNET. Analyses across participants revealed a proportional relationship between AA and methylation of TFAM, a gene involved in mitochondrial biosynthesis.
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Affiliation(s)
- Khethelo R Xulu
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Jacqueline S Womersley
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa; South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Jessica Sommer
- Department of Psychology, University of Konstanz, Konstanz, Germany.
| | | | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany.
| | - Roland Weierstall
- Department of Psychology, University of Konstanz, Konstanz, Germany; Clinical Psychology & Psychotherapy, Medical School Hamburg, Hamburg, Germany.
| | - Debbie Kaminer
- Department of Psychology, University of Cape Town, Cape Town, South Africa.
| | - Stefanie Malan-Müller
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa; South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Sian M J Hemmings
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa; South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
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13
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Onu DU, Ifeagwazi CM, Orjiakor CT, Iorfa SK. Adverse childhood experiences and tramadol use in Nigeria: the mediating role of sociosexuality in a predominantly male student sample. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1846805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Charles Tochukwu Orjiakor
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Nigeria
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14
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Park J, Catani C, Hermenau K, Elbert T. Exposure to family and organized violence and associated mental health in north Korean refugee youth compared to south Korean youth. Confl Health 2019; 13:46. [PMID: 31636698 PMCID: PMC6794884 DOI: 10.1186/s13031-019-0230-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 09/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies on populations affected by organized violence have shown elevated levels of family violence against children. This form of violence has been found to contribute to children's psychopathology independently of traumatic experiences related to war, persecution or flight. Little is known, so far, about the exposure to family violence and its relation to mental health in North Korean refugee youth affected by political violence. The aim of this study was to examine the amount of organized and family violence and associated psychopathology in a sample of North Korean refugee youth living in South Korea compared to their South Korean peers. METHODS Sixty-five North Korean refugee youth and 65 South Korean youth were recruited. Trained researchers conducted the survey in group meetings of five to ten participants. Using questionnaires researchers assessed traumatic experiences, family and organized violence, PTSD symptoms, depressive symptoms and other mental health problems. RESULTS Higher rates of violence and trauma, and higher levels of mental health problems were found in the North Korean sample compared to the South Korean sample. Linear regression analyses including the various types of trauma as potential predictors showed that the severity of PTSD and depressive symptoms in the North Korean sample were associated with the amount of traumatic events and family violence but not with higher levels of organized violence. CONCLUSIONS The findings suggest that in a context of organized violence, abusive experiences by family members constitute an important problem that is strongly linked to the psychopathology of adolescents. Our data suggest that psychological treatment and prevention approaches for North Korean refugees should be carefully tailored to fit the specific requirements of this population and address the mental health of the individual as well as potential problems at the family level.
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Affiliation(s)
- Jinme Park
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Claudia Catani
- Department of Psychology, Clinical Psychology and Psychotherapy Unit, University of Bielefeld, Postbox 100131, 33501 Bielefeld, Germany
| | | | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany
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15
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Franke I, Döringer S, Streb J, Nigel S, Klein V, Huber S, Pollatos O, Dudeck M. [The impact of religiousness on the attitude towards aggression and on aggressive behavior in a forensic-psychiatric inpatient sample]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2019; 89:91-96. [PMID: 31261411 DOI: 10.1055/a-0897-3877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM OF STUDY According to previous research, religiousness might have a positive effect on the risk of delinquent behavior. This study aims to examine this correlation in a forensic-psychiatric inpatient sample. Furthermore, it compares self-reported aggression with the individuals' criminal history of violent offending. METHOD The study sample consisted of 84 forensic patients in mandatory drug treatment according to section 64 of the German Penal Code. Religiousness and attitude towards aggressive behavior were assessed by self-report. The participants' criminal history was screened for violent offences. RESULTS In the male forensic-psychiatric inpatient sample, higher levels of religiousness correlated negatively with the attitude towards appetitive aggression, but not with aggressive behavior. In the female sample, no significant correlation was found. CONCLUSION We found a gender difference regarding the correlation of religiousness with the attitude towards aggression. Additionally, our results indicated a discrepancy between self-report of aggression and actual behavior in the sample of forensic-psychiatric inpatients. This might be explained by cognitive distortions, poor self-perception, or planning deficits.
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Affiliation(s)
- Irina Franke
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg; Psychiatrische Dienste Graubünden, Forensische Psychiatrie
| | - Sabine Döringer
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | - Judith Streb
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | - Stefanie Nigel
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | - Verena Klein
- kbo-Isar-Amper-Klinikum Taufkirchen (Vils), Klinik für Forensische Psychiatrie
| | - Stefan Huber
- Universität Bern, Institut für Praktische Theologie
| | - Olga Pollatos
- Universität Ulm, Institut für Psychologie und Pädagogik
| | - Manuela Dudeck
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
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16
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Winningham RD, Banks DE, Buetlich MR, Aalsma MC, Zapolski TCB. Substance use disorder and posttraumatic stress disorder symptomology on behavioral outcomes among juvenile justice youth. Am J Addict 2018; 28:29-35. [PMID: 30576034 DOI: 10.1111/ajad.12831] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 11/11/2018] [Accepted: 11/17/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Substance use behaviors have been identified as a risk factor that places juveniles at greater risk for engaging in delinquent behaviors and continual contact with the juvenile justice system. Currently, there is lack of research that explores comorbid factors associated with substance use, such as post-traumatic stress disorder (PTSD) symptoms, that could help identify youth who are at greatest risk. The aim of the present study was to examine if PTSD symptomology moderated the relationship between substance use disorder (SUD) symptoms and externalizing behaviors and commission of a violent crime; hypothesizing that risk would be heightened among youth with elevated SUD and PTSD symptomology compared to those with elevated SUD symptoms but lower PTSD symptoms. METHOD The study included 194 predominantly male (78.4%), non-White (74.2%) juvenile justice youth between the ages of 9-18 (M = 15.36). Youth provided responses to assess PTSD symptoms, SUD symptoms, and externalizing behaviors. Commission of a violent crime was based on parole officer report. RESULTS Findings indicated that SUD symptomology was associated with greater externalizing behaviors at high levels of PTSD symptomology. At low levels of PTSD symptomology, SUD symptoms were inversely associated with externalizing behaviors. An interactive relationship was not observed for commission of violent crimes. CONCLUSIONS Findings suggest that the association between SUD symptoms and externalizing behaviors among juvenile offenders may be best explained by the presence of PTSD symptomology. SCIENTIFIC SIGNIFICANCE Addressing PTSD rather than SUD symptoms may be a better target for reducing risk for externalizing behaviors among this population of youth (Am J Addict 2019;28:29-35).
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Affiliation(s)
| | - Devin E Banks
- Department of Psychology, Indiana University-Purdue University, Indianapolis, Indiana
| | - Marcy R Buetlich
- Department of Psychological Science, Ball State University, Muncie, Indiana
| | - Matthew C Aalsma
- School of Medicine-Pediatrics, Indiana University, Bloomington, Indiana
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University-Purdue University, Indianapolis, Indiana
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Schauer M, Robjant K. Commentary on Scheidell et al. (2018): En-counting adversities; the 'building blocks' of psychopathology. Addiction 2018; 113:57-58. [PMID: 29226536 DOI: 10.1111/add.14067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Maggie Schauer
- Center of Excellence for Psychotraumatology, University of Konstanz, Konstanz, Germany.,vivo international e.V., Konstanz, Germany
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18
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Augsburger M, Elbert T. When do traumatic experiences alter risk-taking behavior? A machine learning analysis of reports from refugees. PLoS One 2017; 12:e0177617. [PMID: 28498865 PMCID: PMC5428957 DOI: 10.1371/journal.pone.0177617] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 04/28/2017] [Indexed: 11/19/2022] Open
Abstract
Exposure to traumatic stressors and subsequent trauma-related mental changes may alter a person's risk-taking behavior. It is unclear whether this relationship depends on the specific types of traumatic experiences. Moreover, the association has never been tested in displaced individuals with substantial levels of traumatic experiences. The present study assessed risk-taking behavior in 56 displaced individuals by means of the balloon analogue risk task (BART). Exposure to traumatic events, symptoms of posttraumatic stress disorder and depression were assessed by means of semi-structured interviews. Using a novel statistical approach (stochastic gradient boosting machines), we analyzed predictors of risk-taking behavior. Exposure to organized violence was associated with less risk-taking, as indicated by fewer adjusted pumps in the BART, as was the reported experience of physical abuse and neglect, emotional abuse, and peer violence in childhood. However, civil traumatic stressors, as well as other events during childhood were associated with lower risk taking. This suggests that the association between global risk-taking behavior and exposure to traumatic stress depends on the particular type of the stressors that have been experienced.
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Affiliation(s)
- Mareike Augsburger
- Department of Psychology, University of Konstanz, Konstanz, Germany
- NGO vivo international e.V., Allensbach, Germany
- Department of Psychology, University of Zurich, Zurich, Switzerland
- * E-mail:
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany
- NGO vivo international e.V., Allensbach, Germany
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Plener PL, Groschwitz RC, Brähler E, Sukale T, Fegert JM. Unaccompanied refugee minors in Germany: attitudes of the general population towards a vulnerable group. Eur Child Adolesc Psychiatry 2017; 26:733-742. [PMID: 28074291 PMCID: PMC5446565 DOI: 10.1007/s00787-017-0943-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/05/2017] [Indexed: 11/25/2022]
Abstract
Germany saw an increase in numbers of refugees in 2015, with nearly a third being below the age of 18. Unaccompanied refugee minors (URMs) present an especially vulnerable group. In addition to pre-flight and flight stress, the acculturation process can work as potential stressor, and we wanted to explore attitudes towards URM. We conducted a study in a representative sample (n = 2524) of the German population (ages 14 years or older) between January and March 2016. Only 22.8% of participants thought that Germany could accompany more URM. While few participants argued in support of immediate deportation of URM in general (38.6%) or of URM from the Middle East (35.3%), a majority advocated for immediate deportations of URM from the Balkan region (62%) or from Africa (51.1%). Difference in the variance regarding attitudes towards deportation was explained mostly by right-wing political attitudes as well as by islamophobic attitudes and general rejection of asylum seekers. High rates of approval were found for guaranteeing the same chances to schooling or apprenticeship for URM as to German children and for bestowing URM a right to permanent residence if they were able to complete school or apprenticeship. Education and qualification are key to integration. Studies about needs and wishes of URM consistently report a high motivation to learn the language of their new host country and attend school. At this point, hopes of URM and expectations of society meet, which underlines the importance of participation in education as key factor in integration.
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Affiliation(s)
- Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075, Ulm, Germany.
| | - Rebecca C Groschwitz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075, Ulm, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University Leipzig, Leipzig, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thorsten Sukale
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075, Ulm, Germany
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20
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Affiliation(s)
- Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences, University of Macau, Macau (SAR), People's Republic of China.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; ;
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, Arq Psychotrauma Expert Group, Diemen, The Netherlands
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Hinsberger M, Sommer J, Kaminer D, Holtzhausen L, Weierstall R, Seedat S, Madikane S, Elbert T. Perpetuating the cycle of violence in South African low-income communities: attraction to violence in young men exposed to continuous threat. Eur J Psychotraumatol 2016; 7:29099. [PMID: 26747683 PMCID: PMC4706593 DOI: 10.3402/ejpt.v7.29099] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 12/08/2015] [Accepted: 12/11/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Life in the low-income urban communities of South Africa is imprinted by a cycle of violence in which young males predominantly are in the roles of both victim and perpetrator. There is some evidence that adolescents who show an attraction to cruelty can display high levels of psychosocial functioning despite the presence of posttraumatic stress symptoms. However, the role of appetitive aggression in the context of ongoing threats and daily hassles is not yet fully understood. OBJECTIVE In this study, we examine the role of attraction to violence in areas of continuous traumatic stress exposure and its effect on posttraumatic stress disorder (PTSD) severity and violence perpetration. METHOD A sample of 290 young males from two low-income Cape Town communities was surveyed. We assessed appetitive aggression with the Appetitive Aggression Scale (AAS), PTSD symptoms with the PTSD Symptom Scale-Interview, the number of witnessed and self-experienced traumatic event types with an adaptation of the Child Exposure to Community Violence questionnaire, and the number of perpetrated violence event types with an adapted offence checklist from the AAS. RESULTS Appetitive aggression scores were predicted by witnessed as well as self-experienced traumatic events. Higher appetitive aggression scores resulted in higher levels of PTSD severity and perpetrated violence. CONCLUSIONS Young males living in the low-income areas of South Africa may develop an attraction to cruelty in response to exposure to violence. Their willingness to fight in turn can increase the likelihood of continued violent behaviour. In contrast to previous research from postconflict areas, appetitive aggression and engagement in violence do not prevent the development of PTSD, but are instead associated with higher levels of posttraumatic stress. PTSD symptoms such as avoidance and hyperarousal, as well as an attraction to cruelty and thus the willingness to fight, might support survival in areas of ongoing conflict, but at the same time they could fuel the cycle of violence.
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Affiliation(s)
- Martina Hinsberger
- Department of Psychology, University of Konstanz, Reichenau, Konstanz, Germany;
| | - Jessica Sommer
- Department of Psychology, University of Konstanz, Reichenau, Konstanz, Germany
| | - Debra Kaminer
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Leon Holtzhausen
- Department of Social Development, University of Cape Town, Cape Town, South Africa
| | - Roland Weierstall
- Department of Psychology, University of Konstanz, Reichenau, Konstanz, Germany.,Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | | | - Thomas Elbert
- Department of Psychology, University of Konstanz, Reichenau, Konstanz, Germany
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