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Soldiers may be exposed to traumatic stress during combat deployment and thus are at risk for developing posttraumatic stress disorder (PTSD). Genetic and epigenetic evidence suggests that PTSD is linked to forming stress-related memories. In the current study, we investigated post-deployment associations of PTSD symptoms with differential DNA methylation in a sample of Burundian soldiers returning from the African Union Mission in Somalia's war zone. We used a matched longitudinal study design to explore epigenetic changes associated with PTSD symptoms in N = 191 participants. PTSD symptoms and saliva samples were collected at 1-3 (t1) and 9-14 months (t2) after the return of the soldiers to their home base. Individuals with either worsening or improving PTSD symptoms were matched for age, stressful, traumatic and self-perpetrated events prior to the post-assessment, traumatic and violent experiences between the post- and the follow-up assessment, and violence experienced during childhood. A mixed model analysis was conducted to identify top nominally significantly differentially methylated genes, which were then used to perform a gene enrichment analysis. The linoleic acid metabolism pathway was significantly associated with post-deployment PTSD symptoms, after accounting for multiple comparisons. Linoleic acid has been linked to memory and immune related processes in previous research. Our findings suggest that differential methylation of linoleic acid pathway genes is associated with PTSD and thus may merit closer inspection as a possible mediator of resilience., (© 2024. The Author(s).)

Background: Shame is an emotion reflecting an anticipated social devaluation of the self. It is strongly associated with experiences of humiliation and rejection in early life. Individuals suffering from post-traumatic stress disorder (PTSD) often struggle with shame. However, little is known about how shame contributes to the development and maintenance of PTSD symptoms in children. The present study investigated the ways childhood exposure to human-induced traumatic events promotes a coping mechanism of defeat and withdrawal facilitated by the experience of shame. We tested a dose-response relationship between lifetime experienced traumatic event types and PTSD in children using shame as a mediator., Methods: We conducted semi-structured interviews with 33 male children who lived and worked on the streets of Bujumbura, the capital of Burundi at the time of data collection. We assessed self-reported PTSD symptom severity, lifetime traumatic event load, violence experienced on the streets and shame intensity., Results: Mediation analyses revealed a significant indirect effect of lifetime traumatic events on PTSD symptom severity through shame intensity and a significant indirect effect of violence experienced on the streets on PTSD symptom severity through shame intensity., Conclusion: Our study suggests the mediating role of shame between traumatic experiences as well as violent experiences and PTSD symptom severity in children living on the streets. Shame in children suffering from PTSD seems to play a crucial role in the development and maintenance of PTSD symptoms., (© 2022 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.)

During deployment, soldiers face situations in which they are not only exposed to violence but also have to perpetrate it themselves. This study investigates the role of soldiers' levels of posttraumatic stress disorder (PTSD) symptoms and appetitive aggression, that is, a lust for violence, for their engaging in violence during deployment. Furthermore, factors during deployment influencing the level of PTSD symptoms and appetitive aggression after deployment were examined for a better comprehension of the maintenance of violence. Semi-structured interviews were conducted with 468 Burundian soldiers before and after a 1-year deployment to Somalia. To predict violent acts during deployment (perideployment) as well as appetitive aggression and PTSD symptom severity after deployment (postdeployment), structural equation modeling was utilized. Results showed that the number of violent acts perideployment was predicted by the level of appetitive aggression and by the severity of PTSD hyperarousal symptoms predeployment. In addition to its association with the predeployment level, appetitive aggression postdeployment was predicted by violent acts and trauma exposure perideployment as well as positively associated with unit support. PTSD symptom severity postdeployment was predicted by the severity of PTSD avoidance symptoms predeployment and trauma exposure perideployment, and negatively associated with unit support. This prospective study reveals the importance of appetitive aggression and PTSD hyperarousal symptoms for the engagement in violent acts during deployment, while simultaneously demonstrating how these phenomena may develop in mutually reinforcing cycles in a war setting., (© 2020 The Authors. Aggressive Behavior published by Wiley Periodicals, Inc.)

Objective: Past research revealed war trauma and posttraumatic stress disorder (PTSD) symptoms as potential predictors for domestic and community violence in crisis regions and among soldiers in different armed conflicts. The impact of family violence and other adversities experienced in childhood as well as of a combat-enhanced appeal for aggressive behavior (appetitive aggression) remains to be specified., Method: In the present study, the authors separately predicted violence against children, intimate partner violence and community violence in 381 Burundian soldiers returning from foreign deployment and living in a post- conflict region. Using path analysis, they aimed to disentangle the independent contributions and pathways of the following variables: Exposure to war trauma and childhood familial violence, PTSD and depression symptom severity, and appetitive aggression., Results: Childhood familial violence had an independent effect on all contexts of violence and was the only significant predictor for violence against the soldiers' own children. Intimate partner violence was additionally predicted by depression symptom severity, while community violence was additionally predicted by PTSD symptom severity and appetitive aggression., Conclusions: Besides war-related mental ill-health and appetitive aggression, violent experiences during childhood development must not be overlooked as a factor fueling the cycle of violence in conflict regions. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Appetitive aggression is the attraction to violent behavior, which can peak in the experience of a combat high. In various war and conflict scenarios, members of armed groups have reported developing a desire to hunt and even kill humans. More recently, we reported that the phenomenon has also been observed in female ex-combatants with varying participation in warfare. Despite recent investigations on risk factors for appetitive aggression, sex-specific pathways in the development of appetitive aggression have not yet been delineated. This study investigated moderation effects of sex on previously identified risk factors for appetitive aggression by means of regression analyses in a sample of individuals with varying degrees of warfare participation (overall sample, n = 602). First examining a sample characterized by backgrounds heterogeneous in both sociodemographic data and war experiences, the analysis was then replicated in a subsample of fighters active during the civil war (combatant sample, n = 109). In both samples, regression analyses revealed significant moderation effects of sex. Childhood maltreatment and traumatic events had positive associations on the development of appetitive aggression for males but a negative (childhood maltreatment) or no (traumatic events) association for females. Perpetrated events were more strongly correlated with appetitive aggression for females than for males. This pattern was pronounced for the combatant sample. These results are in favor of sex-linked pathways. In both sexes, appetitive aggression may have evolved as a biologically prepared response to cruel environments but might develop along different trajectories. The current study highlights the need for addressing appetitive aggression in order to support peace-building processes and emphasizes sex specific starting-points.

This study investigated the impact of violent experiences during childhood, posttraumatic stress disorder (PTSD) and appetitive aggression on everyday violent behavior in Burundian females with varying participation in war. Moreover, group differences in trauma-related and aggression variables were expected. Appetitive aggression describes the perception of violence perpetration as fascinating and appealing and is a common phenomenon in former combatants. Semi-structured interviews were conducted with 158 females, either former combatants, supporters of armed forces or civilians during the civil war in Burundi. The PTSD Symptom Scale Interview was used to assess PTSD symptom severity, the Appetitive Aggression Scale to measure appetitive aggression and the Domestic and Community Violence Checklist to assess both childhood maltreatment and recent aggressive behavior. Former combatants had experienced more traumatic events, perpetrated more violence and reported higher levels of appetitive aggression than supporters and civilians. They also suffered more severely from PTSD symptoms than civilians but not than supporters. The groups did not differ regarding childhood maltreatment. Both appetitive aggression and childhood violence predicted ongoing aggressive behavior, whereas the latter outperformed PTSD symptom severity. These findings support current research showing that adverse childhood experiences and a positive attitude toward aggression serve as the basis for aggressive behavior and promote an ongoing cycle of violence in post-conflict regions. Female members of armed groups are in need of demobilization procedures including trauma-related care and interventions addressing appetitive aggression.

Background: During the period between 1993 and 2005, the people of Burundi were trapped within a violent civil war. In post-conflict regions, symptoms of posttraumatic stress disorder (PTSD) were found to be widespread. At the same time, combatants often reported having perceived committing violence as exciting and appealing, an experience referred to as appetitive aggression. Both of these phenomena hamper the building of a functional and peaceful society., Objective: This study aims to investigate the factors that are associated with the level of PTSD and appetitive aggression in former and still active combatants., Methods: Semi-structured interviews were conducted with 948 male Burundians: 556 active soldiers and 392 ex-combatants. PTSD symptom severity was assessed using the PTSD Symptom Scale Interview, while appetitive aggression was assessed using the Appetitive Aggression Scale., Results: Linear regression analyses revealed that the number of traumatic events, childhood maltreatment, and their interaction predicted PTSD symptom severity, whereas self-committed violence did not. The number of traumatic events and self-committed violence were associated with appetitive aggression. Childhood maltreatment alone was not associated with appetitive aggression; however, its interaction with self-committed violence did predict appetitive aggression. When controlling for predictors, ex-combatants reported a higher degree of PTSD symptomatology, whereas active soldiers reported a higher degree of appetitive aggression., Conclusion: We conclude that childhood maltreatment is an additional, significant risk factor that exacerbates the psychological consequences of violent conflicts. Self-committed violence may not necessarily engender trauma-related disorders, but is highly related to appetitive aggression.