Publications by authors named "Manassé Bambonyé"

11 Publications

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Effective Adoption of Tablets for Psychodiagnostic Assessments in Rural Burundi: Evidence for the Usability and Validity of Mobile Technology in the Example of Differentiating Symptom Profiles in AMISOM Soldiers 1 Year After Deployment.

Front Public Health 2021 15;9:490604. Epub 2021 Apr 15.

Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.

Research on the use of mobile technology in health sciences has identified several advantages of so-called mHealth (mobile health) applications. Tablet-supported clinical assessments are becoming more and more prominent in clinical applications, even in low-income countries. The present study used tablet computers for assessments of clinical symptom profiles in a sample of Burundian AMISOM soldiers (i.e., African Union Mission to Somalia; a mission approved by the UN). The study aimed to demonstrate the feasibility of mHealth-supported assessments in field research in Burundi. The study was conducted in a resource-poor setting, in which tablet computers are predestined to gather data in an efficient and reliable manner. The overall goal was to prove the validity of the obtained data as well as the feasibility of the chosen study setting. Four hundred sixty-three soldiers of the AMISOM forces were investigated after return from a 1-year military mission in Somalia. Symptoms of posttraumatic stress disorder (PTSD) and depression were assessed. The used data-driven approach based on a latent profile analysis revealed the following four distinct groups, which are based on the soldiers' PTSD and depression symptom profiles: Class 1: moderate PTSD, Class 2: moderate depression, Class 3: low overall symptoms, and Class 4: high overall symptoms. Overall, the four identified classes of soldiers differed significantly in their PTSD and depression scores. The study clearly demonstrates that tablet-supported assessments can provide a useful application of mobile technology in large-scale studies, especially in resource-poor settings. Based on the data collected for the study at hand, it was possible to differentiate different sub-groups of soldiers with distinct symptom profiles, proving the statistical validity of the gathered data. Finally, advantages and challenges for the application of mobile technology in a resource-poor setting are outlined and discussed.
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http://dx.doi.org/10.3389/fpubh.2021.490604DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083058PMC
May 2021

The cycle of violence as a function of PTSD and appetitive aggression: A longitudinal study with Burundian soldiers.

Aggress Behav 2020 09 3;46(5):391-399. Epub 2020 May 3.

Dr. Amelung Private Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Königstein im Taunus, Germany.

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.
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http://dx.doi.org/10.1002/ab.21895DOI Listing
September 2020

The individual contribution of DSM 5 symptom clusters of PTSD, life events, and childhood adversity to frontal oscillatory brain asymmetry in a large sample of active combatants.

Biol Psychol 2017 10 25;129:305-313. Epub 2017 Sep 25.

Department of Psychology, University of Konstanz, Konstanz, Baden-Württemberg, Germany; MSH Medical School Hamburg, University of Applied Sciences and Medical University, Germany.

Post-Traumatic Stress Disorder (PTSD) has been linked to deviations in lateralized frontal functional oscillatory activity. This is possibly because left and right DLPFC have differential roles in regulating both memory and stress response, which are both dysfunctional in PTSD. However, previous results are heterogeneous, and could be attributable to individual symptom clusters, traumatic or aggressive life events, early life stress, or the interaction of these factors. In a large sample of active combatants (N=401), we regressed these factors on frontal electroencephalography (EEG) asymmetry across 5 frequency bands (delta: 2-4Hz; theta: 4-8Hz; alpha: 8-12Hz; beta: 12-24Hz; gamma: 24-48Hz). Negative cognition and mood was associated with stronger relative left delta and theta band power. Traumatic life events showed stronger right alpha and beta band power. Traumatic life events in interaction with hyperarousal predicted stronger relative right left-right imbalance (theta, alpha, and beta bands), whereas childhood adversity, in interaction with negative cognition and mood, predicted stronger relative left left-right imbalance (delta, theta, alpha and beta bands). The contribution of lateralized DLPFC dysfunction to PTSD is thus dependent on the individual complexities of subsymptom clusters and life history, and future studies need to take these factors into account.
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http://dx.doi.org/10.1016/j.biopsycho.2017.09.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678498PMC
October 2017

Succumbing to the Call of Violence - Sex-Linked Development of Appetitive Aggression in Relation to Familial and Organized Violence.

Front Psychol 2017 9;8:751. Epub 2017 May 9.

Department of Psychology, University of KonstanzKonstanz, Germany.

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, = 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, = 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.
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http://dx.doi.org/10.3389/fpsyg.2017.00751DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422546PMC
May 2017

Predicting domestic and community violence by soldiers living in a conflict region.

Psychol Trauma 2017 Nov 9;9(6):663-671. Epub 2017 Mar 9.

Department of Psychology, University of Konstanz.

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
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http://dx.doi.org/10.1037/tra0000262DOI Listing
November 2017

Appetitive Aggression in Women: Comparing Male and Female War Combatants.

Front Psychol 2015 5;6:1972. Epub 2016 Jan 5.

Department of Psychology, University of KonstanzKonstanz, Germany; Department of Clinical Psychology, Université LumièreBujumbura, Burundi.

Appetitive aggression refers to positive feelings being associated with the perpetration of violent behavior and has been shown to provide resilience against the development of PTSD in combatants returning from the battlefield. Until this point, appetitive aggression has been primarily researched in males. This study investigates appetitive aggression in females. Female and male combatants and civilians from Burundi were assessed for levels of appetitive aggression. In contrast to non-combatants, no sex difference in appetitive aggression could be detected for combatants. Furthermore, each of the female and male combatant groups displayed substantially higher levels of appetitive aggression than each of the male and female civilian control groups. This study demonstrates that in violent contexts, such as armed conflict, in which individuals perpetrate numerous aggressive acts against others, the likelihood for an experience of appetitive aggression increases- regardless of whether the individuals are male or female.
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http://dx.doi.org/10.3389/fpsyg.2015.01972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700207PMC
January 2016

Violent Offending Promotes Appetitive Aggression Rather than Posttraumatic Stress-A Replication Study with Burundian Ex-Combatants.

Front Psychol 2015 8;6:1755. Epub 2015 Dec 8.

Clinical and Neuropsychology Group, Department of Psychology, University of Konstanz Konstanz, Germany ; Vivo International Konstanz, Germany ; Department of Clinical Psychology, Université Lumière de Bujumbura Bujumbura, Burundi.

Research has identified appetitive aggression, i.e., the perception of committed, violent acts as appealing, exciting and fascinating, as a common phenomenon within populations living in precarious and violent circumstances. Investigating demobilized soldiers in the Democratic Republic of Congo (DRC) demonstrated that violent offending is associated with appetitive aggression and not necessarily with symptoms of posttraumatic stress. In the present study, we sought to replicate these results in an independent and larger sample of demobilized soldiers from Burundi. As with the Congolese ex-combatants, random forest regression revealed that the number of lifetime perpetrated violent acts is the most important predictor of appetitive aggression and the number of lifetime experienced traumatic events is the main predictor for posttraumatic stress. Perpetrated violent acts with salient cues of hunting (pursuing the victim, the sight of blood, etc.) were most predictive for perceiving violent cues appealingly after demobilization. Moreover, the association of violent acts and appetitive aggression as well as traumatic events and posttraumatic stress remains strong even years after demobilization. Patterns of traumatic events and perpetrated acts as predictors for posttraumatic stress and appetitive aggression seem to be robust among different samples of ex-combatants who fought in civil wars. Psychotherapeutic interventions that address these complementary facets of combat-related disorders-namely, posttraumatic stress and appetitive aggression-are indispensable for a successful reintegration of those who fought in armed conflicts and to achieve a successful transition to peace.
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http://dx.doi.org/10.3389/fpsyg.2015.01755DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672083PMC
December 2015

Intergenerational violence in Burundi: Experienced childhood maltreatment increases the risk of abusive child rearing and intimate partner violence.

Eur J Psychotraumatol 2015 15;6:26995. Epub 2015 Dec 15.

Department of Clinical Psychology, University Lumière of Bujumbura, Bujumbura, Burundi.

Background: Experiencing abuse during childhood affects the psychological well-being of individuals throughout their lives and may even influence their offspring by enhancing the likelihood of an intergenerational transmission of violence. Understanding the effects of childhood maltreatment on child-rearing practices and intimate partner violence might be of particular importance to overcome the consequences of violent conflicts in African societies.

Objective: Using Burundi as an example, we aimed to explore the associations between childhood maltreatment, intimate partner violence, perceived partner intimidation, gender and the probability of violently acting out against one's own children or romantic partner.

Methods: Amongst a sample of 141 men and 141 women in the capital of Burundi, we identified those who had biological children and those who lived or had lived in relationships. Using culturally appropriate instruments, we enquired about their exposure to childhood maltreatment and partner violence as well as their inclinations to act out violently.

Results: We found that childhood maltreatment and perceived partner intimidation were strong predictors for the perpetration of violence against children. Moreover, we found that women were more likely to use violence against children if they experienced partner violence and less likely to resort to violence if they felt intimidated. Men were more likely to perpetrate violence against their partner. Childhood maltreatment was again a strong predictor. The more women experienced partner violence, the more they fought back.

Conclusions: Childhood maltreatment is a strong predictor for domestic violence and has to be addressed to interrupt the cycle of violence in post-conflict countries.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696461PMC
http://dx.doi.org/10.3402/ejpt.v6.26995DOI Listing
December 2015

Appetitive Aggression and Adverse Childhood Experiences Shape Violent Behavior in Females Formerly Associated with Combat.

Front Psychol 2015 17;6:1756. Epub 2015 Nov 17.

Department of Psychology, University of Konstanz Konstanz, Germany ; Department of Psychology, University Lumière Bujumbura, Burundi.

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.
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http://dx.doi.org/10.3389/fpsyg.2015.01756DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4646969PMC
December 2015

Predictors of posttraumatic stress and appetitive aggression in active soldiers and former combatants.

Eur J Psychotraumatol 2015 21;6:26553. Epub 2015 Apr 21.

Department of Psychology, University of Konstanz, Konstanz, Germany.

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.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408319PMC
http://dx.doi.org/10.3402/ejpt.v6.26553DOI Listing
April 2015

A study on reintegration of street children in Burundi: experienced violence and maltreatment are associated with mental health impairments and impeded educational progress.

Front Psychol 2014 16;5:1441. Epub 2014 Dec 16.

Department of Psychology, Clinical Psychology and Clinical Neuropsychology, University of Konstanz Konstanz, Germany ; Department of Clinical Psychology, University Lumière of Bujumbura Bujumbura, Burundi ; Non Governmental Organization Vivo International Konstanz, Germany.

Street children are exposed to violence, and subsist in poor and generally precarious conditions. In conflict regions, institutional care facilities are often the only well established way to care for vulnerable children. Providing access to school education is considered to be key to allow successful integration into society. However, adverse effects of psychological disorders may pose another serious obstacle. In semi-structured interviews in a sample of 112 Burundian male youths (mean age = 15.9 years), we assessed exposure to traumatic stressors, regularly and recently occurring violence as well as prevalence of posttraumatic stress disorder (PTSD), depression, substance dependence, suicidal risk, and progress in school. Former street children (n = 32) and other vulnerable children (n = 50) in a residential center were compared to children living in the streets (n = 15) or with families (n = 15). While the children living in the center were less regularly exposed to violence and reported less substance dependence than street children, PTSD symptoms were common among the former street children. Furthermore, we provided empirical evidence that for the children living in the center, recently experienced violence - mostly minor physical conflicts, psychological violence and neglect - was associated with increased PTSD symptomatology and impeded progress in school. In a population of children who experienced many traumatic incidences and a lot of violence, even minor violent events may trigger and reinforce PTSD symptoms. Hence controlling exposure to violence and addressing mental ill-health in vulnerable children is mandatory for reintegration.
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http://dx.doi.org/10.3389/fpsyg.2014.01441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267266PMC
January 2015