Audience Exposure to Digital Media Coverage of the Civil War in Sudan and Its Relationship with Psychological Immunity and Post-Traumatic Stress Disorder

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This is a good research paper with indeginious scholarship. 

Paper can be improved by adding some additional insights from the literature including

Frey, E. 2018. “‘Do You Tweet When Your Friends Are Getting Shot?’ Victims’ Experience With, and Perspectives on, the Use of Social Media During a Terror Attack.” Social Media+ Society 4 (1): 2056305117750715. 

Feinstein, A. 2004. “The Psychological Hazards of War Journalism.” Nieman Reports 58 (2): 75.

Clark, D. M., and A. Ehlers. 2004. “Posttraumatic Stress Disorder: From Cognitive Theory to Therapy.”

 

Additionally adding a theoratical lens may also improve the academic rigor of the paper especially in the discussion section

Comments on the Quality of English Language

careful proof reading is suggested

Author Response

My sincere greetings and appreciation to the esteemed editorial board of the journal, and my sincere thanks and appreciation to the reviewers of the research for their time, effort, and valuable comments. Regarding the reviewers' comments, it should be noted at the outset that the required amendments were made for the first reviewer and shaded in (green), inside Revised manuscript.

Comment (1):

Paper can be improved by adding some additional insights from the literature including

Frey (2018); Feinstein (2004); Clark and Ehlers (2004).

Additionally, adding a theoretical lens may also improve the academic rigor of the paper, especially in the discussion section.

Response:

We sincerely thank the reviewer for this insightful and constructive comment, which has significantly contributed to strengthening the theoretical depth of the manuscript.

In response, we have incorporated the recommended references to enrich the literature review and provide a more comprehensive conceptual foundation. Specifically, we have added insights from Frey (2018) to highlight the psychological impact of real-time social media exposure during crisis events, as well as Feinstein (2004) to contextualize the broader psychological risks associated with exposure to war-related media content. These additions help situate the current study within the broader literature on mediated trauma and crisis communication.

Furthermore, we have integrated the cognitive model of post-traumatic stress disorder proposed by Clark and Ehlers (2004) as a theoretical lens to enhance the interpretation of the findings. This framework has been particularly useful in explaining how repeated exposure to distressing digital media content may be associated with maladaptive cognitive processing patterns linked to PTSD symptoms.

In line with the reviewer’s suggestion, the Discussion section has been substantially revised to explicitly incorporate this theoretical perspective. The findings are now interpreted through a cognitive–psychological lens, allowing for a more robust explanation of the observed relationships between media exposure, psychological immunity, and PTSD symptoms.

Comment (2):

careful proof reading is suggested.

Response: Based on the reviewer's observation, we have already conducted a full and thorough review of the revised version and proofread it by a proofreading specialist.

We believe that these revisions have significantly improved the conceptual clarity, theoretical grounding, and overall academic rigor of the manuscript.

Reviewer 2 Report

Comments and Suggestions for Authors

Dear author/s and editors,

Thank you for the opportunity to review this very interesting paper focusing on an under-researched and under-represented region in the world. 

This manuscript addresses an important and timely topic: the psychological impact of digital war coverage on audiences in the context of the civil war in Sudan. The study is empirically rich, with an impressively large sample and a clear quantitative design. However, in its current form, the paper requires substantial revision in terms of theoretical framing, conceptual clarity, and positioning within journalism and news media studies. There are strengths, such as timeliness and social relevance of the topic (Sudan war, digital media exposure), strong sample size and clear quantitative design, the use of mediation analysis which adds analytical depth, addressing an under-researched Global South context (super important), and clear statistical reporting. Yet, it has its weak points too, such as misalignment with CFP focus (which is focused on journalists' mental health and mental health reporting), the overly descriptive and repetitive writing style, limited engagement with journalism/media theory, conceptual ambiguity around 'psychological immunity', ethical and methodological issues (sampling, causality); and weak critical discussion of media systems, power, or journalism practice. The single biggest red flag is the study’s overstated causal claims based on cross-sectional, self-reported data. Even if the author/s are trained in psychology, the issue is that the study relies on remote, self-administered survey data without any clinical or interactive assessment, which weakens the validity of its psychological claims.

Let me explain in detail, section-by-section without coming across as snobbish (I am sorry if the review sounds harsh. I am genuinely trying to help the author/s improve the manuscript. We have all been there).

Abstract: While the abstract clearly states variables, sample size, and key findings; reports mediation effect concisely, it reads like a psychology/public health abstract, not a journalism study. I would suggest the author/s reframe to highlight implications of for journalism ethics and practice and the role of digital news production and circulation. I think it also needs a sentence explicitly linking to media responsibility or newsroom practices.

The introduction introduces the concept of vicarious trauma effectively but lacks engagement with journalism studies literature. The framing is media-effects oriented, not media-critical and while it mentions “absence of professional and ethical filters”, the author/s does not theorise it. I would suggest the author/s incorporate literature on war journalism, witnessing, and mediated suffering, and refer to concepts such as news values, platformisation, and visuality of violence. Also, there is a need to clarify what kinds of “digital media coverage” (journalistic vs user-generated?) is the author/s referring to. That is unclear to me and will also be unclear to other readers of this paper.

Literature review has a logical structure (exposure - immunity - PTSD), but it is overwhelmingly psychology-focused with minimal engagement with journalism ethics, media production practices, and platform logics. Moreover, 'psychological immunity' remains conceptually under-theorised. I would also like to see the study interrogate the types of media content that produce harm and the role of algorithmic amplification and virality.

Conceptual model (mediation) is clear and testable but ignores content differences (e.g., framing, visuals), audience agency, and media trust. I would suggest the author/s expand model to include type of content (visual vs textual) and platform differences.

Methodology: The sample is large and thus justified as representative, however, my other key issue with the paper (in addition to alignment with Cfp) is that the study heavily relied on self-reported exposure and diagnosis of PTSD, which means it risks having a response bias.

Self-diagnosis via audience responses is a significant limitation of the research design. While the authors use a modified PTSD scale (PCL-5), responses still depend on participants’ own perceptions and interpretations of their psychological state. The reliance on self-reported PTSD measures raises concerns about construct validity, as the study does not distinguish between clinically diagnosed PTSD and self-perceived distress. This risks overstating the psychological impact of media exposure.

Additionally, the operationalisation of “media exposure” remains broad and insufficiently differentiated, limiting the study’s ability to draw meaningful conclusions about the specific types of journalistic or digital content driving psychological effects. I understand that the study includes some broad categories of exposure, but ‘exposure’ must not be treated as homogeneous.

I also note platform-specific sampling distortions. The ethical claim is also problematic (“no psychological risk”) given it has a PTSD focus. I suggest the authors consider clarifying sampling limitations explicitly, and discuss self-selection bias (likely heavy media users), over-representation of younger/digital populations (every second Gen Z I know has self-diagnosed themselves with some sort of a mental health issue. This is the case where I live, of course I am not aware of the social media consumption and response habits of young people in Sudan.)

The ethics section also needs to be strengthened. Please note, as you know already, exposure to trauma-related questions is not risk-free.

This brings me to the results. They are clearly presented in tables and with statistical tests, and some are rather strong and powerful, such as exposure positively correlated with PTSD and that psychological immunity partially mediates relationship. However, I see repetition across tables and narrative and no differentiation between types of media exposure. I suggest the author/s reduce repetition and emphasise effect sizes and practical significance. I would also consider adding interpretation of why effects are strong, and if data allows differences across platforms.

The discussion section demonstrates some strengths, particularly in its ability to link the findings to existing literature and to identify key patterns such as the heightened vulnerability of younger audiences and the role of education in shaping psychological resilience. However, it remains largely confirmatory and descriptive, with limited critical engagement with journalism practices or the broader question of media responsibility. The section also tends to overstate causal claims despite relying on correlational data. To strengthen this section, the author/s should reframe the discussion to explicitly consider the implications for journalists and editors, for example, whether limits should be placed on the circulation of graphic content, and engage more directly with the ethical dilemmas of war reporting and the role of platform-driven sensationalism in amplifying harm.

Similarly, while the conclusion effectively summarises the findings and offers some practical recommendations, these remain generic and largely confined to calls for media literacy and awareness. The section would benefit from more concrete and actionable implications tailored to key stakeholders. In particular, the author/s should provide clearer guidance for journalists, news organisations, and digital platforms, such as proposing editorial guidelines for trauma-sensitive reporting, outlining platform moderation strategies, and suggesting targeted training programs for journalists covering conflict and crisis.

The paper needs major revisions before it can be published. Yes, it has strong empirical potential but needs substantial reframing and theoretical strengthening to meet the expectations of a journalism and media special issue focused on mental health in media professions or impact on audiences.

I'd like this study to see the light of day. Best of luck.

Author Response

My sincere greetings and appreciation to the esteemed editorial board of the journal, and my sincere thanks and appreciation to the reviewers of the research for their time, effort, and valuable comments. Regarding the reviewers' comments, it should be noted at the outset that the required amendments were made for the second reviewer and shaded in (yellow) inside Revised manuscript.

Comment 1 (Abstract):

While the abstract clearly states variables, sample size, and key findings, it reads more like a psychology/public health abstract than a journalism study. I suggest reframing it to highlight implications for journalism ethics and practice, as well as the role of digital news production and circulation.

Response:

We thank the reviewer for this insightful suggestion. In response, the abstract has been carefully revised to better reflect the study’s relevance to journalism and media research.

Specifically, we have reframed the abstract to highlight the role of digital news environments in shaping audience exposure, particularly in the context of conflict reporting. In addition, we have explicitly incorporated the implications of the findings for journalism practice and media responsibility, including issues related to ethical news production, the circulation of distressing content, and the need for trauma-sensitive reporting approaches.

These revisions ensure that the abstract more clearly positions the study within the field of journalism and media studies, while maintaining its interdisciplinary contribution to understanding the psychological impact of digital news exposure.

Comment 2 (Introduction):

The introduction lacks engagement with journalism studies literature and remains media-effects oriented. The concept of “absence of professional and ethical filters” is not theorised. The authors should incorporate literature on war journalism, mediated suffering, and concepts such as news values, platformisation, and visuality of violence. Additionally, the type of digital media coverage (journalistic vs user-generated) is unclear.

Response:

the Introduction has been substantially revised to incorporate relevant perspectives from journalism studies, particularly in relation to war reporting, mediated suffering, and the role of audiences as witnesses to conflict. We have expanded the theoretical framing by integrating key concepts such as news values, platformisation, and the visuality of violence, in order to better contextualize how digital media environments shape exposure to conflict-related content.

In addition, we have clarified the meaning of “digital media coverage” within the study. The revised manuscript explicitly states that exposure includes both professionally produced journalistic content and user-generated content circulating on digital platforms, reflecting the hybrid nature of contemporary media environments.

We believe these revisions have substantially enhanced the theoretical depth, clarity, and alignment of the study with journalism and media scholarship.

Comment 3 (Literature Review):

The literature review is overwhelmingly psychology-focused, with limited engagement with journalism ethics, media production practices, and platform logics. The concept of psychological immunity is under-theorised, and there is a need to examine the types of media content that produce harm, as well as the role of algorithmic amplification and virality.

Response:

the Literature Review has been substantially revised to incorporate perspectives from journalism studies and digital media research. Specifically, we have expanded the discussion to include the role of media production practices, journalism ethics, and platform logics in shaping audience exposure. Concepts such as algorithmic amplification, engagement-driven visibility, and the circulation of emotionally intense content have been integrated to better reflect the dynamics of contemporary digital media environments.

In addition, we have introduced a more detailed discussion of the types of media content most likely to produce psychological distress, particularly highly visual, graphic, and repetitive representations of violence, which are often amplified through platform-based mechanisms and viral circulation.

Furthermore, the concept of psychological immunity has been more clearly theorised.

Comment 4 (Conceptual Model):

The conceptual model is clear but ignores content differences, audience agency, and media trust. The authors should consider including content type and platform differences.

Response:

In response, we have clarified the scope of the conceptual model and expanded its theoretical framing. While the current mediation model was designed to examine the core relationships between media exposure, psychological immunity, and PTSD symptoms, we acknowledge that media exposure in digital environments is not homogeneous and may vary depending on content characteristics and platform dynamics.

Accordingly, we have revised the manuscript to explicitly discuss the role of content differences, including the distinction between visual and textual representations of conflict, and their potential impact on psychological responses.

Furthermore, a dedicated paragraph has been added to the Limitations section to acknowledge that these variables were not directly included in the current model, and to suggest their inclusion in future research as potential moderators or extensions of the proposed framework.

We believe that these revisions strengthen the theoretical interpretation of the model while maintaining its empirical clarity and focus.

Comment 5 (Methodology):

The study relies heavily on self-reported exposure and PTSD measures, which may introduce response bias.

Response:

In response, we have clarified in the Methodology section that the study relies on self-reported measures of both media exposure and PTSD symptoms, which is a common approach in survey-based research examining media effects and psychological outcomes. At the same time, we explicitly acknowledge the potential for response bias, including recall bias and subjective interpretation.

Furthermore, the Limitations section has been expanded to address this issue in detail. We clarify that the assessment of PTSD reflects self-reported symptom severity rather than clinical diagnosis, and therefore should be interpreted with appropriate caution. We also highlight the potential influence of self-report bias and suggest that future research could incorporate alternative methodologies, such as behavioral measures or clinical assessments, to enhance validity.

Comment 6

Regarding self-diagnosis and the Post-Traumatic Stress Disorder Scale (PCL-5).

Response

A clarification regarding this has been added to the study's limitations section to avoid overestimating the psychological impact of media exposure.

Comment 7

 (Operationalization of Media Exposure):

The operationalisation of “media exposure” remains broad and insufficiently differentiated. Exposure should not be treated as homogeneous.

Response:

We thank the reviewer for this important comment.

We would like to clarify that the operationalization of media exposure in this study was designed to capture multiple dimensions of audience engagement with digital media coverage, rather than treating exposure as a purely homogeneous construct. Specifically, the measurement included items assessing overall exposure level, duration of exposure, types of media platforms used, forms of content accessed, and levels of interaction with media content.

In addition, the scale incorporated both general indicators of exposure and more specific items tailored to the context of digital coverage of conflict, allowing for a broader representation of how audiences engage with such content. These items were developed based on prior research addressing media exposure in crisis and conflict contexts, and were adapted to align with the objectives of the current study.

Comment 8 (Sampling and Ethics):

There may be platform-specific sampling distortions, including self-selection bias and over-representation of younger, digitally active populations. Additionally, the ethical claim of “no psychological risk” is problematic given the study’s focus on PTSD.

Response:

We thank the reviewer for this important and thoughtful observation.

In response, we have clarified the sampling limitations associated with the use of an online survey. The revised manuscript now explicitly acknowledges the potential for self-selection bias, as participation may be more likely among individuals who are more active or engaged with digital media platforms. We also note the potential for over-representation of younger and more digitally connected populations, which reflects the nature of online data collection in contemporary media research.

Regarding the ethical considerations, we have revised the wording of the ethical statement. Instead of describing the study as involving “no psychological risk,” we now clarify that the study involves minimal risk. While no direct exposure to harmful stimuli occurred, we acknowledge that discussing conflict-related topics may evoke emotional responses. Accordingly, the revised text emphasizes voluntary participation, informed consent, and the right to withdraw at any time.

Comment 9 (Results):

The results are clearly presented, but there is repetition between tables and narrative, and no differentiation between types of exposure. The authors should reduce repetition, emphasize effect sizes and practical significance, and provide an interpretation of why effects are strong.

Response:

We thank the reviewer for this constructive and helpful comment.

In response, we have revised the Results section to reduce redundancy between tables and the narrative text. The revised version now focuses on summarizing the most relevant and statistically significant findings rather than repeating all tabulated values.

In addition, we have incorporated the interpretation of effect sizes, particularly for key relationships such as the correlation between media exposure and PTSD symptoms. These are now described in terms of their magnitude (e.g., moderate to large effects), providing a clearer understanding of their substantive importance.

Moreover, we have expanded the Discussion section to provide a more in-depth interpretation of the observed relationships. Specifically, we offer theoretical explanations for the strength of the associations, linking them to the nature of digital media environments, including continuous exposure, visual intensity, and algorithmic amplification.

We have also added a section highlighting the practical implications of the findings, particularly in relation to journalism practices, audience well-being, and the need for trauma-sensitive reporting.

Finally, while the current dataset does not allow for detailed platform-specific comparisons, we have clarified the dominant role of social media platforms in shaping exposure patterns and discussed their potential influence on the observed effects.

Comment 10 (Discussion):

The discussion is largely descriptive and lacks critical engagement with journalism practices and media responsibility. It also overstates causal claims.

Response:

In response, the Discussion section has been substantially revised to move beyond a primarily descriptive and confirmatory interpretation of the findings toward a more critical and analytically engaged perspective.

First, we have addressed the concern regarding causal language by explicitly clarifying that the findings are based on correlational data and do not imply causal relationships. The revised text consistently uses non-directional language and acknowledges the possibility of alternative or bidirectional explanations.

Second, we have strengthened the engagement with journalism studies by incorporating a more explicit discussion of journalism practices and media responsibility, particularly in the context of war reporting. The revised Discussion now critically examines the ethical implications of exposing audiences to graphic and emotionally distressing content, and raises questions about the role of editorial decision-making in shaping such exposure.

Finally, the section now includes clearer practical implications for journalists and editors, including the importance of trauma-sensitive reporting, contextual framing, and the potential need for content moderation strategies.

Comment 11 (Conclusion):

The conclusion offers general recommendations but lacks concrete and actionable implications tailored to stakeholders such as journalists, news organisations, and digital platforms.

Response:

In response, the Conclusion section has been substantially revised to provide more concrete and actionable recommendations tailored to key stakeholders.

Specifically, we have developed distinct sets of implications for journalists, news organizations, and digital platforms. These include the adoption of trauma-sensitive reporting practices, the development of editorial guidelines for handling conflict-related content, and the implementation of platform-level moderation strategies aimed at reducing the amplification of distressing material.

In addition, the revised Conclusion highlights the importance of targeted training programs for journalists covering conflict and crisis situations, as well as the role of digital platforms in supporting responsible content dissemination and user awareness.

We believe that these revisions enhance the practical relevance and applied contribution of the study.

Reviewer 3 Report

Comments and Suggestions for Authors

The study titled "Audience Exposure to Digital Media Coverage of the Civil War in Sudan and Its Relationship to Psychological Immunity and Post-Traumatic Stress Disorder" addresses a critical and timely intersection between digital communication and mental health during active conflict. The integration of media dependency theories with psychological constructs like "psychological immunity" provides a robust framework for understanding modern media effects.

Below are specific observations and suggestions to further enhance the manuscript:

Strengths of the Manuscript

Methodological Rigor: The use of a large sample size ($N=774$) encompassing both internal residents and the Sudanese diaspora provides a comprehensive view of the conflict's reach.

Statistical Analysis: The application of path analysis to demonstrate the partial mediating role of psychological immunity is a sophisticated and effective way to validate the proposed conceptual model.

Originality: Focusing specifically on the Sudanese civil war fills a significant gap in current interdisciplinary literature regarding "digital trauma" in the Arab and African regions.

Suggestions for Improvement

Conceptual Depth on "Digital Media Exposure": While the study categorizes exposure by frequency and platform (e.g., Facebook), the authors might consider discussing the "algorithmic" nature of these platforms. Algorithms often create "echo chambers" or "trauma loops" that could further explain the high levels of hyperarousal observed in the sample.

Media Literacy as a Solution: The discussion correctly identifies that lower education levels correlate with higher PTSD. Strengthening the section on "Media Literacy" as a proactive tool for building psychological immunity would add significant practical value to the conclusion.

Nuance in "Psychological Immunity": The findings show that while "Positive Thinking" is high, "Resilience and Psychological Strength" is the lowest-rated dimension. A more detailed explanation of why specific dimensions of immunity are more susceptible to media-induced stress than others would be beneficial.

Long-term Implications: Since the conflict is ongoing, the authors could briefly discuss the potential for "chronic" vs. "acute" PTSD as it relates to continuous digital immersion over several years.

Technical and Formatting Notes

Language and Flow: The English language is generally clear and professional; however, a final proofreading for minor grammatical transitions would ensure the highest academic quality.

Data Visualization: Figure 1 is highly informative. Ensure that all labels in the final production version are high-resolution to maintain the professional standard of the journal.

Author Response

My sincere greetings and appreciation to the esteemed editorial board of the journal, and my sincere thanks and appreciation to the reviewers of the research for their time, effort, and valuable comments. Regarding the reviewers' comments, it should be noted at the outset that the required amendments were made for the third reviewer and shaded in (turquoise) inside Revised manuscript.

Comment 1 (Conceptual Depth on Digital Media Exposure):

The authors should consider the algorithmic nature of platforms and concepts such as echo chambers or trauma loops.

Response:

We thank the reviewer for this insightful and valuable comment.

In response, we have expanded the Discussion section to incorporate the role of algorithmic curation in shaping patterns of media exposure. The revised manuscript now explicitly acknowledges that exposure within digital platforms is influenced by engagement-driven algorithms that prioritize emotionally intense and frequently interacted-with content.

We have also integrated the concepts of “echo chambers” and “trauma loops” to provide a more nuanced theoretical explanation of how repeated and algorithmically amplified exposure to conflict-related content may contribute to sustained psychological responses, particularly hyperarousal.

This addition strengthens the conceptual depth of the study by situating media exposure within the broader structural dynamics of digital communication environments.

Comment 2 (Media Literacy):

Strengthening the role of media literacy as a proactive tool would add practical value.

Response:

We thank the reviewer for this valuable and constructive suggestion.

In response, we have expanded both the Discussion and Conclusion sections to more explicitly address the role of media literacy as a potential protective factor in the context of digital media exposure to conflict.

We have also strengthened the practical implications by highlighting the importance of integrating media literacy into educational and public awareness initiatives as a proactive strategy for enhancing audience resilience.

At the same time, we have maintained a cautious interpretation, noting that media literacy was not directly measured in the current study and should be further examined in future research.

Comment 3 (Psychological Immunity Nuance):

The study should explain why certain dimensions of psychological immunity are more affected than others.

Response:

In response, we have expanded a more nuanced interpretation of the internal dimensions of psychological immunity. Specifically, we address the observed discrepancy between the relatively high levels of positive thinking and the lower levels of resilience and psychological strength.

The revised manuscript now explains this difference by distinguishing between cognitive and adaptive components of psychological immunity. While positive thinking reflects a relatively stable cognitive orientation, resilience and psychological strength involve dynamic coping processes that may be more susceptible to depletion under conditions of repeated exposure to distressing media content.

This addition enhances the analytical depth of the study by demonstrating that the components of psychological immunity may respond differently to media exposure, rather than functioning as a uniform construct.

Comment 4 (Long-term Implications):

The authors should discuss acute vs. chronic PTSD in relation to ongoing exposure.

Response:

In response, we have expanded the Discussion section to address the potential long-term psychological implications of sustained exposure to conflict-related digital media. The revised manuscript now distinguishes between acute and chronic manifestations of PTSD symptoms and discusses how continuous exposure in digitally mediated environments may contribute to more persistent patterns of psychological distress.

We also emphasize that, given the ongoing nature of the conflict and the continuous flow of media content, exposure is likely to be cumulative rather than episodic.

Comment 5 (Technical and Formatting Notes):

The language is generally clear but requires final proofreading. Figure quality should be ensured.

Response:

We thank the reviewer for these helpful technical suggestions.

In response, the manuscript has undergone a thorough proofreading process to improve linguistic clarity, grammatical accuracy, and overall flow. Particular attention was given to transitions between sections and consistency in terminology throughout the text.

In addition, Figure 1 has been revised to ensure high-resolution quality and clarity of all labels in accordance with the journal’s publication standards.

We believe that these final adjustments enhance the overall presentation and professionalism of the manuscript.