The interplay between trauma, substance abuse and appetitive aggression and its relation to criminal activity among high-risk males in South Africa.
BACKGROUND
In persistently unsafe environments, the cumulative exposure to violence predicts not only the development of posttraumatic stress disorder (PTSD), but also of increased aggression and violent outbursts. Substance use disorders interact with these developments, as drug consumption may blunt symptoms and also reduce the threshold for violent acts. Investigating the interplay between these variables and the possible cumulative effect of drug abuse on the attraction to cruelty is a crucial step in understanding the cycle of violence and developing intervention programs that address this cycle in violence-troubled communities such as low-income urban areas in South Africa.


METHODS
Young males at risk (N=290) were recruited through a reintegration center for offenders in Cape Town. We assessed types of traumatic events experienced, PTSD symptom severity, appetitive aggression, committed offenses and patterns of drug abuse prior to the perpetration of violence.


RESULTS
Path-analyses confirmed a positive relationship between exposure to traumatic events and PTSD symptom severity, appetitive aggression, the number of committed offenses and drug abuse prior to violence. PTSD symptoms were positively associated with the propensity toward aggression. Furthermore, more severe drug abuse was related to higher attraction to violence and more committed offenses.


CONCLUSIONS
We conclude that like exposure to violence, drug abuse may play a key role in the attraction to aggression and criminal acts. Measures of violence prevention and psychotherapeutic interventions for trauma-related suffering may not be effective without enduring drug abuse rehabilitation.
['Sommer|Jessica|J|', 'Hinsberger|Martina|M|', 'Elbert|Thomas|T|', 'Holtzhausen|Leon|L|', 'Kaminer|Debra|D|', 'Seedat|Soraya|S|', 'Madikane|Solomon|S|', 'Weierstall|Roland|R|']
D000293:Adolescent D000328:Adult D000374:Aggression D003415:Crime D057237:Criminals D006801:Humans D008297:Male D011203:Poverty D012307:Risk Factors D012720:Severity of Illness Index D013019:South Africa D013313:Stress Disorders, Post-Traumatic D019966:Substance-Related Disorders D014505:Urban Population D014754:Violence D055815:Young Adult
Substance abuse Appetitive aggression South Africa Posttraumatic stress disorder Violence perpetration