A Theoretical Model of Victimization, Perpetration, and Denial in Mass Atrocities: Case Studies From Indonesia, Cambodia, East Timor, and Myanmar.

ACADEMIC ABSTRACT: The present article discusses victimization, perpetration, and denial in mass atrocities, using four recent case studies from Southeast Asia. The four cases include Indonesia (in which hundreds of thousands died in anti-Communist violence), Cambodia (in which the Khmer Rouge killed more than one million civilians), East Timor (in which more than one hundred thousand civilians died during the Indonesian occupation), and Myanmar (in which the state/army is accused of genocide toward the Rohingyas). Our aim is to bring a psychological lens to these histories, with a focus on three processes relevant to genocide. We examine, first, how the victims were targeted; second, how the perpetrators were mobilized; and third, the denial, justification, meaning-making, and commemoration of the atrocities. We propose a novel theoretical model, TOPASC: A Theory of the Psychology of Atrocities in Societal Contexts, highlighting the psychology of atrocities as involving factors across the macro, meso, and micro contexts. PUBLIC ABSTRACT: We introduce a new model, "TOPASC: A Theory of the Psychology of Atrocities in Societal Contexts," to explain why people justify mass killings and why certain group members are consistently targeted. In our model, we explore how mass atrocities against specific groups are influenced by psychological dynamics in intergroup situations which, in turn, are shaped by socio-historical contexts and individual psychologies. To illustrate these ideas, we analyze four cases of mass atrocities in Southeast Asia: Indonesia, Cambodia, East Timor, and Myanmar. These cases highlight how different social groups, characterized by diverse ideologies, ethnicities, genders, or religions, exhibit varying vulnerabilities as perpetrators or victims based on their social and power status. Mass atrocities are not sudden occurrences but rather result from a series of complex processes and events.

Understanding the structure of autobiographical memories: A study of trauma memories from the 1994 Rwandan genocide.

How do we remember traumatic events, and are these memories different in individuals who experience post-traumatic stress? Some evidence suggests that traumatic events are mnemonically enhanced, or include more episodic detail, relative to other types of memories. Simultaneously, individuals with post-traumatic stress disorder (PTSD) have more non-episodic details in all of their memories, a pattern hypothesized to result from impairment in executive function. Here, we explore these questions in a unique population that experienced severely traumatic events more than 20 years ago - individuals who lived through the 1994 genocide in Rwanda. Participants recalled events from the genocide, negative events unrelated to the genocide, neutral events, and positive events. We used the Autobiographical Interview method to label memory details as episodic or non-episodic. We found that memories from the genocide showed robust mnemonic enhancement, with more episodic than non-episodic details, and contained more details overall than any other memory type. This pattern was not impacted by post-traumatic stress. Overall, this study provides evidence that traumatic events create vivid long-lasting episodic memories, in this case even more than 20 years later.

Testing the effects of Facebook usage in an ethnically polarized setting.

Despite the belief that social media is altering intergroup dynamics-bringing people closer or further alienating them from one another-the impact of social media on interethnic attitudes has yet to be rigorously evaluated, especially within areas with tenuous interethnic relations. We report results from a randomized controlled trial in Bosnia and Herzegovina (BiH), exploring the effects of exposure to social media during 1 wk around genocide remembrance in July 2019 on a set of interethnic attitudes of Facebook users. We find evidence that, counter to preregistered expectations, people who deactivated their Facebook profiles report lower regard for ethnic outgroups than those who remained active. Moreover, we present additional evidence suggesting that this effect is likely conditional on the level of ethnic heterogeneity of respondents' residence. We also extend the analysis to include measures of subjective well-being and knowledge of news. Here, we find that Facebook deactivation leads to suggestive improvements in subjective wellbeing and a decrease in knowledge of current events, replicating results from recent research in the United States in a very different context, thus increasing our confidence in the generalizability of these effects.

[Toward Cultural Scripts of Trauma Sequelae]. / Auf dem Weg zu kulturellen Skripten von Traumafolgen.

BACKGROUND: The concept of cultural scripts has proven to be very useful for describing depression-like psychological complaints in different cultural regions of the world. The article presents the galaxy model and its implementation in the model of cultural scripts theoretically for the first time and connects these with cultural psychological value research. A new, extensive series of research projects aims to investigate post-trauma -related psychological complaints in various regions of the world. METHODS: The work in two countries/regions began with focus groups in which elements of cultural scripts were collected by traumatized clients and/or by (therapeutic) experts. For this purpose, a theory-based framework of possible post-traumatic script elements was provided. In Switzerland, focus groups were conducted with patients and experts. Focus groups were conducted with genocide survivors and other trauma victims in Rwanda and three East African countries. The evaluation was semi-quantitative. RESULTS: In Switzerland, around 50 symptoms and changes were mentioned as script elements (e. g. still having to function). Approximately 100 symptoms and changes were mentioned as script elements in East Africa (e. g. loss of dignity). The first temporal connections (i. e. strong scripts) were found for the Swiss scripts (e. g. self-devaluation - urge to function). In the East African study, cultural value orientations underlying the script groupings were also assessed (e. g. community reputation). DISCUSSION: The illustrative results presented here demonstrate the galaxy model and the suitability of the cultural script concept for recording the effects of trauma. There are differences and similarities in the two world regions examined so far. Further steps at the two study sites will be the temporal connections and the relationships to value orientations. The studies will be started at the other study sites in the following years.

Mental health in genocide: Balancing between posttraumatic distress and growth among displaced Yazidi mothers.

BACKGROUND: The Islamic State of Iraq and Syria (ISIS) committed genocide of the Yazidis in Sinjar 2014, resulting in dispersion and enslavement. Research shows severe mental health problems, such as posttraumatic stress disorder (PTSD) among survivors, but less is known about their resources and strengths, conceptualized as posttraumatic growth (PTG). AIMS: are to examine the balance between symptoms and strengths among Yazidi women caring for their infants by identifying groups differing in PTSD and PTG, and analyze how demographic, obstetric, and infant-related factors associate with the groups. METHOD: Participants were 283 Yazidi mothers with their 1-18-month-old infants displaced in Kurdish Region of North Iraq. PTSD symptoms were measured by Harvard Trauma Questionnaire and PTG by the Posttraumatic Growth Inventory. RESULTS: identified four groups: "Severe symptoms and low growth" (39%), "Low symptoms and moderate growth" (38%), "Moderate symptoms and very high growth" (13%), and "Moderate symptoms and low growth" (10%). Low education, economic difficulties and obstetric problems related to the "Severe symptoms and low growth" group, whereas newborn and infant health problems did not have an impact. CONCLUSION: Effective help for genocide survivors should both alleviate suffering and encourage resources through tools of recreating a sense of cultural security and pride.

Examining factors influencing Turkish Jewish attitudes towards the Armenian genocide.

The most prominent issue influencing Turkish-Armenian relations is the international recognition of the Armenian genocide. However, there is a notable absence of empirical analyses regarding the perceptions of the genocide among the Turkish population. This study aims to fill this scholarly gap by exploring, for the first time, the perspectives of Turkish Jews. It analyses evidence collected from interviews conducted with 14 Turkish Jews, utilising Stanley Cohen's (2001) theoretical framework, which aids in delineating significant factors by a categorisation of types of acceptance and denial. The findings highlight a diversity of responses linked to political attitudes, which can be broadly categorised into Kayades and Avlaremoz mindsets. They also show that Turkish Jews' views on the Holocaust influence how they perceive the Armenian genocide. Additionally, the results indicate that Cohen's approach is useful in explaining non-denying responses. In conclusion, the study argues that Turkish Jews' perspectives appear to be strongly related to their stance towards the Turkish state and the Holocaust.

Health and social consequences for survivors of genocidal rape: A systematic scoping review.

The unique forms of trauma experienced by survivors of genocidal rape are not well understood. Hence, we conducted a systematic scoping review regarding the consequences for survivors of rape during genocide. Searches conducted in PubMed, Global Health, Scopus, PyscInfo, and Embase produced a total of 783 articles. After completing the screening process, 34 articles were eligible for inclusion in the review. The included articles focus on survivors from six different genocides, with most focusing on either the genocide of the Tutsis in Rwanda or the Yazidis in Iraq. The study findings consistently show that survivors deal with stigmatization as well as a lack of both financial and psychological social support. This lack of support is partly due to social ostracization and shame but is also attributed to the fact that many survivors' families and other providers of social support were murdered during the violence. Many survivors, particularly young girls, reported dealing with intense forms of trauma both as a direct result of sexual violence and due to witnessing the death of their community members during the period of genocide. A notable proportion of survivors became pregnant from genocidal rape and contracted HIV. Group therapy was shown to improve mental health outcomes across numerous studies. These findings have important implications and can inform recovery process efforts. Psychosocial supports, stigma reduction campaigns, community reestablishment, and financial assistance are integral in facilitating recovery. These findings can also play an important role in shaping refugee support programs.

The Demographic Drivers of Grief and Memory After Genocide in Guatemala.

Mortality crises are relatively common demographic events, but we know little about how they affect local populations beyond excess mortality. I argue that using a kinship perspective to study mortality crises provides valuable insights into (1) how excess mortality affects the exposure to kin loss and (2) how family bereavement may contribute to the reproduction of historical memory in the long term. I explore these two processes using a unique genealogical database that records the complete demographic history of Rio Negro, a genocide-affected population in Guatemala, between 1982 and 2015. The analysis shows that deaths from the 1982 genocide were balanced by age, sex, and socioeconomic status. One third of the population were killed, but two thirds were left bereaved (the top 10% most affected individuals lost 30% of their nuclear family relatives and 23% of their extended family relatives). Notably, the proportion of the population related to a victim did not change between 1983 and 2015. The persistence of family bereavement can be interpreted as a prolongation of grief or as a driver of historical memory. These demographic dynamics have implications for the study of historical events beyond mortality crises.

Prevalence of mental disorders, associated co-morbidities, health care knowledge and service utilization in Rwanda - towards a blueprint for promoting mental health care services in low- and middle-income countries?

BACKGROUND: In order to respond to the dearth of mental health data in Rwanda where large-scale prevalence studies were not existing, Rwanda Mental Health Survey was conducted to measure the prevalence of mental disorders, associated co-morbidities and knowledge and utilization of mental health services nationwide within Rwanda. METHODS: This cross-sectional study was conducted between July and August 2018, among the general population, including survivors of the 1994 Genocide against the Tutsi. Participants (14-65 years) completed the Mini-International Neuropsychiatric Interview (Version 7.0.2), sociodemographic and epilepsy-related questionnaires. General population participants were selected first by random sampling of 240 clusters, followed by systematic sampling of 30 households per cluster. Genocide survivors within each cluster were identified using the 2007-2008 Genocide Survivors Census. RESULTS: Of 19,110 general survey participants, most were female (n = 11,233; 58.8%). Mental disorders were more prevalent among women (23.2%) than men (16.6%) (p < 0.05). The most prevalent mental disorders were major depressive episode (12.0%), panic disorder (8.1%) and post-traumatic stress disorder (PTSD) (3.6%). Overall, 61.7% had awareness of mental health services while only 5.3% reported to have used existing services. Of the 1271 genocide survivors interviewed, 74.7% (n = 949) were female; prevalence of any mental disorder was 53.3% for women and 48.8% for men. Most prevalent disorders were major depressive episode (35.0%), PTSD (27.9%) and panic disorder (26.8%). Among genocide survivors, 76.2% were aware of availability of mental health services, with 14.1% reported having used mental health services. CONCLUSIONS: Despite high prevalence of mental disorders among the general population and genocide survivors, utilization of available mental health services was low. A comprehensive approach to mental health is needed for prevention of mental illness and to promote mental healthcare services.

Development and validation of the Clinical Aspects of Historical Trauma Questionnaire in Rwandan genocide survivors.

Historical trauma is a relatively new concept in the literature, and investigations are needed to clarify its clinical aspects and develop instruments to measure its sequelae. The purpose of this study was to develop the Clinical Aspects of Historical Trauma Questionnaire (CAHTQ), which is meant to capture trauma sequelae in different contexts, and provide initial psychometric information. Participants were survivors of the genocide against the Tutsi in Rwanda (N = 261) aged 32-87 years (M = 46.30 years, SD = 11.95) who completed a preliminary version of the CAHTQ, constructed based on theoretical and content-related consideration, as well as the International Trauma Questionnaire, Fatalism Scale, Public Health Depression Questionnaire, Brief Coping Inventory, Forgiveness Questionnaire, and Sentiment of Reconciliation Questionnaire to test the discriminant and convergent validity of the CAHTQ. Exploratory factor analysis was conducted to reduce the number of items and extract factors; confirmatory factor analysis (CFA) was conducted to confirm the measure's dimensionality. The final questionnaire includes 20 items and five subscales. The items demonstrated good internal consistency, Cronbach's α = .91, and the CFA demonstrated a very good fit of the model to the data, χ2 (60, N = 261) = 271, CFI = .963 = , TLI = .956, SMRR = .052, RMSEA = .052. The CAHTQ was developed to capture the clinical aspects of historical trauma sequelae. Unlike comparable previously developed instruments, this questionnaire can be used for various historical traumas globally, and its suitability for this purpose will be the focus of future studies.

'No-One Can Tell a Story Better than the One Who Lived It': Reworking Constructions of Childhood and Trauma Through the Arts in Rwanda.

The intergenerational legacies of conflict and violence for children and young people are typically approached within research and interventions through the lens of trauma. Understandings of childhood and trauma are based on bio-psychological frameworks emanating from the Global North, often at odds with the historical, political, economic, social and cultural contexts in which interventions are enacted, and neglect the diversity of knowledge, experiences and practices. Within this paper we explore these concerns in the context of Rwanda and the aftermath of the 1994 Genocide Against the Tutsi. We reflect on two qualitative case studies: Connective Memories and Mobile Arts for Peace which both used arts-based approaches drawing on the richness of Rwandan cultural forms, such as proverbs and storytelling practices, to explore knowledge and processes of meaning-making about trauma, memory, and everyday forms of conflict from the perspectives of children and young people. We draw on these findings to argue that there is a need to refine and elaborate understandings of intergenerational transmission of trauma in Rwanda informed by: the historical and cultural context; intersections of structural and 'everyday' forms of conflict and social trauma embedded in intergenerational relations; and a reworking of notions of trauma 'transmission' to encompass the multiple connectivities between generations, temporalities and expressions of trauma.

Starvation Genocide: Diabetes and Cancer in the Lodz Ghetto.

BACKGROUND: Extermination via starvation was described in detail as an alternative or precursor to the final solution during the Holocaust in World War II. The main causes of death in the ghettos were exhaustion, environmental conditions (inadequate protection in extreme climates), infectious diseases, or starvation. In previous studies on the Lodz Ghetto, the causes of death via typhus exantematicus, tuberculosis, and heart failure were investigated [1,2]. In this article, we introduce the topic of diabetes in the presence of starvation and assess the incidence of malignancies in the years 1941-1944. The findings from the Lodz Ghetto would retroactively support the Warburg theory.

Starvation Genocide: Myocardial Infarction in the Lodz Ghetto.

BACKGROUND: Medical records discovered after the liberation of ghettos in Nazi-occupied Europe are unique documents that report on the suffering of inmates, on ravaging infectious diseases, and on starvation-related organ degeneration and the resulting mortality. We offer a pathogenetic explanation for the scarcity of acute myocardial infarction in the Lodz Ghetto, Poland, 1941-1944.

Global Public Health Nursing.

BACKGROUND: An often under addressed and tragic legacy of genocide is the conception of children from rape. While the experience has been documented from their mothers' perspective, the perspectives and needs of individuals born of genocidal rape has been under-studied. METHODS: We conducted an integrative review of all peer-reviewed articles that reported on studies conducted among individuals born of genocidal rape published through 2020. We used an inductive process to identify and describe the themes from those studies. RESULTS: Twelve studies met the inclusion criteria. Ten articles reported on youth born of genocidal rape in Rwanda aged between 16 and 21 years, and two articles represented the perspective of adolescents in the former Yugoslavia aged 1416 years. Four themes were indentified: (1) birth origin stories associated with the crime of the father, (2) fractured sense of belonging to the victim-mother, perpetrator-father, their families, and the community at large, (3) intergenerational legacy of trauma and family identity, and (4) strategies to move forward including knowing the truth about one's origin, mental health, and peer support. CONCLUSION: These findings suggest that understanding increased risk of adverse health outcomes of youth born of genocidal rape could inform the design of evidence-based interventions for these and similar populations.

Kongera Kwiyubaka (rebuilding ourselves again): Culturally responsive and contextually relevant collective healing in post-genocide Rwanda.

Drawing on the local experiences, knowledge, and wisdom of Rwandan youth can make them agents of healing from the genocide against the Tutsi in ways that are culturally appropriate, relevant, and meaningful. This qualitative study aimed to develop an emerging framework for intervening with youth that is centered in the experiences and cultural context of the Rwandan youth post-genocide. Drawing on Grounded Action research of post-genocide community-led healing practices with a group of 23 high school students, results indicated that "psychological healing" in post-genocide Rwanda may require different approaches than the dominant Western healing models. For research participants, "healing" meant "kongera kwiyubaka" (building ourselves again after the genocide), requiring "kwigira" (self-reliance) and "gusasa inzobe" (openness to share what is in their hearts). This study recommends that scholars, policy makers, and funders reimagine existing models of healing in post-genocide Rwanda and support local initiatives drawing on wisdom from lived experiences.

Genocide and the Oppression of Indigenous Peoples: The Extermination of the 19th Century Aboriginal Tasmanians.

This article provides a brief outline of the genocides committed during the 20th century, examines the derivation of the appellation and concept of acts of genocide by the lawyer and activist Raphael Lemkin and the development of the United Nations Convention on the Prevention and Punishment of Genocide. The narrative describes the extant socio-economic characteristics of global Indigenous peoples and their vulnerabilities to imposed violence. The work includes a succinct review of the contemporary continuing crimes against humanity perpetrated by the Chinese and Myanmar governments and concludes with the 19th century flawed British colonial administration of the Tasmanian Indigenous tribes between 1803 and 1876 and examines the causes contributing to the genocidal demise of the Tasmanian Aborigines.

[The mental health nurse as a cornerstone of mental health care in Rwanda]. / L'infirmier en santé mentale, pierre angulaire des soins de santé mentale au Rwanda.

In the aftermath of the genocide against the Tutsis in Rwanda in 1994, the country was left with a collapsed health system and a huge burden of mental health problems to deal with. With only one psychiatrist at the time, a health ecosystem had to be reinvented to deal with these fragilities. The training of mental health nurses since 1998 has forged the professionals who have contributed significantly to the rebuilding of the mental health system in Rwanda.