Search Results (157)

Armed conflict is a well-established risk factor for children’s mental health, yet young children remain underrepresented in research on mental health among children affected by conflict in the Gaza Strip. This systematic review synthesized evidence on the relationship between war exposure and mental health outcomes among children aged 0–8 years in the Gaza Strip, drawing on studies published between 2000 and 2026 to compare findings across conflicts preceding and following the October 2023 escalation. Following PRISMA 2020 guidelines, five databases (Scopus, Web of Science, ERIC, PubMed, and PsycINFO) were searched, yielding 220 records. After screening and full-text assessment, seven reports representing six independent samples (N = 309–11,646) met the eligibility criteria; all included studies were conducted in the Gaza Strip, and no eligible studies from the West Bank or East Jerusalem were identified. Methodological quality, assessed using the JBI Critical Appraisal Checklist, ranged from low to high. Across the outcomes examined, including post-traumatic stress, anxiety, depression, and broader psychosocial and behavioral functioning, greater trauma exposure was generally associated with poorer outcomes. Reported PTSD estimates varied substantially across studies and assessment approaches, ranging from 6% in a preschool sample to 57.8% in a broader sample, with the latter estimate decreasing to 15.6% under a stricter DSM-5 diagnostic algorithm. These differences likely reflect, at least in part, variation in age range, assessment instruments, and diagnostic thresholds. Caregiver mental health was consistently associated with child outcomes and, in some studies, showed stronger associations than children’s reported trauma exposure. Household socioeconomic disadvantage was also associated with poorer outcomes, while findings regarding sex differences in internalizing symptoms were inconsistent; boys were more frequently reported to exhibit externalizing problems. All included studies were cross-sectional and conducted in Gaza, limiting causal inference and geographic generalizability. These findings indicate that supporting children’s mental health in the context of war cannot be separated from supporting the caregivers who raise them and underscore the urgent need for longitudinal and intervention-focused research addressing the ongoing consequences of the 2023–2025 war. Full article

Hmong people fleeing Southeast Asia at the end of the Vietnam War carried with them their knowledge of medicinal plants and healing practices. As the refugees resettled into a global diaspora, this knowledge crossed geopolitical, linguistic, and cultural borders, transforming in each new context where it was practiced. These traditions reinforced the health sovereignty of diasporic Hmong communities while helping them navigate the traumas of war and displacement. Over time, the circulation of plants and knowledge through transnational family networks has helped Hmong herbalism emerge as a global phenomenon. The internet and social media have facilitated knowledge exchange, enabling both the transmission of traditions and the adoption and diffusion of new practices and remedies. The dynamism of healing traditions was showcased during the COVID-19 pandemic, as communities acquired new plants and repurposed existing practices to deal with a novel health threat. The currents of change and conservation in medical practices reflect contrasting aspects of the ongoing process of formulating a transnational Hmong identity. Drawing on fieldwork in the U.S., France, French Guiana, and Thailand, I explore the transformations of Hmong healthcare practices as they have become globalized traditions and analyze their links with community resilience and identity. Full article

Traumatic experiences at sea are not uncommon and may arise from events such as piracy, war, accidents or deaths, as well as from harsh working conditions and social confinement. Although occupational stressors at sea and their potential traumatic and mental health impacts have been recognised, there has been limited systematic categorisation of these stressors, as well as insufficient research on interventions to address seafarers’ traumatic experiences. The study conducted a systematic literature review of the causes, impacts, and interventions related to psychological trauma among seafarers. The review aimed to (1) examine the risk associated with psychological trauma among seafarers, and (2) critically assess the existing interventions designed to address or mitigate psychological trauma at sea. Twenty-eight studies were included in the review. Seafarers are exposed to a range of traumatic events, particularly piracy, occupational incidents, violence, and, recently, COVID-19-related stressors. Other potentially traumatic experiences, such as exposure to armed conflict and seafarer abandonment, have received comparatively little research attention. Such stressors are associated with PTSD symptoms, depression, anxiety, sleep disturbances, and occupational disturbances. Trauma support was reported to be limited, including low rates of help-seeking and scarce follow-up care. Interventions include crisis response, psychological support, psychoeducation, family involvement, and resilience-based approaches, although evidence on effectiveness is sparse. Psychological trauma is an under-recognised occupational health issue in seafaring, arising from both acute and chronic stressors. The findings highlight the need for trauma-informed maritime health frameworks, improved access to psychological support, and effective prevention, intervention, and recovery strategies. Full article

Vicarious War Trauma (VWT) refers to psychological distress arising from indirect exposure to war-related suffering through media, social media, news reports, images, videos, or communication with affected individuals. Grounded in theories of vicarious traumatization and secondary traumatic stress, this study aimed to develop and validate the Vicarious War Trauma Scale (VWTS) for the Pakistani population. A cross-sectional design was employed across three studies. In Study I, an initial pool of 40 items was generated through literature review and interviews and refined to 34 items through expert evaluation. Exploratory factor analysis with maximum likelihood extraction and Promax rotation was conducted using data from 311 participants, yielding a 15-item scale with four factors: Shaky Beliefs, Empathic Distress, Hopelessness, and Anxiety, explaining 48.48% of the variance. In Study II, confirmatory factor analysis in an independent sample (N = 200) provided preliminary support for the proposed multidimensional structure. A post hoc revised second-order model with four first-order factors including two theoretically interpretable within-factor residual covariances showed acceptable fit, χ²(84) = 162.83, χ²/df = 1.94, CFI = 0.94, TLI = 0.92, and RMSEA = 0.07. Study III provided validity evidence for the provisional VWTS total score based on relations with external variables, showing positive associations with intolerance of uncertainty, empathy, depression, stress, and anxiety, and a negative association with resilience. Factor-specific validity based on relations with external variables was not examined. The scale is a psychometrically promising research instrument for assessing self-reported multidimensional psychological distress associated with indirect exposure to war-related suffering. Its potential utility as a screening measure requires further evaluation through longitudinal and predictive studies and external replication. It is not intended to assess posttraumatic stress disorder or to serve as a diagnostic measure of trauma-related disorders. Full article

Objective: Modern high-intensity warfare, such as the Russo-Ukrainian conflict, generates a high incidence of multisystem polytrauma, blast-induced traumatic brain injury, and limb amputations often complicated by post-traumatic stress disorder and chronic pain. Traditional specialised rehabilitation protocols are structurally inadequate for these co-occurring symptoms and rely heavily on medical treatments, increasing the risk of opioid dependency. The primary aim of this review is to conceptualise a multidimensional integrative framework for war-related polytrauma; a secondary aim is to evaluate and summarise the evidence underpinning its key rehabilitation strategies for limited-resource, post-conflict environments. Methods: This narrative review synthesises evidence identified through targeted database searches and purposive selection guided by clinical relevance, methodological quality, and applicability to war-related polytrauma across physical, technological, and non-pharmacological rehabilitation domains. Evidence was evaluated using a four-tier (A–D) hierarchy, comprising Tier A (systematic reviews and RCTs), Tier B (prospective cohort studies and non-randomised controlled trials), Tier C (descriptive, case-series, and retrospective studies), and Tier D (exploratory, mechanism-based, or expert opinion evidence). No systematic inclusion/exclusion protocol was applied, and no claims of comprehensive search coverage are made. Results: Concurrent physical and trauma-focused psychological rehabilitation, evidenced by reduced pain and psychological symptom burden alongside improved functional independence, is supported by high-quality evidence (Tier A) for managing comorbid polytrauma. Robotic exoskeletons and AI-supported tele-rehabilitation demonstrate dose-dependent motor benefits in selected rehabilitation populations (Tier A–B), but their scalability in wartime settings is contingent on electricity supply, connectivity, equipment maintenance, and trained personnel. Acupuncture shows Tier A evidence for neuropathic pain and Tier B cost-effectiveness; evidence for phantom limb pain and PTSD is preliminary (Tier C–D) and requires dedicated RCTs in veteran populations. Ayurvedic herbal interventions are exploratory (Tier C–D) with no war-specific clinical trials; mechanistic plausibility is discussed as hypothesis-generating only. Conclusions: Addressing the war-related rehabilitation gap requires integration of biomedical care, technology-assisted rehabilitation, and evidence-graded non-pharmacological adjuncts within a structured biopsychosocial framework. Future priorities include pragmatic, adapted trial designs (e.g., stepped-wedge or cohort-embedded designs, which are more feasible than classical RCTs under wartime conditions) for acupuncture in phantom limb pain, feasibility trials for robotic rehabilitation in frontline-adjacent facilities, and health-economic modelling adapted to the Ukrainian context. Full article

Battlefield preservation is commonly understood as a matter of heritage management, historical education, or cultural tourism. This article argues that its origins and enduring significance lie elsewhere. Modern battlefield preservation emerged as a direct consequence of the transformation of warfare between the late eighteenth and twentieth centuries. Beginning with the French Revolution and the levée en masse, military service became increasingly associated with citizenship, national identity, and mass participation, while industrialization provided the logistical and technological foundations necessary for warfare on an unprecedented scale. As warfare expanded, so too did its human consequences, transforming military death from the experience of a relatively small warrior elite into a shared social reality affecting entire populations. Drawing upon military history, memory studies, sociology, religious studies, and heritage scholarship, this article examines how mass warfare generated new forms of collective bereavement, ritual commemoration, battlefield pilgrimage, and historical preservation. Through case studies ranging from the French Revolutionary and Napoleonic Wars to the Crimean War, Gettysburg, the World Wars, and the conflicts in Korea and Vietnam, it demonstrates how expanding mobilization, industrialized conflict, and rising casualty rates produced enduring landscapes of memory. The article argues that battlefield preservation developed through a cumulative historical process linking mass warfare, mass casualties, collective trauma, commemorative practices, and the creation of commemorative landscapes. Preserved battlefields are not merely remnants of past conflicts; they are cultural institutions through which societies negotiate memory, identity, and meaning. As traditional sources of collective authority weakened in modern societies, battlefields increasingly acquired functions associated with ritual, pilgrimage, and civil religion. The expansion of warfare produced an expansion of remembrance, and the preserved battlefield emerged as one of the most enduring cultural responses to the human consequences of modern conflict. Full article

Background and Clinical Significance: Implant rehabilitation of patients with acquired maxillofacial defects remains challenging, particularly following high-energy war-related trauma. Gunshot and mine blast injuries frequently result in extensive hard and soft tissue loss, often requiring complex reconstructive procedures. Although cortically anchored implants have been successfully used in patients with severe maxillary atrophy and selected traumatic defects, evidence supporting their use for the immediate rehabilitation of critical-size war-related maxillary defects remains limited. Cortically anchored single-piece implants used in conjunction with an immediate loading protocol may provide an alternative rehabilitation strategy for selected patients who decline, or are unsuitable for, conventional implants and bone-grafting procedures. Case Presentation: Two patients with critical-size maxillary defects (approximately 3 cm) resulting from gunshot and mine blast injuries are presented. Treatment consisted of extraction of non-restorable teeth, placement of cortically anchored single-piece implants, including tubero-pterygoid implants, followed by immediate loading with fixed hybrid metal–acrylic hybrid prostheses. Clinical and radiological evaluation was performed using panoramic radiography and cone-beam computed tomography. Conclusions: Successful implant-supported prosthetic rehabilitation was achieved in both patients. Cortically anchored implants engaging the basal bone of the maxilla provided stable support for immediately loaded fixed prostheses despite substantial hard and soft tissue loss. Functional and aesthetic outcomes were satisfactory. Immediate prosthetic rehabilitation was successfully completed in both patients. A 12-month clinical and radiographic follow-up was available for one patient and demonstrated stable implant function without biological or prosthetic complications. Long-term follow-up of the second patient was not available because of active military service. Cortically anchored implant-supported hybrid prostheses may represent a viable treatment option for selected patients with critical-size maxillary defects resulting from gunshot or mine blast injuries, enabling rapid restoration of oral function and facial aesthetics while avoiding extensive bone-grafting procedures. Full article

This article examines the institutional formation and transformation of war commemoration in modern Japan, focusing on the relationship between symbolic enshrinement and the treatment of physical remains. While existing scholarship has emphasized memory, narrative, and political controversy—particularly debates surrounding Yasukuni Shrine—it has paid comparatively little attention to the materiality of the war dead and the embodied practices through which relationships with the deceased continue to be maintained. This study addresses this overlooked dimension as a critical aspect of war’s enduring legacy. Drawing on archival sources, it traces a historical trajectory from early shōkon practices to the establishment of Yasukuni Shrine, the development and postwar dissolution of military cemeteries, and the emergence of large-scale remains recovery. It argues that Japan’s commemoration system developed as a dual structure in which the spirits of selected war dead were symbolically integrated into state-centered institutions, while their bodies were subjected to processes of regulation, mobilization, cremation, and fragmentation. Using Vamik Volkan’s concept of “chosen trauma” and Pauline Boss’s notion of “ambiguous loss,” the article demonstrates that this division has produced enduring tensions in mourning and memory, illustrating the institutional persistence of violence. Full article

Collective intergenerational trauma is a complex phenomenon affecting descendants and families exposed to the enduring effects of collective traumatic events, such as forced displacement, genocide and war. This systematic review aimed to explore the mechanisms through which collective trauma is transmitted across generations, examine its consequences for children and families, and critically analyse interventions employed by health professionals and social workers. A systematic review was conducted using ScienceDirect, Wiley Online Library and PubMed. Studies published between 2016 and 2026 were screened for eligibility, resulting in the inclusion of 22 studies. The indexing terms “collective intergenerational trauma”, “collective transgenerational trauma”, “trauma transmission”, “transmission mechanisms”, “consequences”, “intergenerational trauma interventions”, “Social Care”, and “Health Professionals”, were used, along with the Boolean operators AND and OR. The included studies were synthesised using thematic analysis. The findings indicate that collective intergenerational trauma is transmitted through interacting family, communicative, sociocultural and biological mechanisms. Its consequences include psychological and psychosocial difficulties among descendants, disruptions in family relationships and adverse effects on family functioning. Existing interventions primarily focus on individual trauma, with limited attention to its collective and intergenerational dimensions. The findings highlight the need for culturally responsive, trauma-informed and family-centred interventions addressing collective intergenerational trauma within a systemic framework. Health professionals and social workers can play an important role in promoting mental health, strengthening resilience, mitigating the long-term effects of trauma and supporting affected children, families and communities. Full article

The study explores the trauma experiences and gendered labor of Ukrainian women working as local fixers for international major media outlets covering the Russian war. Using semi-structured interviews (N = 15) with Ukrainian women fixers and drawing on feminist standpoint epistemology and embodied journalism, this research investigates how they perceive and perform their roles in a male-dominated professional environment. Women fixers’ work is shaped by lived, embodied experiences and an alternative knowledge of conflict. The fixers have an unofficial leadership role in international news teams, describing themselves as producers who shape editorial decisions, ensure safety, and influence coverage. From a feminist standpoint, their experiences show how lived experiences afford them authority in war reporting, even when it is not formally recognized. However, they face gender inequalities, primarily from male foreign correspondents who question their competency, as well as from Ukrainian military personnel who undermine their expertise and authority. Women fixers have also received unwanted sexual propositions from other freelancers in the media teams. Participants acknowledged that they have been traumatized by the war coverage, and they do not receive sufficient institutional support, but they invest in self-funded coping strategies. Full article

There is a dearth of research on New Testament and Johannine anthropology and its ethical demands. This paper advances the discussion by arguing that Mary Magdalene (John 20:1–18) demonstrates the limits and horizons of Johannine anthropology from the perspective of a woman’s response to the trauma of the Roman crucifixion of Jesus, his missing, tortured, and crucified body, and her encounter with the Risen Lord. This feminist-trauma hermeneutical characterization of Mary Magdalene, through exploring Johannine anthropology, critically engages Judith Herman’s discussion of the process from trauma to recovery. Read in the context of thousands of extrajudicial killings (EJK) in the so-called “War on Drugs” (2016–2022), Mary Magdalene embodies the anthropological limits of needing to secure the dead body of Jesus, remembering him, and mourning (20:1–15). The anthropological horizon is seen in Jesus sending her, with his resurrection and ascension message, to the rest as a reconnection with ordinary life (20:16–18). The insights gathered from the feminist-trauma hermeneutics study contribute to a Johannine anthropology that informs and inspires the surviving families of the EJK victims, as well as the theologians and pastoral workers who journey with them towards justice and healing with Mary Magdalene as a companion. Full article

This article offers a comparative reading of Ayla Kutlu’s Bir Göçmen Kuştu O and Zülfü Livaneli’s Huzursuzluk, examining how the two novels represent historical migration and contemporary displacement. It argues that, in both texts, migration cannot be reduced to physical movement from one place to another. Rather, it functions as a cultural rupture that reorders space, identity, belonging, memory, witnessing and alienation. Bir Göçmen Kuştu O frames forced migration from the Caucasus to Türkiye through homeland loss, family memory, genealogical continuity and the search for settlement. Huzursuzluk, by contrast, locates the Syrian war, the persecution of Yazidis, refugeehood, trauma and witnessing within the wider violence of the contemporary Middle East, tracing their effects on individual and cultural memory. Its central argument is that the two novels stage witnessing in two distinct modes. Read through Marianne Hirsch’s notion of postmemory, Kutlu’s novel renders witnessing as the intergenerational inheritance of homeland loss, whereas Livaneli’s stages the synchronic implication of a contemporary listener in another’s suffering; on this reading, migration fiction holds these two configurations together as simultaneous ethical possibilities rather than as successive literary phases. Full article

Background: Periods of collective crises are associated with substantial deterioration in mental health. Whereas trauma-related psychopathology has received considerable clinical and policy attention during such periods, eating disorders (EDs) and disordered eating (DE) remain comparatively under-recognized. EDs and DE are well recognized in the Israeli context; however, accumulating evidence indicates a significant increase in their prevalence during periods of collective crisis. Objective: We sought to synthesize empirical findings and clinical observations in Israel about the impact of the COVID-19 pandemic and the October 2023 War on the emergence and exacerbation of DE and EDs, and to examine the implications for clinical practice and mental health policy. Methods: We conducted a narrative review integrating epidemiological data, findings from Israeli healthcare organizations, scientific studies, and clinical insights from specialized ED services. Results: Across both crises, Israel experienced a marked increase in the full spectrum of eating-related disturbances, ranging from emotional eating and subclinical DE to severe full-blown EDs. Adolescents and young adults were particularly affected, but increased ED-related disturbance was also observed among adults and individuals with pre-existing EDs. These findings coincide with a prolonged duration period before receiving treatment and with limited service capacity. In response, the mental health system attempted to implement rapid adaptations, including expanded telemedicine, short-term targeted interventions, and new ambulatory and day treatment programs. Conclusions: Our findings indicate that DE and EDs constitute a significant and escalating mental health burden during periods of collective crises that is comparable to other trauma-related conditions. Just as comprehensive short- and long-term intervention frameworks have been developed for trauma-related conditions, similar models are urgently required for EDs. Full article

Background: Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy among U.S. military service members (SMs), yet the impact of deployment and deployment-related factors on survival remains unclear. Modern military service involves potential exposure to environmental hazards and trauma that could plausibly influence lymphoma biology, treatment tolerance, or long-term outcomes. Methods: Tricare beneficiaries with NHL diagnosed between 2001 and 2022 were identified from the Defense Health Agency Cancer Registry. Deployment history, demographics, lymphoma subtype, and mortality data were obtained from linked Department of War and National Death Index sources. Survival was compared between previously deployed (9/11 DEP) and non-deployed (NON-9/11 DEP) SMs using multivariable Cox models. Among deployed SMs, associations between deployment characteristics and mortality were evaluated. Results: Among 745 SMs, 378 had deployed, and 367 had not. There were no significant differences in all-cause, lymphoma-specific, or non-lymphoma mortality between cohorts. Deployment location, duration, number of deployments, and occupational category did not affect survival. Histologic differences between cohorts, higher diffuse large B-cell lymphoma and follicular lymphoma in deployed SMs, and higher T-cell lymphomas and marginal zone lymphoma in non-deployed SMs, were more consistent with unmeasured confounding and differential deployability than with deployment-related risk. Conclusions: These findings do not suggest major survival differences attributable to deployment status. Given the lack of publicly available validated exposure assessment tools for military personnel, as current military operations expand, including recent deployments to the Middle East, proactive and systematic approaches to exposure assessment are urgently needed. Strengthening military cancer registries and embedding validated exposure tools will be essential to proactively anticipate, identify, and manage exposure-related hematologic concerns in future Veterans. Full article

Background: Modern warfare has introduced novel mechanisms of injury, particularly drone-induced blast trauma, resulting in complex craniomaxillofacial injuries. These injuries differ substantially from typical ballistic wounds and require adapted surgical strategies. This study was conducted to evaluate the clinical characteristics, management approaches, and long-term outcomes of midfacial blast injuries. Methods: A retrospective analytical study was conducted on 41 patients with drone-induced midfacial blast injuries treated at a tertiary referral center in Armenia following the 2020 Nagorno-Karabakh War. All patients underwent surgical management after initial stabilization and were followed for 5 years. Clinical outcomes, complications, and reconstructive needs were assessed. Results: All patients presented with comminuted midfacial fractures, which were frequently associated with polytrauma (87.8%). Burns were observed in 82.9% of cases. Surgical management included radical debridement and early definitive osteosynthesis using titanium fixation systems. No cases of postoperative osteomyelitis, bone sequestration, or implant failure were observed during the 5-year follow-up period. Patients with extensive soft tissue defects, particularly nasal and lip amputations, required multiple reconstructive procedures. Long-term follow-up revealed progressive soft tissue thinning over titanium meshes, especially in the zygomatico-orbital region, necessitating secondary interventions such as lipofilling. Conclusions: Drone-induced midfacial blast injuries represent a distinct and severe form of trauma. Early definitive reconstruction following adequate debridement was associated with favorable outcomes. However, soft tissue reconstruction remains challenging and often requires staged procedures. Long-term follow-up is essential to manage delayed complications and optimize aesthetic outcomes. Full article