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The current evidence base indicates that both victimsand perpetrators of domestic, family and sexualviolence have diverse and complex needs, frequentlyrequiring multiple interventions provided by a range ofcommunity-based services to better ensure immediateand ongoing safety for women (Rees & Silove, 2014).Government and professional recognition of thecomplexity of these women's needs has acted as acatalyst for the growth in what is referred to in manyglobal Western jurisdictions as "integrated responses"(Coy, Lovett, & Kelly, 2008). Indeed, this intention isechoed in Time for action: The National Council's planfor Australia to Reduce Violence Against Women ndTheir Children 2009–2021 (National Council to ReduceViolence against Women and their Children, 2009).At the planning level, The National Plan To ReduceViolence Against Women and Their Children (theNational Plan) states that its success "hinges on thesuccess of the sixth outcome area – that the entiresystem join seamlessly and all its parts work together"(Council of Australian Governments, 2011, p. 15).

Purpose: Cumulative evidence suggests that explosive anger may be a common reaction among survivors of mass conflict. However, little is known about the course of explosive anger in the years following mass conflict, or the psychosocial factors that influence the trajectory of that reaction pattern. We examined these issues in a 6-year longitudinal study (2004–2010) conducted among adult residents of a rural and an urban village in Timor-Leste (n = 1022). Methods: We derived a brief, context-specific index of explosive anger using qualitative methods. Widely used measures of post-traumatic stress disorder (PTSD) and severe psychological distress were calibrated to the Timor context. We developed an index of the cumulative sense of injustice related to consecutive historical periods associated with conflict in Timor-Leste. We applied partial structural equation modeling (SEM) to examine pathways from baseline explosive anger, socio-demographic factors, recurrent trauma, mental health indices (PTSD, severe psychological distress) and the sense of injustice, to explosive anger. Results: Half of the sample with explosive anger at baseline continued to report that reaction pattern after 6 years; and a third of those who did not report explosive anger at baseline developed the response by follow-up. A symmetrical pattern of younger age, female gender and the trauma count for the preceding historical period predicted explosive anger at each assessment point. The sense of injustice was related to explosive anger at follow-up. Explosive anger was associated with impairment in functioning and conflict with the intimate partner and wider family. Conclusions: Sampling constraints caution against generalizing our findings to other populations. Nevertheless, our data suggest that explosive anger may persist for a prolonged period of time following mass conflict and that the response pattern is initiated and maintained by recurrent trauma exposure associated with a sense of injustice. Averting recurrence of mass violence and addressing persisting feelings of injustice may assist in reducing anger in conflict-affected societies. Whether explosive anger at the individual level increases risk of collective violence under conditions of social and political instability requires further inquiry.

Source of Funding This research was supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) (NIHR-BRC-1215-20008) and by the Medical Research Council (MRC) Network of Hubs for Trials Methodology Research (MR/L004933/1-N66), as part of the wider PIRRIST project. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The Health Services Research Unit, University of Aberdeen, receives core funding from the Chief Scientist Office of the Scottish Government Health Directorates. The funders had no input into the study design, data collection, analysis, interpretation or manuscript writing. ACKNOWLEDGEMENTS We are grateful to all survey respondents and to PIRRIST study collaborators and advisers who helped to promote survey. We thank Caroline Jordan and Liz Woolliams for providing administrative support; Rebecca Harmston for providing valuable advice from a patient perspective; Murat Akkulak at the Royal College of Surgeons for providing the RCS portfolio of surgical trials; Amadea Turk for helping to identify potential participants; and colleagues who kindly piloted and helped to improve the survey including Kerry Avery, Karen Barnett, Helen Bulbeck, Marloes Franssen, Nicola Higgins, Jennifer Hirst, Lynne Maddocks, Peter McCulloch, James Shepperd, Jean Simmonds and Sharon Tonner. Anonymised survey data can be made available on request. Please contact the corresponding author. This study was not preregistered. The authors declare no potential competing interests. ; Peer reviewed ; Publisher PDF

The European Union Marine Strategy Framework Directive requires the Good Environmental Status of marine environments in Europe\'s regional seas; yet, maritime activities, including sources of marine degradation, are diversifying and intensifying in an increasingly globalized world. Marine spatial planning is emerging as a tool for rationalizing competing uses of the marine environment while guarding its quality. A directive guiding the development of such plans by European Union member states is currently being formulated. There is an undeniable need for marine spatial planning. However, we argue that considerable care must be taken with marine spatial planning, as the spatial and temporal scales of maritime activities and of Good Environmental Status may be mismatched. We identify four principles for careful and explicit consideration to align the requirements of the two directives and enable marine spatial planning to support the achievement of Good Environmental Status in Europe\'s regional seas.