In contexts of war and crises, 20-50% of individuals develop symptoms of post-traumatic stress disorder (PTSD), which is defined by three main clusters of symptoms: Involuntary re-experiencing of the traumatic event, avoidance of situations or details reminiscent of the event, and hyper-arousal or perception of a persistent ongoing threat. Various pre-, peri-, or post-traumatic risk and protective factors have an impact on inter-individual vulnerability for symptom exacerbation. PTSD plays an important role in the perpetuation of cycles of violence and promotes instability in crisis regions due to various pathways. First, experiencing adverse childhood events are one central mechanism in transmitting violent experiences to subsequent generations. In addition, there is a direct link between the severity of PTSD and the risk of perpetrating aggression. Survivors of traumatic events with PTSD are prone to difficulties in emotion regulation and have an increased risk for reacting aggressively due to PTSD inherent symptoms of hyperarousal. In this context, appetitive aggression can evolve. This type of aggression is associated with feelings of pleasure and thrill with subsequent loss of control when perpetrating violence. It can develop as universal adaptation in the context of extreme brutality in conflict regions and impairs processes of reintegration and reconciliation. Affected persons are often initially survivors and subsequently perpetrators of violence. Due to these mechanisms, the recovery from mental disorders such as PTSD should be a prominent component during reconciliation processes in war and crisis regions. Professional mental health services can be implemented even in resource-poor regions, as models have shown. The inclusion of mental health into peace processes is crucial to break ongoing cycles of violence and promote long-term stability.
Keywords: PTSD, trauma, appetitive aggression, dissemination, spiral of violence, trauma-induced disorder, secondary traumatization, mental health
