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 and Trauma

Volumn 22, Issue 8, 2013, Pages 916-934

  Hermenau, Katharin ^a,b   Hecker, Tobias ^a,b   Schaal, Susanne ^a,b   Maedl, Anna ^b   Elbert, Thomas ^a,b  

^a UNIVERSITY OF KONSTANZ   (Germany)

^b Universität Konstanz und Vivo International EV   (Germany)

Author keywords

appetitive aggression; child soldiers; DR Congo; ex combatants; FORNET; integration; NET; PTSD

Indexed keywords

ADOLESCENT; AGGRESSION; APPETITIVE AGGRESSION SCALE; ARMY; ARTICLE; CHILD PSYCHIATRY; COMMUNITY REINTEGRATION; HUMAN; MAJOR CLINICAL STUDY; MALE; NARRATIVE THERAPY; OFFENDER; POSTTRAUMATIC STRESS DISORDER; PSYCHOLOGICAL RATING SCALE; PTSD SYMPTOM SCALE INTERVIEW; SOLDIER; VOCATIONAL EDUCATION;

EID: 84884614798     PISSN: 10926771     EISSN: 1545083X     Source Type: Journal    
DOI: 10.1080/10926771.2013.824057     Document Type: Article

References (41)

1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: Author.
2. Annan, J., Brier, M., & Aryemo, F. (2009). From "rebel" to "returnee": Daily life and reintegration for young soldiers in northern Uganda. Journal of Adolescent Research, 24, 639-667. doi:10.1177/0743558409350499
3. Bartels, S. A., Scott, J. A., Leaning, J., Kelly, J. T., Mukwege, D., Joyce, N. R., & VanRooyen, M. J. (2011). Sexual violence trends between 2004 and 2008 in South Kivu, Democratic Republic of Congo. Prehospital and Disaster Medicine, 26, 408-413. doi:10.1017/S1049023X12000179
4. Betancourt, T. S., Borisova, I. I., Williams, P., Brennan, R. T., Whitfield, T. H., de la Soudiere, M., . . . Gilman, S. E. (2010). Sierra Leone's former child soldiers: A follow-up study of psychosocial adjustment and community reintegration. Child Development, 81, 1077-1095. doi:10.1111/j.1467- 8624.2010.01455.x
5. Betancourt, T. S., Simmons, S., Borisova, I., & Brewer, S. E. (2008). High hopes, grim reality: Reintegration and the education of former child soldiers in Sierra Leone. Comparative Education Review, 52, 565-587. doi:10.1086/591298
6. Boyden, J. (2003). The moral development of child soldiers: What do adults have to fear Peace and Conflict, 9, 343-362. doi:10.1207/ s15327949pac0904-6 (Pubitemid 38673216)
7. Crombach, A., Weierstall, R., Schalinski, I., Hecker, T., Ovuga, E., & Elbert, T. (2013). Social status and the desire to resort violence-Using the example of Uganda's former child soldiers. Journal of Aggression, Maltreatment & Trauma, 22, 559-575. doi:10.1080/10926771.2013.785458
8. Elbert, T., Hermenau, K., Hecker, T., Weierstall, R., & Schauer, M. (2012). FORNET: Behandlung von traumatisierten und nicht-traumatisierten Gewalttätern mittels Narrativer Expositionstherapie [FORNET: Treatment of traumatized and non-traumatized violent offenders using Narrative Exposure Therapy]. In J. Endrass, A. Rossegger, F. Urbaniok, & B. Borchard (Eds.), Interventionen bei Gewalt-und Sexualstraftätern (pp. 255-276). Berlin, Germany: Medizinisch Wissenschaftliche Verlagsgesellschaft.
9. Elbert, T., Rockstroh, B., Kolassa, I.-T., Schauer, M., & Neuner, F. (2006). The influence of organized violence and terror on brain and mind-A co-constructive perspective. In P. Baltes, P. Reuter-Lorenz, & F. Rösler (Eds.), Lifespan development and the brain: The perspective of biocultural co-constructivism (pp. 326-349). Cambridge, England: Cambridge University Press.
10. Elbert, T., Weierstall, R., & Schauer, M. (2010). Fascination violence: On mind and brain of man hunters. European Archives of Psychiatry and Clinical Neuroscience, 260(Suppl.), S100-S105. doi:10.1007/s00406-010-0144-8
11. Ertl, V., Pfeiffer, A., Saile, R., Schauer, E., Elbert, T., & Neuner, F. (2010). Validation of a mental health assessment in an African conflict population. Psychological Assessment, 22, 318-324. doi:10.1037/a0018810
12. Ertl, V., Pfeiffer, A., Schauer, E., Elbert, T., & Neuner, F. (2011). Communityimplemented trauma therapy for former child soldiers in northern Uganda. Journal of the American Medical Association, 306, 503-512. doi:10.1001/jama.2011.1060
13. Foa, E., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459-473. doi:10.1007/BF00974317 (Pubitemid 24208473)
14. Foa, E., & Tolin, D. F. (2000). Comparison of the PTSD Symptom Scale-Interview version and the clinician-administered PTSD scale. Journal of Traumatic Stress, 13, 181-191. doi:10.1023/A:1007781909213 (Pubitemid 30333790)
15. Guy, K. M. (2009a). Child soldiers as zones of violence in the Democratic Republic of Congo: Three cases of medico-legal evidence of torture. Torture: Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture, 19, 137-144. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19920331
16. Guy, K. M. (2009b). The political and cultural background for using child soldiers. Torture: Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture, 19, 132-136. Retrieved from http://www.ncbi.nlm.nih.gov/ pubmed/21334068
17. Hecker, T., Hermenau, K., Maedl, A., Elbert, T., & Schauer, M. (2012). Appetitive aggression in former combatants-Derived from the ongoing conflict in DR Congo. International Journal of Law and Psychiatry, 35, 244-249. doi:10.1016/j.ijlp.2012.02.016
18. Hecker, T., Hermenau, K., Maedl, A., Hinkel, H., Schauer, M., & Elbert, T. (2013). Does perpetrating violence damage mental health Differences between nonabducted and abducted combatants in DR Congo. Journal of Traumatic Stress, 26(1), 142-148. doi:10.1002/jts.21770
19. Hermenau, K., Hecker, T., Maedl, A., Schauer, M., & Elbert, T. (2013). Growing up in armed groups: Trauma and aggression among child soldiers in DR Congo. Manuscript submitted for publication.
20. Hill, K., & Langholtz, H. (2003). Rehabilitation programs for African child soldiers. Peace Review, 15, 279-285. doi:10.1080/1040265032000130869 (Pubitemid 37261303)
21. Hoge, C. W. (2011). Interventions for war-related posttraumatic stress disorder: Meeting veterans where they are. Journal of the American Medical Association, 306, 549-551. doi:10.1001/jama.2011.1096
22. Kalisya, L. M., Justin, P. L., Kimona, C., Nyavandu, K., Eugenie, K. M., Jonathan, K. M. L., Hawkes, M. (2011). Sexual violence toward children and youth in war-torn eastern Democratic Republic of Congo. PloS one, 6(1), e15911. doi:10.1371/journal.pone.0015911
23. Kingma, K. (1997). Demobilization of combatants after civil wars in Africa and their reintegration into civilian life. Policy Science, 30, 151-165. doi:10.1023/A:1004215705156
24. Maclure, R., & Denov, M. (2006). "I didn't want to die so I joined them": Structuration and the process of becoming boy soldiers in Sierra Leone. Terrorism and Political Violence, 18(1), 119-135. doi:10.1080/09546550500384801 (Pubitemid 43204429)
25. Maedl, A., Schauer, E., Odenwald, M., & Elbert, T. (2010). Psychological rehabilitation of excombatants in non-Western, post-conflict settings. In E. Martz (Ed.), Trauma rehabilitation after war and conflict (pp. 177-213). New York, NY: Springer. doi:10.1007/978-1-4419-5722-1
26. Malan, M. (2000). Disarming and demobilising child soldiers: The underlying challenges. African Security Review, 9(5-6), 35-49.doi:10.1080/ 10246029.2000.9628080
27. McMullin, J. (2004). Reintegration of combatants: Were the right lessons learned in Mozambique International Peacekeeping, 11, 625-643. doi:10.1080/1353331042000248704 (Pubitemid 39492283)
28. Medeiros, E. (2007). Integrating mental health into post-conflict rehabilitation: The case of Sierra Leonean and Liberian "child soldiers." Journal of Health Psychology, 12, 498-504. doi:10.1177/ 1359105307076236 (Pubitemid 46550052)
29. Mogapi, N. (2004). Reintegration of soldiers: The missing piece. Intervention, 2, 221-225.
30. Neuner, F., Onyut, P. L., Ertl, V., Odenwald, M., Schauer, E., & Elbert, T. (2008). Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 76, 686-694. doi:10.1037/0022- 006X.76.4.686
31. Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004). A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Journal of Consulting and Clinical Psychology, 72, 579-587. doi:10.1037/0022-006X.72.4.579 (Pubitemid 38988833)
32. Schaal, S., Elbert, T., & Neuner, F. (2009). Narrative exposure therapy versus interpersonal psychotherapy: A pilot randomized controlled trial with Rwandan genocide orphans. Psychotherapy and Psychosomatics, 78, 298-306. doi:10.1159/000229768
33. Schauer, E., & Elbert, T. (2010). The psychological impact of child soldiering. In E. Martz (Ed.), Trauma rehabilitation after war and conflict (pp. 311-360). New York, NY: Springer. doi:10.1007/978-1-4419-5722-1
34. Schauer, M., Neuner, F., & Elbert, T. (2011). Narrative exposure therapy. Göttingen, Germany: Hogrefe & Huber.
35. Stott, K. (2009). Out of sight, out of mind The psychosocial needs of children formerly associated with armed forces: A case study of Save the Children UK's work in Beni and Lubero territories, North Kivu province, Democratic Republic of Congo. International Journal of Health Planning and Management, 24, 52-72.doi:10.1002/hpm.1022
36. Tabachnik, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Allyn & Bacon.
37. Weierstall, R., Banholzer, L., Haer, R., & Elbert, T. (in press). Becoming cruel-Appetitive aggression released by detrimental socialisation in former Congolese soldiers. International Journal of Behavioral Development.
38. Weierstall, R., & Elbert, T. (2011). The Appetitive Aggression Scale-Development of an instrument for the assessment of human's attraction to violence. European Journal of Psychotraumatology, 2, 1-11.doi:10.3402/ejpt.v2i0. 8430
39. Weierstall, R., Schaal, S., Schalinski, I., Dusingizemungu, J.-P., & Elbert, T. (2011). The thrill of being violent as an antidote to posttraumatic stress disorder in Rwandese genocide perpetrators. European Journal of Psychotraumatology, 2, 1-8. doi:10.3402/ejpt.v2i0.6345
40. Weierstall, R., Schalinski, I., Crombach, A., Hecker, T., & Elbert, T. (2012). When combat prevents PTSD symptoms-Results from a survey with former child soldiers in northern Uganda. BMC Psychiatry, 12(41), 1-8. doi:10.1186/1471-244X-12-41
41. Williamson, J. (2006). The disarmament, demobilization and reintegration of child soldiers: Social and psychological transformation in Sierra Leone. Intervention, 4, 185-205. doi:10.1097/WTF.0b013e328011a7fb