When combat prevents PTSD symptoms—results from a survey with former child soldiers in Northern Uganda

Abstract

BackgroundHuman beings from time immemorial have eradicated neighbouring tribes, languages, religions, and cultures. In war and crisis, the cumulative exposure to traumatic stress constitutes a predictor of the development of post traumatic stress disorder (PTSD). However, homicide has evolved as a profitable strategy in man, leading to greater reproductive success. Thus, an evolutionary advantage of perpetrating violence would be eliminated if the exposure to aggressive acts would traumatize the perpetrator. We argue that perpetrating violence could actually ‘immunize’ a person against adverse effects of traumatic stressors, significantly reducing the risk of developing PTSD.MethodsWe surveyed 42 former child soldiers in Northern Uganda that have all been abducted by the Lord Resistance Army (LRA) as well as 41 non-abducted controls.ResultsLinear regression analyses revealed a dose–response effect between the exposure to traumatic events and the Posttraumatic Diagnostic Scale (PDS) sum score. However, the vulnerability to develop trauma related symptoms was reduced in those with higher scores on the Appetitive Aggression Scale (AAS). This effect was more pronounced in the formerly abducted group.ConclusionsWe conclude that attraction to aggression when being exposed to the victim’s struggling can lead to a substantial risk-reduction for developing PTSD.

Posttraumatic Stress Disorder and Appetitive Aggression in Rwandan Genocide Perpetrators

“…Evidence on this relationship between trauma exposure and appetitive aggression has been reported by other researchers Weierstall et al, , 2012. It is possible that negative feelings like hatred, anger, and the desire to take revenge resulting from self-experienced traumatic events could play a role in this process.…”

“…Thus, it is not solely the instrumental gain that drives aggression, but aiming for an intrinsic reward. A number of recent studies have investigated appetitive aggression in Rwandan genocide prisoners (Weierstall, Schaal, Schalinski, Dusingizemungu, & Elbert, 2011), former Congolese combatants (Hecker, Hermenau, Maedl, Elbert, & Schauer, 2012), and child soldiers from Uganda (Weierstall, Schalinski, Crombach, Hecker, & Elbert, 2012). "We became more and more cruel, more and more calm, more and more bloody" is one of numerous statements of Rwandan genocide perpetrators describing appetitive aggression (Hatzfeld, 2004, p. 50).…”

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

“…Appetitive aggression was assessed with the 15-item AAS , which has been validated with more than 1,600 ex-combatants and former child soldiers and has demonstrated good psychometric properties in comparable samples of former child soldiers and combatants Weierstall et al, 2012). Each item consists of a question regarding the perception of violence or appetitive aggression (e.g., Is it exciting for you if you make an opponent really suffer?…”

Child Soldiering on Myanmar–China Border

“…If a sufficiently large number of former child soldiers are exposed to traumatic stress, it would increase their appetitive aggressions and violent behaviors, even cause a cycle of violence, and another round of a cycle of violence seems inevitable (Weierstall et al 2012;Schauer and Elbert 2010).…”