Effects of war exposure
These are two very different articles but each is related to war exposure. First, Black, McEwen, Smeeth, Popham, Karam & Pluess (2023) published “Effects of War Exposure on Pubertal Development in Refugee Children” in Developmental Psychology. Here’s the edited abstract and impact statement:
Increasing research shows pubertal development accelerates following threats while it decelerates following deprivation. Yet, these environmental stressors are unlikely to occur in isolation. We investigated how war exposure and energetic stress [which they operationalize as nutrition deprivation] impact pubertal development using data from the longitudinal Biological Pathways of Risk and Resilience in Syrian Refugee Children study. Our sample included 1,600 male and female Syrian refugee children and their caregivers who lived in temporary settlements in Lebanon. We hypothesized that (a) energetic stress suppresses pubertal development; (b) war exposure accelerates pubertal timing in boys and increases risk of menarche in girls, but only when energetic stress is low; and (c) when energetic stress is elevated, effects of war exposure on pubertal development will be attenuated. Among boys, we did not find support for Hypothesis 1, but Hypotheses 2 and 3 were supported. Exposure to morbidity/mortality threats accelerated pubertal timing; this effect was attenuated under conditions of elevated energetic stress. Among girls, we found support for Hypothesis 1, but not for Hypotheses 2 and 3. Elevated energetic stress decreased the risk of menarche in girls. Neither war exposure, nor any interactions with energetic stress, predicted risk of menarche. Sensitivity analyses revealed a significant interaction between bombing exposure and the amount of time since leaving Syria. Bombing decreased the risk of menarche, but only for girls who had left Syria four or more years prior to data collection. We discuss implications for translational efforts advocating for puberty screening in medical and mental health settings to identify trauma-exposed youth.
Energetic stress, or nutrition deprivation, can attenuate effects of war exposure on pubertal development, which limits the utility of solely screening for pubertal development to identify trauma-exposed youth. Puberty research conducted in low-resource settings must account for energetic stress when investigating how adverse exposures impact puberty. Findings from this study highlight a critical need for longitudinal research on pubertal development, especially in low- and middle-income countries where >90% of adolescents live, to fully characterize how pubertal development is impacted by adverse experiences.
This is a fairly large sample and complicated findings; the data on the girls is, at the very least, confusing. However, this work raises new questions to ask when clients have had war exposure and/or nutrition deprivation. The next study looks at a different population. Van Voorhees et al. (2023) published “Enjoying the Violence of War: Association with posttraumatic symptomatology in U.S. combat veterans” in Psychological Trauma: Theory, Research, Practice, and Policy. Here’s the edited abstract and impact statement:
Engaging in war-related violence can have a devastating impact on military personnel, with research suggesting that injuring or killing others can contribute to posttraumatic stress disorder (PTSD), depression, and moral injury. However, there is also evidence that perpetrating violence in war can become pleasurable to a substantial number of combatants and that developing this “appetitive” form of aggression can diminish PTSD severity. Secondary analyses were conducted on data from a study of moral injury in U.S., Iraq, and Afghanistan combat veterans, to examine the impact of recognizing that one enjoyed war-related violence on outcomes of PTSD, depression, and trauma-related guilt. Three multiple regression models evaluated the impact of endorsing the item, “I came to realize during the war that I enjoyed violence” on PTSD, depression, and trauma-related guilt, after controlling for age, gender, and combat exposure. Results indicated that enjoying violence was positively associated with PTSD, depression, and guilt. Enjoying violence moderated the relationship between combat exposure and PTSD symptoms, such that there was a decrease in the strength of the relationship between combat exposure and PTSD in the presence of endorsing having enjoyed violence. Implications for understanding the impact of combat experiences on postdeployment adjustment, and for applying this understanding to effectively treating posttraumatic symptomatology, are discussed.
A substantial portion of U.S. combat veterans reported having enjoyed violence during war. Our findings point to the importance of being open to the possibility that appetitive aggression is not uncommon in U.S. combat veterans and to the need to be prepared to face this sequela of combat with the same compassion, openness, and understanding we currently offer when encountering other wounds of war.
I found this study troubling but important and it has clear implications for those who work with veterans. I find the last sentence especially compelling.