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Posttraumatic Stress and Youth Violence Perpetration: a Population-Based Cross-Sectional Study

Published online by Cambridge University Press:  16 December 2016

M. Aebi ,
M. Mohler-Kuo ,
S. Barra ,
U. Schnyder ,
T. Maier  and
M.A. Landolt
M. Aebi*
Affiliation:
Department of Forensic Psychiatry, University Hospital of Psychiatry, Neptunstrasse 60Zurich8032, Switzerland Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, Neumünsterallee 3Zurich8032, Switzerland Department of Clinical Psychology with Children/Adolescents & Families/Couples, Institute of Psychology, University of Zurich, Attenhoferstrasse 9Zurich, Switzerland
M. Mohler-Kuo
Affiliation:
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84Zurich8001, Switzerland
S. Barra
Affiliation:
Department of Forensic Psychiatry, University Hospital of Psychiatry, Neptunstrasse 60Zurich8032, Switzerland
U. Schnyder
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8Zurich8091, Switzerland
T. Maier
Affiliation:
Psychiatric Services of the County of St. Gallen North Zurcherstrasse 30Wil9501, Switzerland
M.A. Landolt
Affiliation:
Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14/8Zurich8051, Switzerland Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, Steinwiesstrasse 75Zurich8032, Switzerland
*
* Corresponding author. University Hospital of Psychiatry, Neptunstrasse 60, 8032 Zurich, Switzerland. Tel.: +41 43 556 40 13; fax: +41 43 556 40 41. E-mail address:marcel.aebi@uzh.ch (M. Aebi).
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Abstract

Background

Exposure to trauma was found to increase later violent behaviours in youth but the underlying psychopathological mechanisms are unclear. This study aimed to test whether posttraumatic stress disorder (PTSD) is related to violent behaviours and whether PTSD symptoms mediate the relationship between the number of trauma experiences and violent behaviours in adolescents.

Method

The present study is based on a nationally representative sample of 9th grade students with 3434 boys (mean age = 15.5 years) and 3194 girls (mean age = 15.5 years) in Switzerland. Lifetime exposure to traumatic events and current PTSD were assessed by the use of the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA-RI). Logistic regression was used to assess associations between PTSD and violent behaviours, and structural equation modelling (SEM) was used to examine the meditation effects of PTSD.

Results

PTSD (boys: OR = 7.9; girls: OR = 5.5) was strongly related to violent behaviours. PTSD symptoms partially mediated the association between trauma exposure and violent behaviours in boys but not in girls. PTSD symptoms of dysphoric arousal were positively related to violent behaviours in both genders. Anxious arousal symptoms were negatively related to violent behaviours in boys but not in girls.

Conclusions

In addition to trauma, posttraumatic stress is related to violent outcomes. However, specific symptom clusters of PTSD seem differently related to violent behaviours and they do not fully explain a trauma-violence link. Specific interventions to improve emotion regulation skills may be useful particularly in boys with elevated PTSD dysphoric arousal in order to break up the cycle of violence.

Keywords

TraumaAggressionPTSDDysphoric arousalAnxious arousalNumbing
Type
Original article
Information
European Psychiatry , Volume 40 , February 2017 , pp. 88 - 95
Copyright
Copyright © Elsevier Masson SAS 2017

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References

Marcel Aebi, Ph.D., born 1971, is a senior researcher at the Department of Forensic Psychiatry and the Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, Zurich, Switzerland. In addition, he is a behavioural therapist and forensic expert at the Institute of Clinical Child and Adolescent Psychology, University of Zurich. His current major research interests include forensic psychology, developmental psychopathology and various neuroscientific, genetic and clinical issues in child and adolescent psychopathology.

Meichun Mohler-Kuo, Sc.D., born 1968, is a trained psychiatric epidemiologist, title Professor at Epidemiology, Biostatistics and Prevention Institute, University of Zurich. She is also the head of competence center for mental health at the University of Zurich. Her current major research interests include mental health and service use, substance use, and child and adolescent health and development.

Steffen Barra, M. Sc., born 1989, is a research assistant at the Department of Forensic Psychiatry, University Hospital of Psychiatry, Zurich, Switzerland, and a Ph.D. candidate at the University of Zurich. His research interests include short- and long-term effects of childhood trauma and current life adversities on psychological and behavioral outcomes in children and adolescents. His current research focuses on forensic child and adolescent psychology/psychiatry, e.g. on risk factors for juvenile delinquency, such as adverse childhood experiences.

Ulrich Schnyder, M.D., born 1952, psychiatrist and licensed psychotherapist. Professor of psychiatry and psychotherapy. Head, Department of Psychiatry and Psychotherapy, University Hospital Zurich, Switzerland. Research activities are currently focused on various aspects of traumatic stress research, including epidemiology, neurobiology, psychotherapy and pharmacotherapy for PTSD, and resilience to stress. Past President, European Society for Traumatic Stress Studies. Past President, International Federation for Psychotherapy. Past President, International Society for Traumatic Stress Studies.

Thomas Maier, M.D., born 1967, is board psychiatrist and currently head of the Psychiatric Services of St. Gallen North/Switzerland. He is a lecturer at Zurich University for psychiatry and psychotherapy. Formerly he headed the Outpatient Clinic for victims of war and torture at Zurich University Hospital. His research interests span from psychotraumatology to psychiatric epidemiology, transcultural psychiatry, and child sexual abuse.

Markus A. Landolt, Ph.D., born 1962, is Professor of Child and Adolescent Health Psychology at the Department of Psychology, University of Zurich and Head of Pediatric Psychology at the University Children’s Hospital Zurich, Switzerland. His research activities focus on different topics of posttraumatic stress in children and adolescents as well as their parents.

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