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Stress, Traumatic Events and Political Violence: Implications for Mental Health...
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Stress, Traumatic Events and Political Violence: Implications for Mental Health Care

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Mental Health and Psychosocial Well-being".

Deadline for manuscript submissions: 30 April 2027 | Viewed by 18054

Editor

Prof. Dr. Alean Al-Krenawi

E-Mail Website
Guest Editor
1. Resilience Research Centre, Dalhousie University, Halifax, NS B3H 4R2, Canada
2. Centre for Research on Immigration and Settlement, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
Interests: mental health; refugees; political violence; acculturation; indigenization

Special Issue Information

Dear Colleagues,

Armed conflict, political violence, torture, detention, imprisonment, forced migration, refugee experiences, natural disasters such as earthquakes, and other forms of social upheaval continue to affect millions worldwide. These traumatic events leave lasting psychological impacts on individuals, families, and communities, posing significant challenges for mental health care systems. This Special Issue seeks to explore the multifaceted mental health consequences of such experiences, with a particular focus on the lived reality of people in conflict, crisis, and disaster-affected regions.

We aim to examine how stress, trauma, and psychological distress manifest across different populations, cultural contexts, and political landscapes. This Special Issue will also investigate the challenges in delivering effective mental health care in these environments, highlighting the structural, logistical, and cultural barriers faced by practitioners, researchers, and affected communities.

In light of ongoing global crises—including protracted armed conflicts, torture, mass displacement, natural disasters, and increasing global recognition of mental health as a public health and development priority—this Special Issue is both timely and essential. We invite contributions from a broad range of disciplines, including psychology, psychiatry, public health, anthropology, sociology, social work, political science, and related fields, to generate interdisciplinary insights.

Special emphasis will be placed on studies that present innovative models of care, especially those demonstrating the successful integration of mental health services into public health systems. We are particularly interested in research that advances equity in mental health access and highlights sustainable solutions for long-term recovery and well-being.

This Special Issue offers a vital platform for addressing mental health as a core component of comprehensive health care. By assembling diverse perspectives and expertise, we aim to inform both practice and policy to better support individuals, families, and communities enduring the psychological toll of traumatic events and political violence.

The research areas of submissions to this Special Issue may include, but are not limited to, the following themes:

  • The psychological impacts of political violence and armed conflict;
  • Stress, trauma, and post-traumatic responses among displaced populations and refugees;
  • Access to and delivery of mental health care in conflict-affected or low-resource settings;
  • Culturally and politically grounded and community-based approaches to mental health care;
  • Enhancing mental health systems in fragile, crisis-affected, and post-conflict areas;
  • Intersections of mental health with gender, age, ethnicity, and other social determinants;
  • Chronic insecurity, structural violence, and their role in intergenerational and collective trauma;
  • Innovative approaches to integrating mental health services into primary health care;
  • Policy responses to addressing mental health needs in zones of conflict, crisis, and displacement;
  • Help-seeking behaviors, stigma, and attitudes toward mental health care utilization.
  • Torture, detention, or imprisonment can result in severe psychological effects, including loss of control, isolation, and trauma. These experiences can lead to conditions such as PTSD, depression, anxiety, and complex trauma.

I look forward to your contributions.

Prof. Dr. Alean Al-Krenawi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • political violence
  • armed conflict
  • mental health
  • stress
  • displacement and refugees
  • conflict-affected populations
  • torture, detention, or imprisonment
  • help-seeking behavior and stigma
  • traumatic events
  • post-traumatic stress (PTSD)

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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16 pages, 927 KB  
Article
Female Scrap Collectors in Qumbu, Eastern Cape, South Africa Through the Lens of Resilience Theory
by Mzukisi Xweso and Catherina Schenck
Healthcare 2026, 14(15), 2398; https://doi.org/10.3390/healthcare14152398 - 5 Aug 2026
Viewed by 132
Abstract
Background/Objectives: Women working in the informal sector are frequently exposed to multiple layers of vulnerability and trauma, yet their mental health experiences remain insufficiently explored. Methods: This qualitative study examined the mental health implications of trauma experienced by female scrap collectors in Qumbu, [...] Read more.
Background/Objectives: Women working in the informal sector are frequently exposed to multiple layers of vulnerability and trauma, yet their mental health experiences remain insufficiently explored. Methods: This qualitative study examined the mental health implications of trauma experienced by female scrap collectors in Qumbu, Eastern Cape. Guided by resilience theory, the study explored how these women navigate and cope with the challenges associated with their daily work. A total of 13 female scrap collectors were selected through convenience sampling and participated in semi-structured interviews. The data were analysed thematically. Results: The findings revealed that women engaged in scrap collection face perpetual insecurity and gendered vulnerability in informal workspaces, enduring public degradation with significant psychological consequences, experience persistent stress due to insufficient earnings and navigate informal relations with truck drivers that act as sites of economic exploitation and psychological insecurity. These experiences may contribute to chronic stress, fear, feelings of worthlessness and mental exhaustion, which significantly affect their psychological wellbeing. Conclusions: Based on these findings, the study recommends the implementation of targeted psychosocial support interventions, such as trauma-informed counselling and peer support groups, to enhance coping mechanisms and strengthen resilience. Furthermore, a multidisciplinary facilitative healthcare approach and advocacy efforts aimed at addressing the mental health needs of female scrap collectors are essential for strengthening their agency, promoting psychosocial wellbeing and reducing their exposure to harm within the informal working environment. Full article
(This article belongs to the Special Issue Stress, Traumatic Events and Political Violence: Implications for Mental Health Care)
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15 pages, 248 KB  
Article
Sexual Torture in Palestinian Male Detainees: Epidemiology, Impacts and Outcomes
by Mahmud Sehwail, Khader Rasras, Wisam Sehwail, Pau Pérez-Sales, Andrea Galan-Santamarina and Raluca Cosmina Budian
Healthcare 2026, 14(8), 1105; https://doi.org/10.3390/healthcare14081105 - 20 Apr 2026
Viewed by 7668
Abstract
Background: Torture, as a fundamental violation of human rights, is unequivocally condemned by all international organizations. Sexual torture is one of the most severe forms of torture, encompassing forced nudity, various forms of humiliation, and physical abuse, including rape. Despite testimonial evidence [...] Read more.
Background: Torture, as a fundamental violation of human rights, is unequivocally condemned by all international organizations. Sexual torture is one of the most severe forms of torture, encompassing forced nudity, various forms of humiliation, and physical abuse, including rape. Despite testimonial evidence indicating the incidental use of sexual torture by Israeli authorities, there is a lack of epidemiological research providing a comprehensive understanding of this issue. This study aims to analyze the prevalence and characteristics of ill treatment and sexual torture among Palestinian male detainees and the subsequent impacts. Methods: This cross-sectional study analyzed a database of 517 former male detainees. The interview protocol included items related to psychological and physical methods of sexual torture, medical impacts, subjective psychological impacts, clinical medical and psychological measures, and psychosocial and community impacts. Results: The findings indicate that the majority of detainees experienced some form of sexual torture, with humiliation being the most common type. The impact of sexual torture are severe, affecting both clinical and social domains. The impacts of sexual torture persist over time and, in some cases, worsen, particularly regarding physical health outcomes. Socially, the consequences extend to the detainees’ families and communities. Conclusions: The prevalence of such torture tactics calls for urgent responses from both the authorities and civil society. These findings highlight the need for proactive measures to address and mitigate the impacts of sexual torture, including independent investigations, robust monitoring, secure reporting mechanisms, the prosecution of perpetrators and comprehensive reparation for victims. Full article
(This article belongs to the Special Issue Stress, Traumatic Events and Political Violence: Implications for Mental Health Care)
17 pages, 1075 KB  
Article
Refugees, Trauma, and Positive Psychological Change: Mindfulness as a Moderator for Posttraumatic Growth
by Ertan Yılmaz, Ufuk Bal and Emre Dirican
Healthcare 2026, 14(3), 379; https://doi.org/10.3390/healthcare14030379 - 3 Feb 2026
Viewed by 1073
Abstract
Background/Objectives: Traumatic experiences may lead to both negative and positive outcomes. Positive psychological changes following trauma are commonly referred to as posttraumatic growth (PTG). The present study aims to examine factors associated with posttraumatic growth among Syrian refugees who have been living in [...] Read more.
Background/Objectives: Traumatic experiences may lead to both negative and positive outcomes. Positive psychological changes following trauma are commonly referred to as posttraumatic growth (PTG). The present study aims to examine factors associated with posttraumatic growth among Syrian refugees who have been living in Turkey for an extended period. Methods: This cross-sectional study included a sample of 240 Syrian refugees. Participants completed the Posttraumatic Stress Disorder Checklist (PCL-5), the Posttraumatic Growth Inventory (PTGI), and the Mindful Attention Awareness Scale (MAAS). Path analysis was conducted to examine the effects of PTSD symptoms and mindfulness levels on posttraumatic growth. In addition, Multivariate Adaptive Regression Spline (MARS) analysis was used to identify threshold values for the contributions of these variables to posttraumatic growth. Results: The mean age of the participants was 36.9 ± 10.4 years, and 47% were female. The direct effect of PTSD symptoms on posttraumatic growth was negative and statistically significant (β = −0.291, p < 0.001). PTSD symptoms also had an indirect effect on posttraumatic growth through mindfulness (β = −0.254), resulting in a total effect of −0.545. According to the MARS model, when MAAS scores exceeded 78, mindfulness demonstrated a positive effect on posttraumatic growth. Conclusions: The findings indicate that PTSD symptoms among refugees are associated with posttraumatic growth through both direct and indirect pathways. Furthermore, mindfulness emerges as a key factor in understanding the development of posttraumatic growth in this population. Full article
(This article belongs to the Special Issue Stress, Traumatic Events and Political Violence: Implications for Mental Health Care)
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19 pages, 259 KB  
Article
Wartime Experiences of Single Parents by Choice
by Dorit Segal-Engelchin, Maya Tsfati and Alean Al-Krenawi
Healthcare 2025, 13(23), 3133; https://doi.org/10.3390/healthcare13233133 - 2 Dec 2025
Viewed by 1133
Abstract
Background/Objectives: Despite extensive research on the outcomes faced by parents in contexts of political violence, as well as the protective factors that enhance their well-being, the experiences of single parents by choice (SPCs) in such circumstances have largely been neglected. This study sought [...] Read more.
Background/Objectives: Despite extensive research on the outcomes faced by parents in contexts of political violence, as well as the protective factors that enhance their well-being, the experiences of single parents by choice (SPCs) in such circumstances have largely been neglected. This study sought to address this gap by examining the experiences of SPCs during the current phase of the Israel–Hamas war that began on 7 October 2023. Method: This qualitative study used a context-informed approach. Semi-structured interviews were conducted with 11 Israeli SPCs (5 fathers and 6 mothers), including 2 displaced due to the destruction of their homes. All participants were secular Jews, predominantly middle- to upper-middle-class, aged 40–58, and had at least one child aged 15 months to 17 years. A thematic analysis method was utilized. Results: Two overarching themes emerged from the interviews, shaping participants’ wartime experiences: (1) the intensified challenges associated with parenting alone in the context of armed conflict and (2) the factors that mediated the impact of these challenges. Three key challenges identified by participants included: (1) persistent perceptions of danger and threat to life; (2) heightened financial insecurity; and (3) significant disruptions to daily routines. Three systemic-level protective factors were identified as instrumental in mitigating these challenges: (1) engagement in joint familial activities; (2) the presence of a supportive work environment; and (3) social and political engagement. These factors appeared to foster resilience and enhance participants’ psychological coping capacities amidst ongoing conflict. Conclusions: By highlighting the distinct stressors faced by SPCs in wartime and the factors mediating their impact on well-being, our findings extend the Stress Process Model to conflict settings, enhancing understanding of how single parenting is contextually shaped during major community crises. The findings may encourage clinicians and social workers to adopt a more nuanced approach when working with parents in conflict zones, enabling them to tailor interventions to the specific needs of different family structures. For SPCs, such interventions may include tele-counseling to provide psychosocial support and guidance for parents in supporting their children, without the need for childcare or travel, as well as advocacy for workplace policies that reduce financial and emotional vulnerabilities. Full article
(This article belongs to the Special Issue Stress, Traumatic Events and Political Violence: Implications for Mental Health Care)

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26 pages, 2907 KB  
Systematic Review
A Systematic Review and Meta-Analysis Investigating the Efficacy of Various Psychedelic Drugs for the Treatment of Substance Use Disorder
by Eve E. Keighley, Eid Abo Hamza, Dalia A. Bedewy, Shahed Nalla and Ahmed A. Moustafa
Healthcare 2025, 13(21), 2668; https://doi.org/10.3390/healthcare13212668 - 23 Oct 2025
Cited by 2 | Viewed by 3900
Abstract
Objectives: This study investigates psychedelic drugs to treat substance use disorder (SUD). Researchers have recently begun conducting clinical trials of psychedelic treatment for SUD. The current meta-analysis investigates the extent of efficacy in alleviating SM behaviours (P) using psychedelic therapy (I), concurrent with [...] Read more.
Objectives: This study investigates psychedelic drugs to treat substance use disorder (SUD). Researchers have recently begun conducting clinical trials of psychedelic treatment for SUD. The current meta-analysis investigates the extent of efficacy in alleviating SM behaviours (P) using psychedelic therapy (I), concurrent with determining which psychedelic enables the greatest effect (C) as a treatment tool for reducing SUD (O). Methods: The inclusion criteria in this study include evaluating the efficacy of LSD, psilocybin, ketamine, or ibogaine in human beings with an SUD. The exclusion criteria include studies on rodents, patients with schizophrenia, case studies, incomplete or ongoing trials, and studies with insufficient quantitative data. The search criteria obtained 1278 articles, acquired through PubMed and PsycINFO. After excluding literature, 30 papers were kept in the final meta-analysis. A random-effects model analysis was applied to investigate individual psychedelic interventions, with a corresponding combined psychedelic intervention analysis. Results: The results favoured psychedelics as an SM treatment, with ibogaine evidencing the most prominent. We also found a non-significant difference between the effectiveness of psychedelic treatment paired with psychotherapy and psychedelic treatment alone. This study aims to contribute knowledge to future clinical research on the psychedelic treatment of SUD. Full article
(This article belongs to the Special Issue Stress, Traumatic Events and Political Violence: Implications for Mental Health Care)
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