Exploitative leaders incite intergroup warfare in a social mammal.

Collective conflicts among humans are widespread, although often highly destructive. A classic explanation for the prevalence of such warfare in some human societies is leadership by self-serving individuals that reap the benefits of conflict while other members of society pay the costs. Here, we show that leadership of this kind can also explain the evolution of collective violence in certain animal societies. We first extend the classic hawk-dove model of the evolution of animal aggression to consider cases in which a subset of individuals within each group may initiate fights in which all group members become involved. We show that leadership of this kind, when combined with inequalities in the payoffs of fighting, can lead to the evolution of severe intergroup aggression, with negative consequences for population mean fitness. We test our model using long-term data from wild banded mongooses, a species characterized by frequent intergroup conflicts that have very different fitness consequences for male and female group members. The data show that aggressive encounters between groups are initiated by females, who gain fitness benefits from mating with extragroup males in the midst of battle, whereas the costs of fighting are borne chiefly by males. In line with the model predictions, the result is unusually severe levels of intergroup violence. Our findings suggest that the decoupling of leaders from the costs that they incite amplifies the destructive nature of intergroup conflict.

Double trouble: How sectarian and national narcissism relate differently to collective violence beliefs in Lebanon.

Collective narcissism is a belief in ingroup greatness which is contingent on external validation. A lack of research on collective narcissism amongst non-Western contexts and minority groups remains a challenge for the field. However, here we test two types of collective narcissism (sectarian and national) as differential predictors of two dimensions of collective violence beliefs (against outgroup members and leaders) in a large, diverse, community sample from Lebanon (N = 778). We found that sectarian narcissism (narcissism related to smaller political and religious ingroup identity) predicted support for collective violence against members of different sects, while national narcissism predicted opposition to such collective violence. Neither form of collective narcissism had any significant relationship with collective violence against outgroup leaders. We controlled for both sectarian and national identification and found no significant effects in predicting either one of the two dimensions of collective violence beliefs. In this non-Western context, in which a coherent national identity is undermined by sectarianism, national narcissism seems to be a progressive motivator for unity and social change, while sectarian narcissism is rather associated with extreme attitudes, such as support for collective violence.

Cardiovascular diseases and their risk factors among Syrian refugees in Turkey.

BACKGROUND: Information on the world distribution of cardiovascular disease and its risk factors in refugees/migrants is not available at the same rate for all countries or for different ethnic and socioeconomic groups. Today, Syria's humanitarian catastrophe has become a public health concern, which cannot be ignored. METHODS: A search was conducted across PubMed and Google Scholar for papers on cardiovascular diseases among refugees/migrants worldwide with a focus on Syrian in Turkey. RESULTS: The total number of papers identified through the database searches and from reference lists was 486. Of these, 62 were found to be relevant after further screening. A further 42 papers were considered not eligible after full-text, language and data assessments, resulting in a final 20 papers included in the qualitative analysis. These studies discussed several major themes: cardiovascular diseases and their risk factors among refugees/migrants, the effects of changing living conditions on refugees/migrants, the effects of psychological and socioeconomic factors, and the prevention and treatment of cardiovascular diseases in refugees/migrants. The risk of cardiovascular disease varied by country of origin, country of destination, and duration of residence. The findings suggest that cardiovascular diseases and their risk factors are increased for Syrian refugees in Turkey. CONCLUSION: Raising awareness, prevention, early detection, and good management as well as monitoring and reporting of risk factors are the key components to controlling cardiovascular diseases in refugees. Further studies and greater acquisition of survey data are urgently needed.

Climate Change and Collective Violence.

Climate change is causing increases in temperature, changes in precipitation and extreme weather events, sea-level rise, and other environmental impacts. It is also causing or contributing to heat-related disorders, respiratory and allergic disorders, infectious diseases, malnutrition due to food insecurity, and mental health disorders. In addition, increasing evidence indicates that climate change is causally associated with collective violence, generally in combination with other causal factors. Increased temperatures and extremes of precipitation with their associated consequences, including resultant scarcity of cropland and other key environmental resources, are major pathways by which climate change leads to collective violence. Public health professionals can help prevent collective violence due to climate change (a) by supporting mitigation measures to reduce greenhouse gas emissions, (b) by promoting adaptation measures to address the consequences of climate change and to improve community resilience, and

Remembering Collective Violence: Broadening the Notion of Traumatic Memory in Post-Conflict Rehabilitation.

In the aftermath of war and armed conflict, individuals and communities face the challenge of dealing with recollections of violence and atrocity. This article aims to contribute to a better understanding of processes of remembering and forgetting histories of violence in post-conflict communities and to reflect on related implications for trauma rehabilitation in post-conflict settings. Starting from the observation that memory operates at the core of PTSD symptomatology, we more closely explore how this notion of traumatic memory is conceptualized within PTSD-centered research and interventions. Subsequently, we aim to broaden this understanding of traumatic memory and post-trauma care by connecting to findings from social memory studies and transcultural trauma research. Drawing on an analysis of scholarly literature, this analysis develops into a perspective on memory that moves beyond a symptomatic framing toward an understanding of memory that emphasizes its relational, political, moral, and cultural nature. Post-conflict memory is presented as inextricably embedded in communal relations, involving ongoing trade-offs between individual and collective responses to trauma and a complex negotiation of speech and silence. In a concluding discussion, we develop implications of this broadened understanding for post-conflict trauma-focused rehabilitation.

"It will always be Temporary": A qualitative study of Syrian young adults expressing histories of collective violence and forced displacement in participatory theatre.

Given the increased prevalence of mental health problems in Syrian refugee communities, there have been efforts to develop adequate mental health care for their well-being. Herein, clinical literature is increasingly emphasizing the importance of locating refugees' healing at the nexus of personal and social realities, understanding the process of trauma narration within social restorative spaces of witnessing and communal support. Alongside this debate, there is growing interest in the relevance of participatory theatre for refugees. This innovative approach understands how voicing narratives of life histories within a broader social sphere may support personal and socio-political transformation. In this article, we aim to further the understanding of participatory theatre's relevance to these issues, focusing on the reparative dimensions of trauma narration. Based on a case study of a theatre project with Syrian young adults resettled in Belgium, we explore the different ways participants expressed experiences of collective violence and displacement in dialogue with each other, their diasporic and home communities, and their host society, and consider how these processes relate to their construction and meaning and coping with trauma. In a final section, we discuss the implications of our findings, raising questions about the value of participatory theatre as a reparative space and outlining suggestions to introduce and mobilize reparative modes of trauma narration in therapeutic practices in refugee trauma care.

Peace through health: traditional medicine meditation in the prevention of collective stress, violence, and war.

In the midst of global armed conflicts, notably the Israel-Hamas and Ukraine-Russia wars, there is an urgent need for innovative public health strategies in peacebuilding. The devastating impact of wars, including mortality, injury, disease, and the diversion of healthcare resources, necessitates effective and durable interventions. This perspective aligns with WHO recommendations and examines the role of evidence-based meditation from Ayurveda and Yoga in public health to mitigate collective stress and prevent collective violence and war. It highlights the Transcendental Meditation program, recognized for reducing stress, with contemporary evidence supporting its effectiveness in mental health, mind-body disorders, cardiovascular disease, and public health. Empirical studies with cross-cultural replications indicate that these Traditional Medicine meditation practices can reduce collective stress and prevent collective violence and war activity while improving quality of life. The mechanisms of group meditation in mitigating collective violence are explored through public health models, cognitive neuroscience, population neuroscience, quantum physics principles, and systems medicine. This perspective suggests that Transcendental Meditation and the advanced TM-Sidhi program, as a component of Traditional Medicine, can provide a valuable platform for enhancing societal well-being and peace by addressing brain-based factors fundamental to collective stress and violence.

Undiagnosed prediabetes in Mexican adolescents under poverty in contexts affected by collective violence: A clinical comparison among health services users and hidden population.

Introduction: The epidemiological pattern of prediabetes in adolescents is understudied. In Mexico, adolescents are exposed to social adversity conditions, including poverty and violence. Therefore, understanding their clinical profiles and how the social determinants of health impose barriers to access to health services is important to address detection, in those who, by their vulnerability, remain a hidden population. Aim: This study aimed to describe undiagnosed prediabetes in Mexican adolescents under poverty in violent contexts and to compare the clinical features among health services users and hidden population. Methods: This cross-sectional study included 371 adolescents from difficult access locations in violent contexts. Poverty, lack of health services access, and perceived vulnerability were determined in all samples. Endocrine markers (BMI, HOMA-IR, HbA1c, and cortisol) were measured in those with high violence perception. Results: A total of 61.7% of the adolescents had a suburban grid and urban cluster residence, and 77.7-85.7% of them belonged to locations where 35-50% of their population lived below the poverty line. In total, 40-75% had a lack of 10-20% access to health services, and 18.8% had a high perceived vulnerability due to collective violence and were screened. Overall, 61.9% of respondents were newly diagnosed with prediabetes and showed the worst HbA1c (p = 0.001) compared to the health services subsample, which showed the highest BMI (p = 0.031) and insulin resistance (p = 0.025). Conclusion: There is a prediabetes hidden population living in violent contexts under poverty. These social determinants promote poor outcomes in perceived vulnerability and endocrine response and represent barriers to access to health services.

'The War Made Me a Better Person': Syrian Refugees' Meaning-Making Trajectories in the Aftermath of Collective Trauma.

The centrality of the collective to Syrian identity and the ability of war to disrupt community ties have led to significant violations of Syrians' pre-war assumptions about themselves, the world, and their place in the world. Guided by the integrated meaning-making model, this qualitative cross-sectional study assessed Syrian refugees' meaning trajectories through their reappraisals of the war, attempts to repair community-informed shattered meanings, and those processes' outputs (i.e., meanings-made) and outcomes (i.e., perceived psychological adjustment). We conducted semi-structured cognitive interviews with 39 Syrian war-exposed adults living in urban communities across Portugal, most of whom were beneficiaries of higher education programs for refugees. Interviews were analyzed through thematic analysis. Results suggest that the war severely disrupted Syrians' sense of collective self, and that they repeatedly engaged in search for meaning, appraisals of the war, and reappraisals of shattered beliefs, life goals, and sense of purpose, both during wartime and in resettlement. In Portugal, despite persistent negative beliefs about the collective and ongoing and distressing searches for meaning, participants' lived experiences concomitantly informed positive meaning reappraisals, including progressive restoration of worldviews, new opportunities for self-realization, and newly-found purpose, leading to perceived psychological benefits and growth. These findings suggest that meaning-making is both a trajectory and a dynamic process, informed by place and sociopolitical context. Clinical work to facilitate adaptive meaning-making and meaning-informed psychosocial interventions that help restore refugees' shattered beliefs about safety, predictability, trust, and belonging, may be helpful directions to promote positive psychological adjustment and improve long-term integration prospects in refugees.

Mob Justice in South Africa: A comparison of blunt trauma secondary to community and non-community assaults.

BACKGROUND: The phenomenon of extrajudicial "mob justice" and community assault (CA) has been documented in news reports and anecdotes from a number of low- and middle-income countries, but there is little literature on its burden on trauma systems. This study reviews a single center's management of CA victims and compares the spectrum of injuries seen following mob assault with those sustained via other forms of interpersonal violence (IPV). METHODS: Clinical data, injury details, and mortality among injured patients (age≥18) hospitalized in a South African tertiary referral center from 2012-2018 were abstracted. Patients with penetrating injury or missing ISS were excluded. CA was determined at time of admission by either self-designation or by patients' escorts. Univariate analyses compared the presentation and outcomes for CAs and non-CAs. RESULTS: Overall, CA constituted 5% of total trauma admissions and 8% of IPV-related admissions during the study period. Of 1,323 incidents of blunt injury following IPV, 239 (18%) were CAs. One in two CA victims (n=119, 50%) were struck by an identifiable weapon. Patients injured in CA were more frequently male (97% vs 85%), presented with ISS>15 (28% vs 21%), and had a shock index>0.9 (25% vs 19%) compared to non-CA (all p<0.001). Rates of operative intervention, ICU admission, and mortality did not differ (all p>0.05). CAs were more likely to be complicated by acute kidney injury (9% vs 1%, p<0.001) but less likely to involve neurologic complications (3% vs 10%. P<0.001) compared to non-CAs. Acute kidney injury in CA showed a pattern of significant musculocutaneous injury with rhabdomyolysis. CONCLUSION: CA contributes considerably to the high rates of IPV in a single South African center. Victims of such assaults sustain more severe injury with unique mechanisms and subsequent complications. This evidence supports the need to strengthen local governance and improve law enforcement efforts to prevent such violence.

A life-course approach to early-onset of diabetes mellitus: Probable contribution of collective violence in Mexico.

Type 2 diabetes mellitus (T2DM) is a growing health problem among the pediatric population in the world, and particularly in Mexico. Official data in Mexico reported that during the period from 2003 to 2013 there was an increase in the cumulative incidence among older adolescents between 2010 and 2012, which decreased to the usual measures in 2013. All these variations occurred in a period in which collective violence permeated all levels of Mexican society. It can be argued that there might be a relationship between the two phenomena. This is an ecologic analytical study of trends over time comprising older adolescents (15-19 year olds). T2DM cumulative incidence and mortality rates attributable to violent death (VD) were standardized by direct method according to the World Health Organization. Data were sourced from nationwide official reports. Time series analysis was performed with ARIMA models and significant predictors. The disease ecology analysis was done using cluster analysis. Using significant predictors with ARIMA models, we found that the male VD mortality rates series could forecast 63.1% of the temporal variability of the cumulative incidence of T2DM series. Geographically, states with higher rates of violence also showed a higher incidence of T2DM. These data suggest that collective violence may make some contribution to the early onset of T2DM among adolescents, particularly in those regions most affected by violence. These findings can be conducive to opening new lines of research to explore the relationship between variables at the individual level and the clinical implications.

Disarming Ex-Combatants' Minds: Toward Situated Reintegration Process in Post-conflict Colombia.

Collective violence in the context of armed conflict impacts the economy, health systems, and social stability of affected countries. This is considered a complex phenomenon with interwoven biological, psychological, social, cultural, and political factors. However, most of the research on this topic still lacks suitable established integrative approaches to assess multilevel perspectives. Social, cognitive and affective mental processes (SCAMP) are critical factors that should be considered in multilevel approaches. In this article, we critically discuss some of the classically isolated approaches used in violence research, the absence of successful interventions for ex-combatants reintegration, and the specific neglect of SCAMP in these interventions. We present the case of post-conflict Colombia as a unique opportunity to study the different roots of collective violence, and we call for a more robust and situated approach to understanding of and intervention in this multifaceted phenomenon. In addition, we suggest a two-stage approach for addressing ex-combatants' reintegration programs, which considers the situated nature of post-conflict scenarios and the urgent need for evidence-based interventions. This approach focuses on the comprehensive scientific assessment of specific factors involved in violence exposure and the subsequent design of successful interventions. The implementation of this approach will contribute to the effective reintegration of individuals who have been exposed to extreme violence for more than 50 years.

Institutional apologies and socio-emotional climate in the South American context.

This study examined perceptions of institutional apologies related to past political violence and socio-emotional climate among victims and non-victims in Argentina (n = 518), Chile (n = 1,278), and Paraguay (n = 1,172) based on quasi-representative samples. The perceptions of apology as sincere and efficient in improving intergroup relations were associated with a positive socio-emotional climate across the three nations. Victims evaluated apologies more positively and perceived a more positive socio-emotional climate compared to non-victims in Paraguay and Argentina, whereas the opposite was true in Chile where the government opposed the victims' leftist political orientation. The evaluations of apologies also mediated the effects of exposure to violence on the perception of socio-emotional climate, but these effects were moderated by the context. Together, these findings suggest that apologies reinforce positive sociopolitical climate, and that, personal experience of victimization is an important factor determining these effects.

Psychoanalysis and the law.

The paper discusses Freud's view of the law as the implementation of collective violence on the individual violator. I focus on the implications of the link between the superego (as the source of moral judgment) and the aggressive drive and suggest that we need to be ever vigilant regarding the danger of employing the law as a disguised means of taking pleasure in collective violence. The paper also discusses Freud's conception of personal responsibility, according to which we are responsible for all our behavior, including unconsciously motivated behavior (such as slips and dreams). However, the kind of responsibility Freud has in mind is not the moral responsibility of blameworthiness or praiseworthiness, but rather responsibility in the sense that, whether or not acknowledged, all our behavior reflects our personal desires and motives.

Shaking the tyrant's bloody robe.

Group violence, despite much study, remains enigmatic. Its forms are numerous, its proximate causes myriad, and the interrelation of its forms and proximate causes poorly understood. We review its evolution, including preadaptations and selected propensities, and its putative environmental and psychological triggers. We then reconsider one of its forms, ethnoreligious violence, in light of recent discoveries in the behavioral and brain sciences. We find ethnoreligious violence to be characterized by identity fusion and by manipulation of religious traditions, symbols, and systems. We conclude by examining the confluence of causes and characteristics before and during Yugoslavia's wars of disintegration.

The "treatment gap" in global mental health reconsidered: sociotherapy for collective trauma in Rwanda.

BACKGROUND: The "treatment gap" (TG) for mental disorders refers to the difference that exists between the number of people who need care and those who receive care. The concept is strongly promoted by the World Health Organization and widely used in the context of low- and middle-income countries. Although accepting the many demonstrable benefits that flow from this approach, it is important to critically reflect on the limitations of the concept of the TG and its implications for building capacity for mental health services in Rwanda. OBJECTIVE: The article highlights concerns that the evidence base for mental health interventions is not globally valid, and problematizes the preponderance of psychiatric approaches in international guidelines for mental health. Specifically, the risk of medicalization of social problems and the limited way in which "community" has been conceptualized in global mental health discourses are addressed. Rather than being used as a method for increasing economic efficiency (i.e., reducing healthcare costs), "community" should be promoted as a means of harnessing collective strengths and resources to help promote mental well-being. This may be particularly beneficial for contexts, like Rwanda, where community life has been disrupted by collective violence, and the resulting social isolation constitutes an important determinant of mental distress. CONCLUSIONS: Moving forward there is a need to consider alternative paradigms where individual distress is understood as a symptom of social distress, which extends beyond the more individually oriented TG paradigm. Sociotherapy, an intervention used in Rwanda over the past 10 years, is presented as an example of how communities of support can be built to promote mental health and psychosocial well-being.

Departamentos de frontera y violencia periférica en Colombia / Border departments and peripheral violence in Colombia / Departamentos de fronteira e violência periférica na Colômbia

Resumen El presente trabajo tiene como principal propósito exponer algunas de las dinámicas de la violencia directa y estructural de siete departamentos de frontera que, en los últimos años, se han erigido como algunos de los escenarios en los que concurren una suerte de variables que pueden experimentar nuevas violencias en el marco del posconflicto armado en Colombia, que serán prioridad para el Acuerdo de Paz suscrito con la guerrilla de las FARC-EP. Estos departamentos son Arauca, Cauca, Chocó, Nariño, Norte de Santander, Putumayo y Valle del Cauca, para todos ellos se presenta un análisis de indicadores de activismo armado y de carácter socioeconómico que va desde el número de acciones guerrilleras o muertes por violencia directa hasta las necesidades básicas insatisfechas o la condición de pobreza, pasando por la presencia de economías ilícitas como los cultivos cocaleros o la minería ilegal. El trabajo, asimismo, integra percepciones de las alcaldías -recogidas entre 2014 y 2015- en las que ya se alertaba de las especiales dificultades en estos escenarios a efectos de atender un proceso de construcción de paz integral.

Abstract This work has as main purpose to expose some of the dynamics of the direct and structural violence of seven border departments that, in the last years, have raised as some of the scenarios in which concur a sort of variables that can experience new violences in the framework of the post-conflict in Colombia, which will be priority for the Peace Agreement subscribed with the FARC-EP guerrilla. Those departments are Arauca, Cauca, Chocó, Nariño, Norte de Santander, Putumayo and Valle del Cauca; for all of them an analysis of indicators of armed activism and socio-economic character is presented that goes from the number of guerilla actions or deaths by direct violence up to unsatisfied basic needs or the poverty condition, through the presence of illicit economies such as the coca crops or the illegal mining. The work, likewise, integrates perceptions of the municipal governments - collected between 2014 and 2015 - in which a warning was already issued about the special difficulties on those scenarios for the purpose of attending a process of building of comprehensive peace.

Resumo O presente trabalho tem como principal propósito exporalgumas das dinâmicas da violência direta e estrutural de sete departamentos de fronteira que, nos últimos anos, tem sido erigidos como alguns dos cenários nos que concorrem uma sorte de variáveis que podem experimentar novas violências no marco do pôs-conflito na Colômbia, que serão prioridade para o Acordo de Paz subscrito com a guerrilha das FARCEP. Estes departamentos são Arauca, Cauca, Chocó, Nariño, Norte de Santander, Putumayo e Valle del Cauca; para todos estes apresenta-se uma análise de indicadores de ativismo armado e de caráter socioeconómico que vai desde o número de ações guerrilheiras ou mortes por violencia direta até as necessidades básicas insatisfeitas ou a condição de pobreza, passando pela presença de economias ilícitas como os cultivos cocaleros ou a mineração ilegal. O trabalho, do mesmo modo, integra percepções das prefeituras -recolhidas entre 2014 e 2015- nas que já se alertava das especiais dificuldades nestes cenários para efeitos de atender um processo de construção de paz integral.

The emotional and behavioral problems of children exposed to poverty and/or collective violence in communities at the Mexico-United States border: A comparative study / Problemas emocionales y de comportamiento entre niños expuestos a la pobreza y/o la violencia colectiva en comunidades en la frontera México-Estados Unidos: Un estudio comparativo

Background Collective violence attributed to organized crime has shown to be responsible for a considerable burden of physical and mental health morbidity among youth. Objective To compare the emotional and behavioral problems of children exposed to early childhood poverty and/or collective violence in communities at the Mexico-United States border to children exposed to other social and health risks. Method A cross-sectional study was carried out with individuals living in poverty at two sites at the Mexico-United States border. Individuals who responded once to the Pictorial Child Behavior Checklist (P+CBCL) in Spanish were selected randomly from clinics in a metropolitan area of El Paso, Texas, United States (poverty alone group), and Ciudad Juarez, Chihuahua, Mexico (poverty plus collective violence group). In addition, emotional and behavioral problems present in these groups were compared with available published emotional and behavioral CBCL scales of children exposed to other social and health risks. Results Children exposed to both poverty and collective violence had higher emotional and behavioral problem scores as measured by the P+CBCL than those exposed to poverty alone. In addition, compared with children who were brain-injured, hearing impaired, or whose parents were exposed to drugs or alcohol, the poverty and collective violence group had higher levels of emotional and behavioral problems. Discussion and conclusion Systematic detection and treatment of children as young as 18 months exposed to trauma are necessary to diminish the mental health problems caused by the collective violence attributed to organized crime.

Antecedentes La violencia colectiva atribuida al crimen organizado ha mostrado causar considerables daños en la salud mental de jóvenes. Objetivo Comparar los problemas emocionales y de comportamiento de niños expuestos a la pobreza y/o violencia colectiva en comunidades localizadas en la frontera México-Estados Unidos, así como con niños expuestos a otros riesgos. Método Estudio transversal con participantes viven en la pobreza en ambos lados de la frontera de México y Estados Unidos. Los participantes respondieron a la versión con pictogramas en español del Cuestionario de Comportamientos de Niños (P+CBCL) en clínicas localizadas en El Paso, Texas (grupo expuesto a la pobreza), y en Ciudad Juárez, Chihuahua, México (grupo expuesto a la pobreza + violencia colectiva). De forma adicional se compararon los problemas emocionales y de comportamiento de estos grupos con resultados históricos obtenidos a partir de la evidencia científica. Resultados Los niños expuestos a la pobreza/violencia colectiva registraron resultados más altos en las escalas de problemas emocionales y de comportamiento al medirlos con el P+CBCL cuando se compararon con el grupo expuesto solamente a la pobreza. De forma adicional, al comparar los grupos con niños con problemas cerebrales, de audición, o con padres expuestos a drogas y alcohol, el grupo expuesto a la pobreza y a la violencia registró mayores problemas emocionales y de comportamiento. Discusión y Conclusión La detección sistemática y el tratamiento de niños desde los 18 meses expuestos a trauma son necesarios para disminuir los problemas mentales causados por la violencia colectiva atribuida al crimen organizado.