Sexual Violence

Rape, Torture, and Traumatization of Bosnian and Croatian Women

Citation:

Kozaric-Kovacic, Dragica, Vera Folnegovic-Smalc, Jarmila Skrinjaric, Nathan M. Szajnberg, and Ana Marusic. 1995. "Rape, Torture, and Traumatization of Bosnian and Croatian Women." American Journal of Orthopsychiatry 65 (3): 428-433.

Authors: Dragica Kozaric-Kovacic, Vera Folnegovic-Smalc, Jarmila Skrinjaric, Nathan. M. Szajnberg, Ana Marusic

Abstract:

The first 25 Bosnian women admitted to the Zagreb Obstetrics and Gynaecological Clinic or its associated regional psychiatric centers were assessed using both clinical and post-traumatic stress disorder interviews. Most of the women had been multiply traumatized; all had been repeatedly raped. Psychological status was assessed for those women who were not impregnated, for those impregnated who received abortions, and for those impregnated who carried the fetus to term.

Keywords: war rape, Torture, trauma, mental health, posttraumatic stress disorder

Topics: Gender, Women, Gender-Based Violence, Health, Mental Health, PTSD, Reproductive Health, Trauma, Sexual Violence, Rape, SV against Women, Torture Regions: Europe, Balkans, Eastern Europe Countries: Bosnia & Herzegovina, Croatia

Year: 1995

The Role of Sexual Assault on the Risk of PTSD among Gulf War Veterans

Citation:

Kang, Han, Nancy Dalager, Clare Mahan, and Erick Ishii. 2005. "The Role of Sexual Assault on the Risk of PTSD among Gulf War Veterans." Annals of Epidemiology 15 (3): 191-95.

Authors: Han Kang, Nancy Dalager, Clare Mahan, Erick Ishii

Abstract:

Purpose: The 1991 Gulf War was the first major military deployment where female troops were integrated into almost every military unit, except for combat ground units. We evaluated the impact of reported sexual trauma during this deployment on the risk of post-traumatic stress disorder (PTSD) after the war.

Methods: A nested case–control analysis was conducted using the data collected in a population-based health survey of 30,000 Gulf War era veterans. A total of 1381 Gulf War veterans with current PTSD were compared with 10,060 Gulf veteran controls without PTSD for self-reported in-theater experiences of sexual harassment/assault and combat exposure.

Results: The adjusted odds ratio (aOR) for PTSD associated with a report of sexual assault was 5.41 (95% confidence interval [CI], 3.19–9.17) in female veterans and 6.21 (95% CI, 2.26–17.04) in male veterans. The aOR for PTSD associated with “high” combat exposure was also statistically significant (aOR, 4.03 [95% CI, 1.97–8.23] for females; aOR, 4.45 [95% CI, 3.54–5.60] for males).

Conclusion: Notwithstanding a possibility of recall bias of combat and sexual trauma, for both men and women, sexual trauma as well as combat exposure appear to be strong risk factors for PTSD.

Keywords: military sexual assault, posttraumatic stress disorder, male veterans, female veterans, mental health

Topics: Combatants, Female Combatants, Male Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Sexual Violence Regions: Americas, North America Countries: United States of America

Year: 2005

Gender Differences in Rates of Depression, PTSD, Pain, Obesity, and Military Sexual Trauma among Connecticut War Veterans of Iraq and Afghanistan

Citation:

Haskell, Sally G., Kirsha S. Gordon, Dristen Mattocks, Mona Duggal, Joseph Erdos, Amy Justice, and Cynthia A. Brandt. 2010. "Gender Differences in Rates of Depression, PTSD, Pain, Obesity, and Military Sexual Trauma among Connecticut War Veterans of Iraq and Afghanistan." Journal of Women's Health 19 (2): 267-271.

Authors: Sally G. Haskell, Kirsha S. Gordon, Dristen Mattocks, Mona Duggal, Joseph Erdos, Amy Justice, Cynthia A. Brandt

Abstract:

Purpose: The current wars in Iraq and Afghanistan have led to an increasing number of female veterans seeking medical and mental healthcare in the Department of Veterans Affairs (VA) healthcare system. To better understand gender differences in healthcare needs among recently returned veterans, we examined the prevalence of positive screenings for depression, posttraumatic stress disorder (PTSD), military sexual trauma ( MST), obesity, and chronic pain among female and male veterans of Operation Enduring Freedom=Operation Iraqi Freedom (OEF=OIF) receiving care at the VA Connecticut Healthcare System.

Methods: We performed a retrospective, cross-sectional data analysis of OEF=OIF veterans at VA Connecticut who received services in either Primary Care or the Women’s Health Clinic between 2001 and 2006. 

Results: In this study, 1129 electronic medical records (1032 men, 197 women) were examined. Female veterans were more likely to screen positive for MST (14% vs. 1%, p < 0.001) and depression (48% vs. 39%, p ¼ 0.01) and less likely to screen positive for PTSD (21% vs. 33%, p ¼ 0.002). There was no significant gender difference in clinically significant pain scores. Men were more likely than women to have body mass index (BMI) >30 kg=m2 (21% vs. 13%, p ¼ 0.008).

Conclusions: These results suggest that important gender differences exist in the prevalence of positive screenings for MST, depression, obesity, and PTSD. As the VA continues to review and improve its services for women veterans, clinicians, researchers, and senior leaders should consider innovative ways to ensure that female veterans receive the health services they need within the VA system.

Keywords: depression, posttraumatic stress disorder, obesity, military sexual assault, female veterans, male veterans

Topics: Armed Conflict, Combatants, Female Combatants, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Sexual Violence Regions: MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2010

Prevalence of Depressive and Alcohol Abuse Symptoms among Women VA Outpatients Who Report Experiencing Sexual Assault While in the Military

Citation:

Hankin, Cheryl S., Katherine Skinner, Lisa M. Sullivan, Donald R. Miller, Susan Frayne, and Tara J. Tripp. 1999. "Prevalence of Depressive and Alcohol Abuse Symptoms among Women VA Outpatients Who Report Experiencing Sexual Assault While in the Military." Journal of Traumatic Stress 12 (4): 601-612.

Authors: Cheryl S. Hankin, Katherine Skinner, Lisa M. Sullivan, Donald R. Miller, Susan Frayne, Tara J. Tripp

Abstract:

Among a national sample of 3,632 women VA outpatients, we determined self-reported prevalence of sexual assault experienced during military service and compared screening prevalence for current symptoms of depression and alcohol abuse between those who did and did not report this history. Data were obtained by mailed questionnaire. Military-related sexual assault was reported by 23%. Screening prevalence for symptoms of current depression was 3 times higher and for current alcohol abuse was 2 times higher among those who reported experiencing military-related sexual assault. Recent mental health treatment was reported by 50% of those who reported experiencing sexual assault during military service and screened positive for symptoms of depression, and by 40% of those who screened positive for symptoms of alcohol abuse.

Keywords: depression, substance abuse, female veterans, military sexual assault

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, Military Forces & Armed Groups, Sexual Violence, SV against Men Regions: Americas, North America Countries: United States of America

Year: 1999

Focus on Women: Duty-Related and Sexual Stress in the Etiology of PTSD among Women Veterans Who Seek Treatment

Citation:

Fontana, Alan, and Robert Rosenheck. 1998. "Focus on Women: Duty-Related and Sexual Stress in the Etiology of PTSD among Women Veterans Who Seek Treatment." Psychiatric Services 49 (5): 658-662.

Authors: Alan Fontana, Robert Rosenheck

Abstract:

Objective: The stressful experiences of women serving in the military have been a focus of increasing concern. A model of the impact of stress related to military duty and stress related to sexual abuse and harassment on the development of posttraumatic stress disorder (PTSD) among female veterans was evaluated. 

Methods: Structural equation modeling was applied to data from 327 women treated in a VA clinical program for women with stress disorders. The model was a chronological one and included variables related to the women's premilitary experience, their military service, and their postmilitary experience.

Results: Altogether 48 percent of the sample served overseas, and 12 percent were exposed to enemy fire. A total of 63 percent reported experiences of physical sexual harassment during military service, and 43 percent reported rape or attempted rape. Both duty-related and sexual stress were found to contribute separately and significantly to the development of PTSD. Sexual stress was found to be almost four times as influential in the development of PTSD as duty-related stress. Postmilitary social support played a highly significant mediational role between sexual stress during military service and development of PTSD.

Conclusions: Women's exposure to sexual stress in the military is much more prevalent than previously believed. It is particularly toxic for the development of PTSD. Correct assessment is essential to effective treatment.

Keywords: female veterans, posttraumatic stress disorder, mental health, counseling, sexual assault

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Sexual Violence, Rape, SV against Women Regions: Americas, North America Countries: United States of America

Year: 1998

Impact of Combat and Sexual Harassment on the Severity of Posttraumatic Stress Disorder among Men and Women Peacekeepers in Somalia

Citation:

Fontana, Alan, Brett Litz, and Robert Rosenheck. 2000. "Impact of Combat and Sexual Harassment on the Severity of Posttraumatic Stress Disorder among Men and Women Peacekeepers in Somalia." Journal of Nervous and Mental Disease 188 (3): 163-169.

Authors: Alan Fontana, Brett Litz, Robert Rosenheck

Abstract:

The impact of combat and sexual harassment on the severity of posttraumatic stress disorder (PTSD) is compared for 1307 men and 197 women peacekeepers who served in the same military units. A theoretical model was proposed to express the nature of the impact. Structural equation modeling was used to evaluate the model separately for men and women. Good-fitting, parsimonious models were developed that showed substantial similarity for men and women. For men, severity of PTSD symptoms was impacted by exposure to combat directly and indirectly through fear and sexual harassment. For women, severity of PTSD symptoms was impacted by combat indirectly through the same two influences, although the mechanisms involving fear and sexual harassment were somewhat different. For both genders, moreover, PTSD severity was impacted directly by exposure to the dying of the Somali people. These similarities suggest that in modern stressful overseas military missions, both genders may be susceptible to the same types of risk for the development of PTSD. The incidence and impact of sexual harassment is particularly noteworthy in the case of men and calls for more detailed investigation in future studies.

Keywords: sexual assault, posttraumatic stress disorder, peacekeepers

Topics: Armed Conflict, Combatants, Gender, Women, Men, Health, Mental Health, PTSD, Trauma, Humanitarian Assistance, Peacekeeping, Peace Processes, Sexual Violence, Sexual Exploitation and Abuse Regions: Africa, East Africa Countries: Somalia

Year: 2000

Improvement in Post-Traumatic Stress Disorder in Post-Conflict Rwandan Women

Citation:

Cohen, Mardge H., Qiuhu Shi, Mary Fabri, Henriette Mukanyonga, Xiaoto Cai, Donald R. Hoover, and Kathryn Anastos. 2011. "Improvement in Post-Traumatic Stress Disorder in Post-Conflict Rwandan Women." Journal of Women's Health 20 (9): 1325-1332.

Authors: Mardge H. Cohen, Qiuhu Shi, Mary Fabri, Henriette Mukanyonga, Xiaoto Cai, Donald R. Hoover, Kathryn Anastos

Abstract:

BACKGROUND: Depression and posttraumatic stress disorder (PTSD) are common in developing and postconflict countries. The purpose of this study is to examine longitudinal changes in PTSD in HIV-infected and uninfected Rwandan women who experienced the 1994 genocide.

METHODS: Five hundred thirty-five HIV-positive and 163 HIV-negative Rwandan women in an observational cohort study were followed for 18 months. Data on PTSD symptoms were collected longitudinally by the Harvard Trauma Questionnaire (HTQ) and analyzed in relationship to demographics, HIV status, antiretroviral treatment (ART), and depression. PTSD was defined as a score on the HTQ of >/=2.

RESULTS: There was a continuing reduction in HTQ scores at each follow-up visit. The prevalence of PTSD symptoms changed significantly, with 61% of the cohort having PTSD at baseline vs. 24% after 18 months. Women with higher HTQ score were most likely to have improvement in PTSD symptoms (p<0.0001). Higher rate of baseline depressive symptoms (p<0.0001) was associated with less improvement in PTSD symptoms. HIV infection and ART were not found to be consistently related to PTSD improvement.

CONCLUSIONS: HIV care settings can become an important venue for the identification and treatment of psychiatric problems affecting women with HIV in postconflict and developing countries. Providing opportunities for women with PTSD symptoms to share their history of trauma to trained counselors and addressing depression, poverty, and ongoing violence may contribute to reducing symptoms.

Keywords: posttraumatic stress disorder, mental health, HIV/AIDS, genocide, war rape

Topics: Armed Conflict, Gender, Women, Genocide, Health, HIV/AIDS, Mental Health, PTSD, Trauma, Post-Conflict, Sexual Violence, Rape Regions: Africa, Central Africa, East Africa Countries: Rwanda

Year: 2011

Prevalence and Predictors of Posttraumatic Stress Disorder and Depression in HIV-Infected and At-Risk Rwandan Women

Citation:

Cohen, Mardge H., Mary Fabri, Xiaotao Cai, Qiuhu Shi, Donald R. Hoover, Agnes  Binagwaho, Melissa A. Culhane, Henriette Mukanyonga, Davis K. Karegeya, and Kathryn Anastos. 2009. "Prevalence and Predictors of Posttraumatic Stress Disorder and Depression in HIV-Infected and At-Risk Rwandan Women." Journal of Women's Health 18 (11): 1783-1791.

Authors: Mardge H. Cohen, Mary Fabri, Xiaotao Cai, Quihu Shi, Donald R. Hoover, Agnes Binagwaho, Melissa A. Culhane, Henriette Mukanyonga, Davis K. Karegeya, Kathryn Anastos

Abstract:

OBJECTIVE: During the 1994 Rwandan genocide, rape was used as a weapon of war to transmit HIV. This study measures trauma experiences of Rwandan women and identifies predictors associated with posttraumatic stress disorder (PTSD) and depressive symptoms.

METHODS: The Rwandan Women's Interassociation Study and Assessment (RWISA) is a prospective observational cohort study designed to assess effectiveness and toxicity of antiretroviral therapy in HIV-infected Rwandan women. In 2005, a Rwandan-adapted Harvard Trauma Questionnaire (HTQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess genocide trauma events and prevalence of PTSD (HTQ mean > 2) and depressive symptoms (CES-D > or = 16) for 850 women (658 HIV-positive and 192 HIV-negative).

RESULTS: PTSD was common in HIV-positive (58%) and HIV-negative women (66%) (p = 0.05). Women with HIV had a higher prevalence of depressive symptoms than HIV-negative women (81% vs. 65%, p < 0.0001). Independent predictors for increased PTSD were experiencing more genocide-related trauma events and having more depressive symptoms. Independent predictors for increased depressive symptoms were making < $18 a month, HIV infection (and, among HIV-positive women, having lower CD4 cell counts), a history of genocidal rape, and having more PTSD symptoms. 

CONCLUSIONS: The prevalence of PTSD and depressive symptoms is high in women in the RWISA cohort. Four of five HIV-infected women had depressive symptoms, with highest rates among women with CD4 cell counts < 200. In addition to treatment with antiretroviral therapy, economic empowerment and identification and treatment of depression and PTSD may reduce morbidity and mortality among women in postconflict countries.

Keywords: mental health, HIV/AIDS, posttraumatic stress disorder, depression, genocide, war rape

Topics: Gender, Women, Genocide, Health, HIV/AIDS, Mental Health, PTSD, Trauma, Post-Conflict, Sexual Violence, Rape, SV against Women Regions: Africa, Central Africa, East Africa Countries: Rwanda

Year: 2009

Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health

Citation:

Betancourt, Theresa S., Robert T. Brennan, Julia Rubin-Smith, Garrett M. Fitzmaurice, and Stephen E. Gilman. 2010. "Sierra Leone's Former Child Soldiers: A Longitudinal Study of Risk, Protective Factors, and Mental Health." Journal of the American Academy of Child and Adolescent Psychiatry 49 (6): 606-15.

Authors: Theresa S. Betancourt, Robert T. Brennan, Julia Rubin-Smith, Garrett M. Fitzmaurice, Stephen E. Gilman

Abstract:

OBJECTIVE: To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes.

METHOD: Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences.

RESULTS: The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems (b = -1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance (b = -0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance (b = 1.93).

CONCLUSIONS: Psychosocial interventions for former child soldiers may be more effective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended.

Keywords: child soldiers, mental health

Topics: Age, Youth, Armed Conflict, Combatants, Child Soldiers, Gender, Girls, Boys, Health, Mental Health, Trauma, Military Forces & Armed Groups, NGOs, Post-Conflict, Sexual Violence, Rape, Violence Regions: Africa, West Africa Countries: Sierra Leone

Year: 2010

Women and the Genocidal Rape of Women: The Gender Dynamics of Gendered War Crimes

Citation:

Sjoberg, Laura. 2011. "Women and the Genocidal Rape of Women: The Gender Dynamics of Gendered War Crimes." In Confronting Global Gender Justice: Women's Lives, Human Rights, edited by Debra Bergoffen, Paula Ruth Gilbert, Tamara Harvey, and Connie L. McNeely, 21-34. New York: Routledge.

Author: Laura Sjoberg

Abstract:

Expanding on work from my 2007 book, Mothers, Monsters, Whores: Women’s Violence in Global Politics (with Caron Gentry), this chapter looks at the dynamics of women’s participation in the war crime of genocidal rape against other women. It asks both about why women participated and about how their participation was portrayed in media and scholarly accounts. The chapter looks at these questions by exploring five cases of women’s (alleged) commission of the war crime of genocidal rape. It concludes with a reformulated approach to the laws and norms against genocidal rape in the international community, taking account of women’s roles in the crime not only as (often) victims but also as (sometimes) perpetrators.

Annotation:

Quotes:

“This work, more often than not, defines genocidal rape as a crime where men are the perpetrators and women are the victims." (Sjoberg, 21)

“In previous work, Caron Gentry and I (2007) have identified these as the mother, monster, and whore narratives. The mother narratives feature women’s motherhood as a key motivator for their participation in violence. The mother narrative has two general strands – one that portrays women perpetrators of genocide as nurturing mothers, whose role in the conflict is to take care of and provide for their men – the fact that those men happen to be participating in genocide (and therefore nurturing them is too) does not change the women’s role in society or perception of their familial duty. The other strand of the mother narrative portrays women who commit genocide as vengeful mothers – avenging the deaths of their husbands, brothers, or fathers at the hand of those on the other side of the conflict.” (Sjoberg, 22-23)

“The second narrative we’ve identified is the monster narrative. This story of women’s motivation for involvement in genocide frames women perpetrators as severely psychologically disturbed. These stories tell women perpetrators as crazier and more monstrous than the men that they act with or alongside. Women’s monstrosity, in these stories, comes from the sort of irrational anger only women could have, or feelings of personal inadequacy coming from the inability to marry or have children.” (Sjoberg, 23) 

“The final narrative we’ve identified is the whore narrative. In the whore narrative, women’s participation in genocide is either defined by erotomania or erotic dysfunction. The erotomania story tells of women sexually obsessed with and therefore controlled by men – of women’s sexuality gone wrong and out of control. These women are portrayed as having committed genocide because their sex drive had gone out of control, and female sexuality at its worst is violent and brutal. The story of erotic dysfunction tells as story of a woman who has turned to violence because she is either unwilling to or unable to please men. These women are portrayed as having turned to violence because they were unable to function/serve as real women, which requires getting married and having children.” (Sjoberg, 23)  

“All of these stories about why women commit genocide share several things. First, they assume that the problem of why women commit genocide is a problem separate from the question of why men commit genocide (or even the question of why people generally commit genocide). Second, they preserve a distinction between women who are capable of violence and real or normal women who remain, as we have always assumed, more peaceful than men. Third, though real or normal women are seen as more peaceful than men, these stories depict women’s violence as the result of the excesses of femininity. Finally, these narratives imply that women cannot both be victims of genocide (as a class) and perpetrators of genocide (as individuals or as a group) – it has to be one or the other. Often, both in the public eye and in the academic literature, the identification of women as perpetrators has traded off with the recognition of women as victims.” (Sjoberg, 23)  

“Several accounts have also read women’s perpetration of genocide, genocidal rape, and other sexual crimes as a reversal of gender subordination – where women have become the perpetrators, and are therefore no longer the victims." (Sjoberg, 24)

“As such, the question of why women commit violence generally and genocide specifically is treated as a different question than the question of why men commit such violence. Women’s violence is often almost exclusively explained by gender-specific theories or gender-specified versions of traditional theories of individual violence. Women’s violence is explained as women’s violence rather than as women committing violence.”  (Sjoberg, 27)

“Their stories contradict the dominant narrative about what a woman is generally and about women’s capacity for violence specifically. Because their stories do not resonate with these inherited images of femininity, violent women are marginalized in political discourse. Their choices are rarely seen as choices, and, when they are, they are characterized as apolitical.” (Sjoberg, 27) 

“Those with a political interest in the gender order cannot hear or tell those stories of women’s participation in genocidal rape; instead, stories are produced and reproduced where women’s agency in their violence is denied and violent women are characterized as singular and abnormal aberrations.” (Sjoberg, 27) 

“If violent women are seen as different from what women as women should be, then their existence can be explained away without interrogating the fundamental problems with the stereotypical understanding of what women are – peaceful, virtuous, non-violent, etc.” (Sjoberg, 27)  

“In other words, in these accounts, women’s violence is worse (and to be feared more) than men’s violence, because women are naturally emotional and unpredictable as opposed to men’s presumed rationality and consistency, even in the commission of crimes.” (Sjoberg, 28) 

“Therefore, though they are a blight on the purity of femininity, women who commit genocidal rape or other sex-based crimes in genocide are described as being motivated by things that could only come from their status as women – what is abnormal to women is not their femininity, it is its uncontrolled status and extreme expression.” (Sjoberg, 28) 

“Finally, these stories of women’s participation in genocidal rape share that they either argue or imply that women’s perpetration of genocidal rape against women disrupts narratives of female victimhood….In other words, there are those who argue that women’s participation in violence signals the end of women’s victimization in war and genocide. Still, many of the women that were discussed in the five snapshots above sexually victimized women on the basis of gender. In other words, they perpetrated gender subordination.” (Sjoberg, 28)  

“Along with the implied naturalness of women’s subordination and the assumption of women’s incapability, we can see in the stereotyped reactions to women’s commission of sexual violence not only that women are expected not to violate other women – but also that there’s some normalness to men’s sexual violation of women.” (Sjoberg, 30) 

“The third step, then, is to reformulate international legal approaches to genocidal rape to accommodate the possibility of women perpetrators while still preserving the understanding that women are, as a class, victimized by genocidal rape based on gender.” (Sjoberg, 31)

Topics: Gender, Women, Gender-Based Violence, Genocide, Justice, War Crimes, Peace Processes, Sexual Violence, Female Perpetrators, Rape, SV against Women Regions: Africa, Central Africa, Europe, Balkans, Central Europe Countries: Bosnia & Herzegovina, Germany, Rwanda

Year: 2011

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