Becoming cruel in the face of war

161 Pages·2017·2.67 MB·English

by  Mareike Augsburger

Becoming cruel in the face of war -
Sex-specific, individual, and social aspects affecting the
relation between exposure to traumatic stress and aggression

Dissertation
zur Erlangung des akademischen Grades des Doktors
der Naturwissenschaften (Dr. rer. nat)

vorgelegt von
Mareike Augsburger

an der

Mathematisch-Naturwissenschaftliche Sektion
Fachbereich Psychologie

Tag der mündlichen Prüfung: 31.03.2017
1. Referent: Prof. Dr. Thomas Elbert
2. Referent: Prof. Dr. Jérôme Endrass
Konstanzer Online-Publikations-System (KOPS)
URL: http://nbn-resolving.de/urn:nbn:de:bsz:352-0-402550

Acknowledgments
Acknowledgments
I would like to thank all those who have contributed to the success of this dissertation. First of all I
thank my supervisor Thomas Elbert for his helpful advices, unwavering support, and his generosity in
giving me the freedom to realize own projects. I am also grateful to Jérôme Endrass for being the
second referent.

The realization of my PhD projects would not have been possible without the help of a number of
colleagues based in Burundi, Germany, and South Africa. I would like to thank the entire team of the
Centre of Excellence for Psychotraumatology for their crucial assistance: Eva Barnewitz, Katharin
Hermenau, Dorothe Isele, Elisa Kaltenbach, Veronika Müller, Charlotte Salmen, and Johanna Sill,
thank you!! I am also very grateful to Katalin Dohrmann and Maggie Schauer for helpful advices, and
Heike Riedke for organizational support and more.
With respect to the project in Burundi I thank Anselm Crombach, firstly for spending so much time
on complicated logistics and organizational matters during data collection, but also for his
encouraging words whenever I experienced a setback. Thanks to Corina Nandi for the precious time
in Burundi and beyond. My deepest gratitude goes to the entire Burundian team: Manassé Bambonye,
and all students and translators, that is Gina-Alida Gatore, Gynelle Mugisha, Hervé Mugisha, Jean-
Arnaud Muhoza, Landry-Robert Ndaboroheye, Thierry Ndayikengurukiye, Lydia Nitamgaand, Jean-
Baptiste Niyungeko, and Amini-Ahmed Rushoza. You did a great job!
Furthermore, thanks to Martina Hinsberger, Jessica Sommer, and the entire team of REALISTIC for
providing me the opportunity to take part in the South Africa project.
I also wish to thank all former students and student assistants, especially, Daisy Georgii, Clemens
Schweizer, Kwanele Shishane, Sebastian Siehl, Hannah Weiland, and Veronika Wieshammer. I thank
Sarah Klepper for the many inspiring discussions. Danie Meyer-Parlapanis and James Moran, I am
very grateful for your helpful comments regarding language and writing style.
Finally, I would like to thank all those countless valuable persons. Thanks to all friends for providing
emotional support during difficult times. I am particularly grateful to Carmen Agricola, Robert
Gregor, Elisa Helms, Maja Schlichting, my family, and especially my mother who among other
things, looked after the dog whilst I was caught up in work or absent abroad. I am also thankful to my
parents who have always supported my ambitions.
Vielen Dank! Merci beaucoup! Murakoze chan! Thank you! Enkosi!
V
VI
Contents
Contents

SUMMARY ....................................................................................................................................... XIII
ZUSAMMENFASSUNG ................................................................................................................ XVII
RECORD OF ACHIEVEMENT .................................................................................................... XXI
1 INTRODUCTION ........................................................................................................................... 3
1.1 APPETITIVE AGGRESSION .................................................................................................... 3
1.1.1 RELATION TO OTHER TYPES OF AGGRESSION ............................................................................... 5
1.2 FEMALE AGGRESSION ............................................................................................................ 6
1.3 VICTIMIZATION AND POSTTRAUMATIC STRESS DISORDER .................................... 7
1.3.1 AGGRESSION FOLLOWING TRAUMATIC STRESS ........................................................................... 8
1.3.2 ADVERSE CHILDHOOD EXPERIENCES ............................................................................................ 10
1.4 AFFECTING PATHWAYS FROM TRAUMA TO AGGRESSION: IMPULSIVITY ....... 11
1.5 BEYOND AGGRESSION: RISK-TAKING BEHAVIOR ..................................................... 13
1.6 OUTLOOK: SOCIAL ACKNOWLEDGMENT IN THE CYCLE OF VIOLENCE .......... 14
2 RATIONALE FOR THE CURRENT THESIS .......................................................................... 16
2.1 SETTINGS OF POST-WAR AND CRISIS ............................................................................. 17
2.1.1 FRAGILE STATES AND POST-CRISIS REGIONS: THE CASE OF BURUNDI ................................ 17
2.1.2 FLEEING WAR AND TERROR: ASYLUM SEEKERS IN GERMANY .............................................. 18
2.1.3 LIVING UNDER CONTINUOUS STRESS: ADOLESCENTS IN SOUTH AFRICA ........................... 18
3 APPETITIVE AGGRESSION AND ADVERSE CHILDHOOD EXPERIENCES SHAPE
VIOLENT BEHAVIOR IN FEMALES FORMERLY ASSOCIATED WITH COMBAT .......... 19
3.1 ABSTRACT ................................................................................................................................. 19
3.2 INTRODUCTION ...................................................................................................................... 20
3.3 MATERIALS AND METHODS ............................................................................................... 23
3.3.1 PARTICIPANTS ....................................................................................................................................... 23
3.3.2 PROCEDURE ........................................................................................................................................... 24
3.3.3 MEASURES .............................................................................................................................................. 24
3.3.4 DATA ANALYSIS ................................................................................................................................... 26
3.4 RESULTS .................................................................................................................................... 26
3.4.1 GROUP DIFFERENCES IN OUTCOMES RELATED TO TRAUMA AND AGGRESSION .............. 26
3.4.2 PREDICTION OF CURRENT VIOLENT BEHAVIOR .......................................................................... 28
3.5 DISCUSSION .............................................................................................................................. 30
3.6 CONCLUSION ........................................................................................................................... 32
4 APPETITIVE AGGRESSION AND THE SEXES ..................................................................... 33
4.1 SURRENDERING TO THE CALL OF VIOLENCE – SEX-LINKED BIOGRAPHICAL
INFLUENCES ON THE DEVELOPMENT OF APPETITIVE AGGRESSION .......................... 33
4.1.1 ABSTRACT .............................................................................................................................................. 33
4.1.2 BACKGROUND ....................................................................................................................................... 33
4.1.3 METHOD .................................................................................................................................................. 36
4.1.4 RESULTS .................................................................................................................................................. 39
4.1.5 DISCUSSION ............................................................................................................................................ 45
VII
Contents
4.1.6 ACKNOWLEDGMENTS ......................................................................................................................... 47
4.2 HUNTER OR PREY: PREDICTING APPETITIVE AGGRESSION AND PTSD BY
EVENT TYPES. A STUDY WITH WOMEN FROM A POST-CONFLICT REGION ............... 48
4.2.1 ABSTRACT .............................................................................................................................................. 48
4.2.2 INTRODUCTION ..................................................................................................................................... 48
4.2.3 METHOD .................................................................................................................................................. 51
4.2.4 RESULTS .................................................................................................................................................. 54
4.2.5 DISCUSSION ............................................................................................................................................ 56
5 RELATIONS BETWEEN TRAUMATIC STRESS, DIMENSIONS OF IMPULSIVITY,
AND REACTIVE AND APPETITIVE AGGRESSION IN INDIVIDUALS WITH REFUGEE
STATUS ................................................................................................................................................ 58
5.1 ABSTRACT ................................................................................................................................. 58
5.2 BACKGROUND ......................................................................................................................... 59
5.3 METHODS .................................................................................................................................. 62
5.3.1 PROCEDURE ........................................................................................................................................... 62
5.3.2 MEASURES .............................................................................................................................................. 62
5.3.3 PARTICIPANTS ....................................................................................................................................... 64
5.3.4 DATA ANALYSIS ................................................................................................................................... 65
5.4 RESULTS .................................................................................................................................... 66
5.5 DISCUSSION .............................................................................................................................. 71
5.5.1 LIMITATIONS ......................................................................................................................................... 73
5.5.2 CONCLUSION ......................................................................................................................................... 73
5.6 ACKNOWLEDGMENTS .......................................................................................................... 74
6 WHEN DO TRAUMATIC EXPERIENCES ALTER RISK-TAKING BEHAVIOR? A
MACHINE LEARNING ANALYSIS OF REPORTS FROM REFUGEES .................................. 75
6.1 ABSTRACT ................................................................................................................................. 75
6.2 BACKGROUND ......................................................................................................................... 75
6.3 METHOD .................................................................................................................................... 78
6.3.1 PROCEDURE ........................................................................................................................................... 78
6.3.2 MEASURES .............................................................................................................................................. 79
6.3.3 PARTICIPANTS ....................................................................................................................................... 81
6.3.4 DATA ANALYSIS ................................................................................................................................... 81
6.4 RESULTS .................................................................................................................................... 82
6.4.1 BIVARIATE ASSOCIATIONS BETWEEN VARIABLES .................................................................... 83
6.4.2 STOCHASTIC GRADIENT BOOSTING MACHINE ............................................................................ 83
6.5 DISCUSSION .............................................................................................................................. 85
6.5.1 LIMITATIONS ......................................................................................................................................... 87
6.5.2 CONCLUSION ......................................................................................................................................... 87
6.6 ACKNOWLEDGMENTS .......................................................................................................... 87
7 ASSOCIATIONS BETWEEN SOCIETAL DISAPPROVAL AND CHANGES IN
SYMPTOMS OF PTSD AND APPETITIVE AGGRESSION FOLLOWING TREATMENT
AMONG HIGH-RISK SOUTH AFRICAN MALES ....................................................................... 88
7.1 ABSTRACT ................................................................................................................................. 88
7.2 BACKGROUND ......................................................................................................................... 89
7.2.1 OBJECTIVE .............................................................................................................................................. 91
7.3 METHOD .................................................................................................................................... 92
VIII
Contents
7.3.1 PARTICIPANTS AND STUDY DESIGN ............................................................................................... 92
7.3.2 MATERIALS ............................................................................................................................................ 92
7.3.3 PROCEDURE ........................................................................................................................................... 94
7.3.4 DATA ANALYSIS ................................................................................................................................... 95
7.4 RESULTS .................................................................................................................................... 95
7.4.1 GROUP COMPARISONS AND CORRELATIONS ............................................................................... 95
7.4.2 PATH ANALYSES ................................................................................................................................... 96
7.5 DISCUSSION .............................................................................................................................. 98
7.5.1 CONCLUSIONS ....................................................................................................................................... 99
7.6 ACKNOWLEDGMENTS ........................................................................................................ 100
8 GENERAL DISCUSSION .......................................................................................................... 101
8.1 CONSEQUENCES OF WARFARE FOR MENTAL HEALTH AND AGGRESSIVE
BEHAVIOR IN FEMALES .............................................................................................................. 101
8.2 SEX AND APPETITIVE AGGRESSION .............................................................................. 102
8.3 IMPACT OF IMPULSIVITY FACETS ................................................................................. 103
8.4 ALTERATIONS IN RISK-TAKING BEHAVIOR ............................................................... 104
8.5 OUTLOOK: EFFECTS OF SOCIAL ACKNOWLEDGMENT ......................................... 105
9 IMPLICATIONS ......................................................................................................................... 107
9.1 FUTURE RESEARCH ............................................................................................................. 107
9.2 CLINICAL AND PRACTICAL IMPLICATIONS ............................................................... 109
9.3 CONCLUSION ......................................................................................................................... 111
10 REFERENCES ............................................................................................................................. 113
APPENDICES .................................................................................................................................... 133

IX
Contents
List of tables

Table 3.1.Participant Demographics and military involvement. ........................................................................... 23
Table 3.2. Correlations between outcome variables ............................................................................................. 28
Table 3.3. Multiple Regression Analysis for the prediction of current aggressive behavior. ............................... 29
Table 4.1. Correlation matrix grouped by sex for the overall sample (A) and the combatant sample (B) ........... 41
Table 4.2. Final models predicting appetitive aggression from a sex-linked pathway perspective for the overall
sample (A) and the combatant sample (B) ............................................................................................................ 42
Table 5.1. Descriptive Statistics and Correlations for Childhood Maltreatment, PTSD Symptoms, Aggression
Types, and Impulsivity Dimensions ...................................................................................................................... 68
Table 5.2. Parameter estimates of the structural equation model .......................................................................... 70
Table 7.1. Means, standard deviations (SD) and correlations (Spearman’s rho) between potential predictors and
change in PTSD and appetitive aggression ........................................................................................................... 96

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