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Post-traumatic stress disorder (PTSD) has been shown to predict psychotic symptomology. However, few studies have examined the relative contribution of PTSD compared to broader post-traumatic sequelae in maintaining psychosis. Complex PTSD (cPTSD), operationalized using ICD-11 criteria, includes core PTSD (intrusions, avoidance, hyperarousal) as well as additional “disturbances of self-organisation” (DSO; emotional dysregulation, interpersonal difficulties, negative self-concept) symptoms, more likely to be associated with complex trauma histories. It was hypothesized that DSOs would be associated with positive psychotic symptoms (paranoia, voices, and visions) in daily life, over and above core PTSD symptoms.
Methods
This study (N = 153) employed a baseline subsample of the Study of Trauma And Recovery (STAR), a clinical sample of participants with comorbid post-traumatic stress and psychosis symptoms. Core PTSD, DSO and psychosis symptoms were assessed up to 10 times per day at quasi-random intervals over six consecutive days using Experience Sampling Methodology.
Results
DSOs within the preceding 90 min predicted paranoia, voices, and visions at subsequent moments. These relationships persisted when controlling for core PTSD symptoms within this timeframe, which were themselves significant. The associations between DSOs and paranoia but not voices or visions, were significantly stronger than those between psychosis and core PTSD symptoms.
Conclusions
Consistent with an affective pathway to psychosis, the findings suggest that DSOs may be more important than core PTSD symptoms in maintaining psychotic experiences in daily life among people with comorbid psychosis and cPTSD, and indicate the potential importance of addressing broad post-traumatic sequelae in trauma-focused psychosis interventions.
The chapter continues the discussion of Iran–Senegal relations in Chapter 7 and the nature of Iran’s aid policy in Chapter 8 to explore the expansion of these ties in the mid- to late 1970s. During this period, President Senghor travelled to Iran multiple times and Empress Farah travelled to Senegal to lay the foundation stone of a city that would bear her name: Keur Farah Pahlavi. The chapter explores this extraordinary Iranian–Senegalese joint venture, that was planned to result in the construction of an oil refinery, petrochemical complex and adjoining town, which would have an eventual population of 200,000. An important asset of Keur Farah Pahlavi was to be its cultural centre, reflecting the close cultural relations that developed between Iran and Senegal during this period. The chapter examines in detail the extensive cultural ties that were nurtured, through which African art, culture and philosophy were broadcast to the Iranian public, and how these came to shape Iranian perceptions of Africa and Africans.
The chapter explores Iran’s policy in West Africa through two very different relationships; those with Senegal and Nigeria. Senegal was identified early in the 1970s as a country that Iran would pursue a special relationship with. This political partnership was facilitated by the strong personal bonds developed between the two sets of leaders, which were shaped by their francophone backgrounds. The president of Senegal, Léopold Sédar Senghor, in particular, shared a close bond with Empress Farah Pahlavi, and spoke eloquently about the inherent similarities between his philosophy of Négritude and Iran’s Iranité. On the other hand, Iran’s relationship with Nigeria was very pragmatic. Iran’s ambassador there, Shāhrokh Firuz, found himself frustrated by the rigidity of Iran’s policy, and the lack of freedom he had to explore new opportunities for Iran, not only in Nigeria, but also other countries in the region. These two relationships provide fascinating insights into Iran’s strategy in arguably the only part of Africa in which it had no immediately obvious security or strategic interests. The chapter explores what drove these relationships, and what each side gained from them.
This chapter examines Iran’s growing security interests in Africa during the 1970s, as its sphere of influence broadened following the British withdrawal from the Persian Gulf in 1971. The shah spoke in this period about his Indian Ocean policy – the plan to form an economic and security union of the countries bordering the Indian Ocean, which would work together to free the area from imperial power interference. This formed the basis of Iran’s grand strategy in the mid- to late 1970s. The chapter explores Iran’s increasing preoccupation with Soviet expansion in the Horn of Africa, and how this prompted the shah to develop relations with countries such as Sudan and, after the Ethiopian Revolution and the fall of Haile Selassie in 1974, Somalia.
During the 1970s, Iran’s relationships across Africa developed, both in terms of the number of ambassadors accredited to African countries, and in terms of the volume of trade and extent of political dialogue. At the beginning of the decade, Iran had diplomatic relations with just five countries in the whole of Africa – Algeria, Ethiopia, Libya, Morocco and Tunisia – but by the middle of the 1970s it had established formal ties with over thirty-five nations. This chapter investigates the nature of Iran’s diplomacy in Africa and why it was so successful during the 1970s. It questions why the shah was appealing to the independent states of Africa, and what strategies the regime employed to project an image of the shah as the leader of a country that had historically been an important global power and a civilising force in the world, and which aspired to continue to influence world affairs in a positive way. At the same time, after the British withdrawal from the Persian Gulf in 1971, the shah sought to expand Iran’s sphere of influence beyond its immediate neighbourhood towards the Indian Ocean.
Until the very end of Pahlavi rule, Africa remained an important geographical focus of Iran’s foreign policy and a key part of the shah’s grand strategy. Reflecting on the evidence presented in the previous chapters, this chapter explores why the shah’s Africa policy was so successful, and why he was able to appeal to leaders of all manner of political and religious persuasions. After the shah fled Iran in 1979, the relationships that he and his diplomats had nurtured in Africa were redefined, as the new regime sought to export its revolution. Leaders such as Julius Nyerere, long shunned by the shah, were quick to congratulate Ayatollah Khomeini, while some of the shah’s closer allies, such as Senghor, approached the Islamic regime with caution.
Continuing from the account of Iran–South Africa relations in Chapter 3, this chapter looks in particular at the increasing importance of Iranian oil to South Africa in the wake of the 1973 Arab oil embargo, as a result of which, by 1978, Iran supplied over 90 per cent of South Africa’s crude oil imports. Because of its importance as a supplier of oil, not just to South Africa but also its neighbouring countries, Iran attained an influential position in Southern Africa during this period. Its influence was such that in 1977 and 1978, the United States and Britain asked the shah to help negotiate a settlement with the Ian Smith government to end the crisis in Rhodesia. The chapter explores Iran’s role in the crisis, not only its support of US-British initiatives, but also its outreach to Rhodesia’s revolutionary politicians, like Joshua Nkomo, who travelled to Iran and met with the shah several times during this period. As the chapter will show, Iran’s involvement was driven by concerns over the possibility of civil war spreading into neighbouring countries, and the implications of this for Iran’s Indian Ocean aspirations.
Building on Chapter 5, which established the basis of Iran’s security concerns in Africa, this chapter looks at the reasons for and nature of Iran’s support for Somalia’s Siad Barre in his war against Ethiopia in 1977–78. The chapter examines the complex relationship between the shah’s Iran and the Carter administration, and questions the extent to which the shah’s much-talked-about independent foreign policy was actually independent from US interests and demands. For although the shah wanted to support the Barre regime in Somalia, he was constrained by the United States, which would not allow him to supply US-made weapons to the regime. On the other hand, the shah’s lobbying on behalf of Barre, and his pledges to come to Somalia’s aid if it were attacked by Ethiopia, were taken seriously by, and influenced policy-making decisions in, not only the United States, but also Ethiopia, Cuba and the Soviet Union.
This introductory chapter examines the development of Iran’s relations with Africa in the late Pahlavi period. It argues that decolonisation and the Cold War profoundly shaped the shah’s worldview in the decades after the Second World War and Iran’s interactions with countries across the Global South, including in Africa. During this period, particularly in the decades following the ouster of Mosaddeq in 1953, the shah became the single most important actor in conceptualising and driving foreign policy. The chapter asks whether the shah’s ambitions in the 1960s and 70s for Iran to assume a leadership role in the Indian Ocean, and the civilisational discourse he adopted, could be considered a key component of Pahlavi Iran’s grand strategy.
In his search for allies who would help him challenge Nasserism and other radical movements, the shah found a companion in the emperor of Ethiopia, Haile Selassie I. This chapter investigates the early years of this relationship and some of the issues that prompted the two sides to cooperate – including common security concerns in the Red Sea, threats to the global monarchical institution, and the challenges that decolonisation presented to conservative regimes in the Global South. Ethiopia provided Iran with its first ally in sub-Saharan Africa, but it was not until the Summit Conference of Independent African States in Addis Ababa in 1963 that Iran began seriously to consider its future role in Africa. Several emissaries from Africa had already visited Iran, for example from Nigeria and Cameroon, and in 1964, a report was published by the Imperial Court on the opportunities Africa could present to Iran. Subsequently, the decision was taken to deepen ties with the continent as a matter of urgency. Because Addis Ababa was the de facto diplomatic capital of Africa, it was perceived as a bridge to the rest of Africa.
During his visit to Ethiopia in 1968, the shah spoke to representatives of the Organisation of African Unity about his commitment to combatting colonialism and racial discrimination. It is surprising, therefore, that not long after the shah had returned to Iran, his diplomats began to discuss with South African diplomats the establishment of political relations between the two countries. The chapter explores the origins of this engagement and examines what drove the two sides together in this period. At the United Nations and other international forums, the shah and his diplomats spoke out in harsh terms against discrimination, racism and human rights violations in Southern Africa. But in spite of this public condemnation, the shah developed and maintained strong security and economic ties with apartheid South Africa. The chapter questions to what extent the shah was able to maintain his position as a champion of independence and human dignity, while enjoying such friendly ties with the apartheid regime.
The threat of Nasserism shaped the shah’s regional strategy in the 1950s and 1960s. This chapter explores the development of the shah’s policy of building relations with moderate allies in the Arab world who could help to contain and balance the radicalism of Nasser. The shah found two allies in North Africa: Tunisia under President Habib Bourguiba and Morocco under King Hassan II. Bourguiba and King Hassan were, like the shah, moderate rulers, with strong ties to the West, who shared the same concerns over Egyptian ambitions and the threat that Nasserism posed to regional stability. One of the strategies the shah developed, for which he sought the support of King Hassan in particular, was to challenge Nasser’s claims to leadership in the Islamic world, by attempting to form a separate grouping of Islamic countries. The ultimate manifestation of this was the Islamic Summit Conference, held in Rabat in 1969, in which King Hassan and the shah played leading roles.