Multiple Traumas in Civilian Casualties of Organized Political Violence
Civilians’ experience of organized political violence (OPV) can vary widely depending upon the political context in which it occurs. Conventional warfare, state-sponsored terrorism, and political terrorism by non-nation-state entities can be associated with different potentially traumatic events (PTEs). For example, conventional warfare often entails the close proximity of noncombatants to military action focused on establishing control over de¢ned areas and institutions. Stressors most commonly associated with conventional warfare include loss of life; lack of access to basic needs such as food, water, shelter, and health care; as well as destruction of personal property, infrastructure, and means for livelihood. Terrorism practiced by nation-states is mainly utilized to achieve foreign policy goals or to maintain domestic control and often entails imprisonment and torture but can also include intimidation and exile, among other tactics. To the extent that these forms of violence necessitate that civilians seek shelter outside of their country of origin, Žeeing civilians are conferred refugee status. Refugee status comes with its own broad set of acute and chronic stressors. In this chapter, we will review the epidemiological evidence for postviolence disruption, review these disparate potential traumas, provide a theoretical frame to conceptualize the impact of these events, and discuss the assessment and treatment of civilians exposed to OPV.