Associations between societal disapproval and changes in symptoms of PTSD and appetitive aggression following treatment among high-risk South African males

Asociaciones entre desaprobación social y cambios en síntomas de TEPT y apetencia por la agresión después del tratamiento en hombres sudafricanos de alto riesgo

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European Journal of Psychotraumatology. 2017, 8(1), 1369831. ISSN 2000-8198. eISSN 2000-8066. Available under: doi: 10.1080/20008198.2017.1369831

Zusammenfassung

Background: In violent communities, social rejection as a person with victim–offender attributes is associated with more intense symptoms of posttraumatic stress disorder (PTSD) and a higher propensity towards violence, i.e. appetitive aggression. Successful community reintegration encompassing adequate social acknowledgment of individuals with both a history of violence exposure and perpetration may be necessary to enhance the treatment effects of interventions addressing PTSD and aggression.
Objective: In this study, the effects of treatment and post-treatment traumatic events, violent offenses, and social acknowledgment (with sub-dimensions of general disapproval, family disapproval, and recognition as a person with both a history of violence exposure and commission) on changes in PTSD symptom severity and appetitive aggression from baseline to 8-month follow-up were investigated.
Method: Data were collected from 54 males recruited through a Cape Town offender reintegration programme for an intervention study targeting trauma and aggression (n = 28 treatment; n = 26 wait-list). Changes in PTSD symptom severity after treatment were assessed with the PTSD Symptom Scale-Interview, changes in appetitive aggression with the Appetitive Aggression Scale (AAS), post-treatment traumatic events with an adapted version of the Child’s Exposure to Violence Checklist, offenses with an adapted checklist from the AAS, and social acknowledgment with an adapted form of the Social Acknowledgment Questionnaire. Results: Path analyses revealed negative relationships between ongoing societal disapproval and changes in PTSD symptom severity and appetitive aggression at 8-months, controlling for age. All other variables were non-significant, except for treatment, which was associated with PTSD symptom reduction. Conclusions: As a complementary strategy to effective psychotherapeutic treatment, increased social acknowledgment may contribute significantly to the alleviation of PTSD symptoms and appetitive aggression. Psychological interventions should, therefore, not neglect the impact of societal factors on treatment effects.

Zusammenfassung in einer weiteren Sprache

Planteamiento: En comunidades violentas, el rechazo social como persona con atributos de víctima-agresor se asocia con síntomas más intensos del trastorno por estrés postraumático (TEPT) y una mayor propensión a la violencia, es decir, a la apetencia por la agresión. Puede que sea necesaria una reintegración con éxito en la comunidad –que incluya un adecuado reconocimiento social de aquellos individuos con una historia tanto de exposición a la violencia como de agresión– para mejorar los efectos del tratamiento de las intervenciones que abordan el TEPT y la agresión. Objetivo: En este estudio, se investigaron los efectos del tratamiento y los eventos traumáticos post-tratamiento, los delitos violentos y el reconocimiento social (con subdimensiones de desaprobación general, desaprobación familiar y reconocimiento como persona con antecedentes tanto de exposición a la violencia como de perpetración) sobre los cambios en la gravedad de los síntomas del TEPT y la apetencia por la agresión desde el inicio hasta el seguimiento a los 8 meses.
Método: Se recogieron datos de 54 varones reclutados a través de un programa de reintegración de delincuentes de Ciudad del Cabo para un estudio de intervención dirigido a trauma y agresión (n = 28 tratamiento, n = 26 lista de espera). Se evaluaron los cambios en la gravedad de los síntomas del TEPT después del tratamiento con la Escala-Entrevista de Síntomas de TEPT (PTSD Symptom Scale-Interview), los cambios en la apetencia por la agresión con la Escala de Apetencia por la Agresión (AAS, siglas en ingles de Appetitive Aggression Scale), los eventos traumáticos posteriores al tratamiento con una versión adaptada de la Lista de verificación de exposición a la violencia para niños (Child’s Exposure to Violence Checklist), las agresiones con una lista de verificación adaptada del AAS, y el reconocimiento social con una forma adaptada del Cuestionario de Reconocimiento Social (Social Acknowledgment Questionnaire). Resultados: Los análisis de ruta revelaron relaciones negativas entre la desaprobación social continuada y los cambios en la gravedad de los síntomas del TEPT y la apetencia por la agresión a los 8 meses, controlando la edad. Todas las demás variables no fueron significativas, excepto por el tratamiento, que se asoció con la reducción de los síntomas de TEPT.
Conclusiones: Como estrategia complementaria a un tratamiento psicoterapéutico efectivo, el aumento del reconocimiento social puede contribuir significativamente al alivio de los síntomas del TEPT y la apetencia por la agresión. Por lo tanto, las intervenciones psicológicas no deben descuidar el impacto de los factores sociales sobre los efectos del tratamiento.

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150 Psychologie

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SOMMER, Jessica, Martina HINSBERGER, Leon HOLTZHAUSEN, Debra KAMINER, Soraya SEEDAT, Thomas ELBERT, Mareike AUGSBURGER, Andreas MAERCKER, Roland WEIERSTALL, 2017. Associations between societal disapproval and changes in symptoms of PTSD and appetitive aggression following treatment among high-risk South African males. In: European Journal of Psychotraumatology. 2017, 8(1), 1369831. ISSN 2000-8198. eISSN 2000-8066. Available under: doi: 10.1080/20008198.2017.1369831

BibTex

@article{Sommer2017Assoc-40622,
  year={2017},
  doi={10.1080/20008198.2017.1369831},
  title={Associations between societal disapproval and changes in symptoms of PTSD and appetitive aggression following treatment among high-risk South African males},
  number={1},
  volume={8},
  issn={2000-8198},
  journal={European Journal of Psychotraumatology},
  author={Sommer, Jessica and Hinsberger, Martina and Holtzhausen, Leon and Kaminer, Debra and Seedat, Soraya and Elbert, Thomas and Augsburger, Mareike and Maercker, Andreas and Weierstall, Roland},
  note={Article Number: 1369831}
}

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