“Hidden” and Diverse Long-Term Impacts of Exposure to War and Violence

Abstract

Nowadays, the PTSD diagnosis is often a prerequisite for the survivor's access to specialized treatment services and for obtaining legal recognition or financial compensation when exposed to violence. However, some survivors do not meet all necessary criteria for the PTSD diagnosis, particularly not in the long term. Therefore, they run the risk of being misdiagnosed, inadequately helped or undertreated, and may remain legally unrecognized and unprotected. In this article the "hidden" long-term impacts of exposure to war and violence, beyond the PTSD diagnosis, are presented, discussed, and illustrated with case presentations. They include dissociative states, attachment problems, personality changes, guilt, shame, rage, identity issues, moral injury, substances abuse, damaged core beliefs, and bodily sensations linked to stress activation. These phenomena are not persistent, but fluctuate over the survivor's life trajectories. Moreover, the "hidden" impacts are framed within theoretical models for understanding long-term impacts of exposure to violence. The models help us grasp the dynamics of interactions between resilience, psychological damage, context and time. These interactions are non linear, and contingently result in development of psychopathological phenomena when reaching a threshold during a process of accumulating potentially traumatic experiences over a survivors' lifetime. Understanding psychological impacts of exposure to violence as a spectrum of interchangeable phenomena over a lifetime, and learning to recognize the "hidden" manifestations of psychological trauma will help to improve mental and legal assistance to the survivors both on a short and long term.

Narrating Crisis From War Zones to Disease Zones

“…Trauma has been a major concern (Bryant et al, 2020). Some scholars have cautioned against overuse of the concept of trauma, based on scientific (Griffin, 2020), cultural (Drožđek et al, 2020), and methodological issues (Daiute, 2017). That said, the preponderance of researcher concerns about trauma and other psychological effects of the pandemic invokes the serious shock facing contemporary humanity.…”

“…In times of crisis, narrating focuses intensely on what is important, how to interact with others, how to face threats, and, somehow, still to dream (Frankl, 1985). In addition to serving therapeutic functions (Drožđek et al, 2020), narrating in education and community practices integrates socioemotional and cognitive processes (Siller & Waibel, 2018).…”

Machine learning to reveal hidden risk combinations for the trajectory of posttraumatic stress disorder symptoms

“…Considering the multifactorial nature of the condition, the most straightforward approach for obtaining useful information with sufficient effect sizes regarding the prognosis of PTSD would be effective accumulation of risk factors by considering interaction among the factors. Several studies have demonstrated interactions among risk and protective factors for the prognosis of PTSD symptoms 5 – 9 . Satisfaction with social support has a significantly larger positive effect on the prognosis of PTSD symptoms in females than in males 5 .…”

“…Loss of family members or lack of family support influences the prognosis of PTSD more in younger subjects than in older subjects 7 , 8 . Drožđek et al considers combinations of risk factors and shows the hidden long-term impacts of exposure to war and violence 9 .…”

The Impact of COVID-19 on the Delivery of Critical Health Care: Experience From a Non–High-Income Country

“…The fear psychosis in the region had to be understood in the light of the population in Northern Sri Lanka recovering from three decades of civil war, during which similar lockdowns and curfews were imposed, and the possible impact of psychological carryovers and traumatic flashbacks from this period. 6…”