title: Posttraumatic stress and youth violence perpetration: A population-based cross-sectional study.
abstract: Exposure to trauma was found to increase later violent behaviours in youth but the underlying psychopathological mechanisms are unclear. This study aimed to test whether posttraumatic stress disorder (PTSD) is related to violent behaviours and whether PTSD symptoms mediate the relationship between the number of trauma experiences and violent behaviours in adolescents.
  
  
  
  The present study is based on a nationally representative sample of 9th grade students with 3434 boys (mean age=15.5 years) and 3194 girls (mean age=15.5 years) in Switzerland. Lifetime exposure to traumatic events and current PTSD were assessed by the use of the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA-RI). Logistic regression was used to assess associations between PTSD and violent behaviours, and structural equation modelling (SEM) was used to examine the meditation effects of PTSD.
  
  
  
  PTSD (boys: OR=7.9; girls: OR=5.5) was strongly related to violent behaviours. PTSD symptoms partially mediated the association between trauma exposure and violent behaviours in boys but not in girls. PTSD symptoms of dysphoric arousal were positively related to violent behaviours in both genders. Anxious arousal symptoms were negatively related to violent behaviours in boys but not in girls.
  
  
  
  In addition to trauma, posttraumatic stress is related to violent outcomes. However, specific symptom clusters of PTSD seem differently related to violent behaviours and they do not fully explain a trauma-violence link. Specific interventions to improve emotion regulation skills may be useful particularly in boys with elevated PTSD dysphoric arousal in order to break up the cycle of violence.
authors.affiliation: Department of Forensic Psychiatry, University Hospital of Psychiatry, Neptunstrasse 60, 8032 Zurich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, Neumünsterallee 3, 8032 Zurich, Switzerland; Department of Clinical Psychology with Children/Adolescents & Families/Couples, Institute of Psychology, University of Zurich, Attenhoferstrasse 9, Zurich, Switzerland. Electronic address: marcel.aebi@uzh.ch.
authors.forename: M
authors.initials: M
authors.lastname: Aebi
authors.affiliation: Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Mohler-Kuo
authors.affiliation: Department of Forensic Psychiatry, University Hospital of Psychiatry, Neptunstrasse 60, 8032 Zurich, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Barra
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Culmannstrasse 8, 8091 Zurich, Switzerland.
authors.forename: U
authors.initials: U
authors.lastname: Schnyder
authors.affiliation: Psychiatric Services of the County of St. Gallen North, Zurcherstrasse 30, 9501 Wil, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Maier
authors.affiliation: Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14/8, 8051 Zurich, Switzerland; Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
authors.forename: M A
authors.initials: MA
authors.lastname: Landolt
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D001007:Anxiety / Q000175:diagnosis; D001143:Arousal / Q000502:physiology; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D000297:Psychology, Adolescent; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D013557:Switzerland; D014754:Violence / Q000523:psychology*
keywords: Aggression; Anxious arousal; Dysphoric arousal; Numbing; PTSD; Trauma