War-related Trauma Research Articles

24 Longitudinal Neuropsychological Functioning in Gulf War Veterans Exposed to Neurotoxicants and War-Related Trauma

Objective:Gulf War (GW) veterans were exposed to many neurotoxicants during the 1990-1991 Gulf War. Neurotoxicants included: chemical warfare such as sarin nerve gas, combustion byproducts from oil well fires and diesel fuels from tent heaters, pesticides, and prophylactic anti- nerve gas pyridostigmine bromide pills (PB); all of which have been associated with both cognitive and mood concerns. There are few longitudinal studies that have examined cognitive functioning regarding these toxicant exposures. In our longitudinal Fort Devens cohort, we found decrements over time in the area of verbal learning and memory but no differences in measures of nonverbal memory and executive function. To describe changes more accurately over time in this GW veteran cohort, we examined cognitive functioning in those with probable Post-Traumatic Stress Disorder (PTSD) versus those without.Participants and Methods:The FDC is the longest running cohort of GW veterans with initial baseline cognitive, mood, exposure and trauma assessments in 1997-1998 and follow-up evaluations in 2019-2022. FDC veterans (N=48) who completed both time points were the participants for this study. Veterans were categorized into dichotomous (yes/no) groups of PTSD classification. The PTSD checklist (PCL) was used to determine PTSD case status. Symptom ratings on the PCL were summed (range:17-85) and a cutoff score of 36 or higher was utilized to indicate probable PTSD. Neuropsychological measures of mood (POMS) and memory (Visual Reproductions from the Weschler Memory Scale-R; California Verbal Learning Test Second Edition; CVLT2) and executive function and language; (Delis-Kaplan Executive Function System- Color Word and Verbal fluency- Animals) were compared overtime using Paired T-tests.Results:The study sample (N=48) was 92% male and 96% reported active-duty status at the time of the GW. Mean current age was 58 years. All veterans reported exposure to at least one war-related toxicant. 48% met criteria for probable PTSD (N = 23) while 52% did not (n=25). No differences between groups were found in any of the POMS subscales, nor were differences seen in verbal memory, executive function, or language tasks. There were, however, significant differences in nonverbal memory in those with probable PTSD showing fewer details recalled during delay on the WMS-R Visual Reproductions (p<0.05).Conclusions:In this longitudinal analysis, GW veterans with PTSD showed declines in nonverbal memory and consistent levels of function in all other tasks. Basic mood scales did not show decline; therefore, these results are not due to generalized changes in mood. All participants reported at least one neurotoxicant exposure and we did not have the power to examine the impact of the individual exposures, thus we cannot rule any contributing factors other than PTSD. This study highlights the importance of longitudinal follow up and continual documentation of GW veterans’ memory performance and their endorsement of mood symptoms overtime. Specifically, these findings reveal that future studies should examine the prolonged course of memory and mood symptomatology in GW veterans who have endorsed a traumatic experience.

Impact of access to housing on mental health and coping amongst Ukrainian refugees in England

Abstract Background Though the link between war-related trauma and poor mental health is well-established, less is known about stressors due to prolonged displacement, and how these relate to mental health. As the numbers of forcibly displaced persons rise worldwide, the associated mental health burden represents an urgent public health need. This qualitative paper explores housing-related stressors amongst adult female Ukrainian refugees England, mental health impacts, and coping responses. Methods We draw on 40 semi-structured interviews: 30 with Ukrainian refugee women, 10 with stakeholders (council staff, mental health professionals, staff/volunteers at relevant charities). Thematic analysis identified macro- and micro-level factors impacting housing access, perceived mental health and coping. Results Most of the Ukrainian sample were provided with housing for an initial 6 months. Facing the pervasive shortage in council housing, many were attempting to transfer into rented accommodation at interview time. These efforts were hindered by a lack of employment history, discrimination from landlords, and the language barrier. Interviewees linked these issues to high stress levels and deteriorating well-being, adding to their anxiety over the ongoing war. Coping centred on support-seeking (reaching out to councils, charities, other Ukrainians), distraction (exercise, volunteering), problem-solving (taking a methodical approach to problems), and cognitive restructuring (focusing on the positive). Conclusions Ukrainian refugees face significant barriers in accessing long-term housing in England, forcing some to choose between insecure housing and returning to a war zone. This bind has compounded mental health issues attributed to the trauma of leaving Ukraine and the ongoing war. Though refugees took an active approach to coping with housing hardships, resources to support the transition to long-term housing is necessary to better safeguard their mental health from further harm. Key messages • Ukrainian refugees face significant barriers in accessing housing in England, forcing some to choose between insecure housing and returning to an active war zone. • Participants linked barriers to accessing housing to high stress levels and a deterioration of well-being, compounding trauma from fleeing Ukraine and anxiety over the ongoing war.

Approaches to surgical treatment and antibacterial therapy in patients with chronic infection after war injuries

Fracture-related infection following orthopedic surgery, especially in cases of war-related trauma, represents a grave complication. The injuries sustained in war often entail severe damage to soft tissues, including significant impairment of vessels, nerves, tendons, muscles, and result in substantial bone defects. Complicating matters further, these infections often involve multidrug-resistant pathogens, making effective treatment a significant challenge. Optimal management of patients with combat-related trauma and signs of infection necessitates specialized care in dedicated centers. The approach to treatment should be guided by a well-defined algorithm that incorporates appropriate surgical interventions alongside systemic and localized antibiotic administration. In instances where chronic infection manifests after war-related injuries and specific causative agents are not definitively identified, initiating empiric therapy is advisable. A combination of meropenem, colistin, and vancomycin can be a suitable choice for initial treatment. Subsequently, once the causative microbes are identified, targeted treatment can be prescribed based on the susceptibility patterns. This article delves into the primary pathogens commonly found in war-related wounds and provides effective antibiotic regimens based on the specific microorganisms. One promising approach for managing severe war injuries is suppressive antibiotic therapy, which enhances the prospects of successful treatment. The comprehensive strategy outlinedhere aims to mitigate the serious risks posed by fracture-related infections in the context of war-induced trauma, ultimately improving patient outcomes and prognosis.

Effect of daily stressors and collective efficacy on post-traumatic stress symptoms among internally displaced persons in post-war northern Sri Lanka.

Daily stressors have been shown to mediate the relationship of war trauma and trauma-related distress among refugees and internally displaced persons exposed to war and conflict. To examine the extent to which the relationship between war-related trauma and mental distress was mediated by daily stressors and collective efficacy among internally displaced communities a decade after exposure to war. In a cross-sectional study, we recruited a random sample of residents in villages severely affected by conflict in five districts in the Northern Province of Sri Lanka. Measures of war trauma, daily stressors, collective efficacy and post-traumatic stress symptoms (PTSS) were examined. Statistical analyses of the mediating and moderating effects of daily stressors were conducted using regression based methods. Daily stressors mediated the association of war trauma and PTSS, as both paths of the indirect effect, war trauma to daily stressors and daily stressors to PTSS, were significant. The predictive effect of war trauma on PTSS was positive and significant at moderate and high levels of daily stressors but not at low levels. Higher levels of neighbourhood informal social control, a component of collective efficacy, function as a protective factor to reduce effects of war trauma and daily stressors on mental distress in this population. Daily stressors are an important mediator in the well-established relationship between war exposure and traumatic stress among internally displaced persons, even a decade after the conflict. Mental health and psychosocial support programmes that aim to address mental distress among war-affected communities could reduce daily stressors and enhance collective efficacy in this context.

Gender differences in transdiagnostic domains and function of adults measured by DSM-5 assessment scales at the first clinical visit: a cohort study

BackgroundMeasurement-based care has been called for as best practice in psychiatric care and learning health systems and use of transdiagnostic measures was suggested as part of the DSM-5. Our objective is to examine gender differences in first visit socioeconomic, transdiagnostic, and functional characteristics of a dynamic, real-world measurement-based care cohort.MethodsTransdiagnostic, functional, and clinical measures were collected from 3,556 patients at first visit in an ambulatory psychiatric clinic. All patients were evaluated at the first visit by board-certified psychiatrists or licensed clinical psychologists. Demographic variables and clinical diagnoses were collected from the Electronic Medical Record. Self-report measures were collected that assessed transdiagnostic symptoms (DSM-5 Level 1 Cross-cutting Measure and Level 2 symptom scales), disability, alcohol use, attention deficit hyperactivity disorder (ADHD) symptoms, depression, anxiety, mania, suicidal thoughts and behaviors, and trauma exposure.ResultsMen and women did not differ in age, BMI, household income, high school graduation rate, race, or ethnicity, but women were more likely to be formerly married and less likely to have commercial insurance. Compared to men, women reported significantly higher overall psychopathology on the transdiagnostic Level 1 Cross-cutting measure and had higher depression, anxiety, sleep, anger, ADHD combined presentation, and suicidality severity. Women also had higher disability scores than men. However, men reported higher alcohol, tobacco and substance use, and more risky behavior than women. Trauma exposure differed significantly by gender; men reported more exposure to accidents, war-related trauma, serious accidents, and major disasters and women reported more unwanted sexual contact.ConclusionsThis cross-sectional study of a transdiagnostic, ecologically-valid real-word measurement-based care cohort demonstrates gender differences in socioeconomic factors, trauma exposure, transdiagnostic symptoms, and functioning.

‘New war, same old story’: Gender and War-related Trauma in ITV’s Home Fires

Airing during the centenary of the First World War and the 75th anniversary of the Blitz, Home Fires (ITV, 2015–16) deals with both world wars by linking them through war-related trauma that not only coloured wartime experiences but also shaped generational experiences in the decades following both conflicts. Set in the Second World War and focusing on the women of the Great Paxford Women’s Institute in rural Cheshire, the series complicates simplified narratives of Britons’ experiences in the world wars that represent the first as futile and the second as triumphalist and definitive. Rather than confining trauma to surviving combat conditions, Home Fires explores second-generation trauma, patriotic marriages versus non-heteronormative identities as a threat to the nation, and spousal abuse and adultery as consequences of war trauma. Ultimately, Home Fires is an emotionally wrought fictionalised narrative of the Second World War that encourages audiences to think critically about the world wars, their commemoration and the gendered valuation of trauma.

Genre of Comedy Ballet in Music of Yurii Shevchenko as an Effective Tool for Overcoming Social and Psychological Traumas of War: on the Example of Ballet “The Adventures of Pinocchio”

The purpose of the study is to substantiate and reveal the cultural potential of the comedic ballet genre as an effective tool for overcoming the social and psychological traumas of war on the example of Yurii Shevchenko's ballet “The Adventures of Pinocchio”. The research methodology is based on the complex application of specifically scientific methods (historical, systematic-analytical, hermeneutic, and generalisation). The historical method is used to study the topic in its historical retrospective, understanding the origins, which helps to establish links between the studied ballet productions and the socio-cultural landscape of their creation and performance. The systematic-analytical method is applied to explain the art of interpretation, in particular, the content and semantic aspects of musical and stage works through the correlation of higher-order aggregates of different structural levels – composition, instrumental accompaniment, and the choreographic part of the production. The hermeneutic method is used to study the musical framework of ballets, which can have many different interpretations. The method of generalization is used to generalise common scientific principles and regularities, and helps to identify the overall trends in the development of ballet music in different periods of composer Yurii Shevchenko's work. The scientific novelty of the study lies in the consideration of the genre of comedy ballet as an effective tool for overcoming the socio-psychological trauma of war, which contributes to the restoration of the moral and psychological state of society, the improvement of morale, and the return of faith in justice. The ballet “The Adventures of Pinocchio” by Yuriy Shevchenko is presented, which is a vivid example of the composer's work in the context of the current conditions of the Ukrainian theatre. In the course of the study, the scientific justification of the comedy ballet genre is expanded and supplemented. Conclusions. The article reflects the significance of theatre music as an important component of the artistic and creative activity of theatre groups in modern conditions. The evolution of theatre music testifies to its connection with modernity, and also reveals a tendency to strengthen the role of art and culture in the education and support of positive social values. The direct connection of the creative tasks of theatre music with the present is observed. It is established that there is a consonance of manifestations in music of both traditional folklore motifs and new national and cultural characteristics, which allows it to become more emotional and understandable to the audience. It is stated that Ukrainian society, traumatised by war, is going through a difficult historical, moral, and spiritual period. There is a need for music, in particular, for theatre performances, which will play not only an aesthetic role, but will also become a means of restoring a positive attitude, help overcome war-related traumas, and have a powerful cultural and therapeutic function. It is shown that one of the vivid examples of the development of the comedy ballet genre in theatre music is the work of the famous Ukrainian composer Yurii Shevchenko and his ballet “The Adventures of Pinocchio”. This ballet is an apt example of how art can help maintain a positive attitude and hope for the future in difficult times of social disasters and become an important support for people during wartime. The story of Pinocchio and his friends, which is presented through classical dance, comedy ballet, grotesque, and pantomime, shows that good triumphs over evil in any circumstances. The ballet “The Adventures of Pinocchio” provides the audience not only with entertainment and relaxation, but also helps to maintain a positive attitude, hope for the future and is an effective tool for overcoming the socio-psychological traumas of war. Key words: genre of comedy ballet, ballet «The Adventures of Pinocchio» («Pinocchio and the Magic Violin» until September 2022), Yuriy Shevchenko, ballet theater, choreography, musical theater, stage art, musical art, academic and non-academic music, synthesis of musical and choreographic art, art therapy function, socio-psychological traumas of war.

Post-Traumatic Stress Disorder After Natural Disasters: A Review

Natural disasters, which are considered as one of the most important problems of recent times, affecting all humanity, have become a public health problem. Disasters have effects on both individuals and society in different dimensions, including health, economic, social, and psychological, and can have serious negative consequences. The number of individuals affected by natural disasters is increasing every year. While it is clear that natural disasters threaten human life and bodily health, little attention has been paid to their effects on mental health. Natural disasters threaten our psychological well-being in many ways, cause both short-term and long-term psychological distress and create a significant psychological burden. Post-traumatic stress disorder (PTSD) is a syndrome that occurs as a result of a serious threat or physical injury, a near-death experience, war-related trauma, sexual assault, interpersonal conflicts, child abuse, or a medical illness. When the literature is examined comprehensively, it has been determined that the incidence of PTSD after natural disasters is quite high. Causes of post-disaster PTSD include the nature of the trauma, its severity, loss of relatives and/or property, poor coping skills, displacement, and direct exposure to disaster. Studies have shown that both non-pharmacological and pharmacological treatments are effective on PTSD.

What drives change in children receiving telephone-delivered Common Elements Treatment Approach (t-CETA)? A multiple n = 1 study with Syrian refugee children and adolescents in Lebanon

BackgroundAlthough the evidence-base for mental health and psychosocial support (MHPSS) interventions in humanitarian settings is growing rapidly, their mechanisms of change remain poorly understood despite the potential to improve the effectiveness and reach of interventions. ObjectiveThis study aimed to explore the mechanisms or factors that drive change in a modular transdiagnostic telephone-delivered mental health intervention, Common Elements Treatment Approach (t-CETA). Participants and settingParticipants were Syrian refugee children and adolescents living in tented settlements in Lebanon. MethodsWe used a multiple n = 1 design, drawing on secondary data from 9 children who completed t-CETA during a pilot randomized controlled trial. ResultsChildren with historical war-related trauma were more likely to show significant improvement across symptom clusters by the end of treatment compared to children presenting with depression related to daily living conditions. Children also showed fluctuating symptoms during the early stages of treatment (engagement and cognitive restructuring) but significant decline in symptoms after the trauma module (prolonged imaginal exposure) and depression module (behavioral activation). Salient external life events identified were starting or dropping out of school, working, change in living conditions, family conflict and the October Revolution; and interpersonal factors of parental engagement (with or without full attendance) and counsellor skills in building rapport were also identified as having an impact on treatment success. ConclusionsImplications of our findings are discussed in terms of integrating active ingredients into MHPSS programming, and building on parental and multi-sector involvement in child and adolescent mental health care in humanitarian settings.

No association between war-related trauma or PTSD symptom severity and epigenome-wide DNA methylation in Burundian refugees

ABSTRACT Background: War-related trauma is associated with varying posttraumatic stress disorder (PTSD) prevalence rates in refugees. In PTSD development, differential DNA methylation (DNAm) levels associated with trauma exposure might be involved in risk versus resilience processes. Studies investigating DNAm profiles related to trauma exposure and PTSD among refugees remain sparse. Objective: The present epigenome-wide association study investigated associations between war-related trauma, PTSD, and altered DNAm patterns in Burundian refugee families with 110 children and their 207 female and male caregivers. Method: War-related trauma load and PTSD symptom severity were assessed in structured clinical interviews with standardised instruments. Epigenome-wide DNAm levels were quantified from buccal epithelia using the Illumina EPIC beadchip. Results: Controlling for biological confounders, no significant epigenome-wide DNAm alterations associated with trauma exposure or PTSD were identified in children or caregivers (FDRs > .05). Co-methylated positions derived as modules from weighted gene correlation network analyses were not significantly associated with either war-related trauma experience in children or caregivers or with PTSD. Conclusions: These results do not provide evidence for altered DNAm patterns associated with exposure to war-related trauma or PTSD.

Prevalence of suicidality and associated factors of suicide risk in a representative community sample of families in three East African refugee camps

PurposeTo assess the prevalence of suicidality and associated factors of suicide risk in a sample of Burundian refugee families living in three refugee camps in Tanzania.MethodsChildren (n = 230) and their parents (n = 460) were randomly selected and interviewed about suicidality (suicidal ideation, plans, and attempts) and a range of sociodemographic, psychological, and environmental factors. Multinomial logistic regression analyses were conducted to examine factors associated with children and parents’ lower and moderate or high current suicide risk.ResultsPast-month prevalence of suicidal ideation, plans, and attempts were 11.3%, 0.9% and 0.9%, respectively, among children; 37.4%, 7.4% and 5.2%, respectively, among mothers; and 29.6%, 4.8% and 1.7%, respectively, among fathers. Older age in years (aORlower = 2.20, 95% CI 1.38–3.51; aORmoderate/high = 3.03, 95% CI 1.15–7.99) and higher levels of posttraumatic stress disorder symptoms (aORlower = 1.64, 95% CI 1.05–2.57; aORmoderate/high = 2.30, 95% CI: 1.02–5.16), internalizing (aORmoderate/high = 2.88, 95% CI 1.33–6.26) and externalizing problems (aORlower = 1.56, 95% CI: 1.06–2.31; aORmoderate/high = 3.03, 95% CI 1.42–6.49) were significantly positively associated with children’s current suicide risk. For mothers, higher perceived instrumental social support (aORmoderate/high = 0.05, 95% CI < 0.01–0.58) was significantly negatively related to suicide risk, whereas exposure to community violence (aORlower = 1.97, 95% CI 1.30–2.99; aORmoderate/high = 1.59, 95% CI 1.00–2.52), living in larger households (aORlower = 1.74, 95% CI 1.17–2.57), and higher psychological distress (aORmoderate/high = 1.67, 95% CI 1.05–2.67) were significantly positively associated with suicide risk. For fathers, higher perceived instrumental social support (aORmoderate/high = 0.04, 95% CI < 0.01–0.44) and having more years of formal education (aORmoderate/high = 0.58, 95% CI 0.34–0.98) were significantly negatively and exposure to war-related trauma (aORmoderate/high = 1.81, 95% CI 1.03–3.19) was significantly positively associated with suicide risk.ConclusionPrevention programs should target psychopathology, community violence and social support to mitigate children and parents’ current suicide risk.

Ölçek Geliştirme Çalışması: Savaş Travması Maruziyet Ölçeği

Despite being widely studied, research only deals with consequences of war. While assessing war effects, the existing instruments take war as a general trauma, simply ask about its existence and skip to the consequences. Thus, there is a gap in assessing what experiences the survivor went through. Aim of the study is to develop a scale that will enable understanding war experiences qualitatively, and also evaluate the impact of them quantitatively, named as War Trauma Exposure Scale (WTES). This study was carried out as part of a thesis (Author), with Turkish Cypriot women in North Cyprus (N = 168) considering Cyprus War. Three phases were followed: interview, pilot study, and psychometric examination. At psychometric investigation, factor analysis revealed three-factor solution: “Negative Emotions”, “Exposure to Violence”, and “Loss”. The overall reliability of WTES was good (r = .91). Both, Impact of Events Scale (IES-R) and the scale were gathered under the same factor with 75.68% variance. Scale showed significant correlations with other related constructs. ANOVA supported that the scale was parallel to IES-R. Chi-square fit test (χ²) revealed a good fit. Consequently, the scale is relatively valid and reliable for measuring war-related exposure despite limitations. WTES, is a distinct one since (1) it directly focuses on war-trauma, (2) lists 23 real war-trauma exposures to be identified, (3) asks the survivor’s war experience and (4) assess its influence. Therefore, unlike existing scales to assess war-trauma, WTES helps to understand unique exposure of the war-survivor and assess the psychological impact these exposures.

War-related traumatic brain injuries during the Syrian armed conflict in Damascus 2014–2017: a cohort study and a literature review

BackgroundThe decade-long Syrian armed conflict killed or injured more than 11% of the Syrian population. Head and neck injuries are the most frequent cause of war-related trauma, about half of which are brain injuries. Reports about Syrian brain trauma victims were published from neighboring countries; However, none are available from Syrian hospitals. This study aims to report war-related traumatic brain injuries from the Syrian capital.MethodsWe conducted a retrospective cohort study between 2014 and 2017 at Damascus Hospital, the largest public hospital in Damascus, Syria. Target patients were the victims of combat-related traumatic brain injuries who arrived alive and were admitted to the neurosurgery department or to another department but followed by the neurosurgery team. The collected data included the mechanism, type, and site of injury based on imaging findings; types of invasive interventions; intensive-care unit (ICU) admissions; as well as neurological status at admission and discharge including several severity scales.ResultsOur sample consisted of 195 patients; Ninety-six of them were male young adults, in addition to 40 females and 61 children. Injuries were caused by shrapnel in 127 (65%) cases, and by gunshots in the rest, and most of them (91%) were penetrating. Sixty-eight patients (35%) were admitted to the ICU, and 56 (29%) underwent surgery. Neurological impairment was reported in 49 patients (25%) at discharge, and the mortality rate during hospitalization was 33%. Mortality and neurological impairment associated significantly with higher values on clinical and imaging severity scores.ConclusionsThis study captured the full spectrum of war-related brain injuries of civilians and armed personnel in Syria without the delay required to transport patients to neighboring countries. Although the clinical presentation of injuries at admission was not as severe as that in previous reports, the inadequate resources (i.e., ventilators and operation rooms) and the lack of previous experience with similar injuries might have resulted in the higher mortality rate. Clinical and imaging severity scales can provide a handy tool in identifying cases with low probability of survival especially with the shortage of personal and physical resources.

Trauma, mind and brain: the impact of war on mental health

Abstract The PTSD diagnosis was in 1980 largely facilitated by consequences of the Vietnam War. Since then, there have been hundreds of other war-related conflicts in the world. My presentation will distinguish between war-related trauma effects on military personnel (where most research has been done) and on civilians, distinguishing effects on children/adolescents, adults and older people. I will answer the question, how do war-related trauma sequelae differ from other man-made or accidental traumas? Further, I will address the issue of whether “moral injury” research in military personnel after wartime operations is also relevant to similar phenomena in civilian populations traumatised by war? Which of the brain-related research approaches (localisation, network connectivity, altered RDoC functions) are particularly relevant in this context? Finally, emerging research priorities related to the current war of invasion against Ukraine will be addressed. Disclosure of Interest None Declared

Mental Health Screening for Korean Ukrainian Refugee Minors in the Republic of Korea: A Cross Sectional Pilot Study

Since February 2022, the Ukrainian refugee crisis has been highlighting mental health problems associated with trauma and distress. This study aimed to evaluate the mental health status of twenty-seven refugee minors (10 to 18 years old) who fled Ukraine and temporarily settled in the Republic of Korea (ROK). This cross-sectional survey study aimed to evaluate the mental health status of ethnic Korean Ukrainian refugee minors. The Child and Adolescent Trauma Screen—Youth Report (CATS), generalized anxiety disorder seven-item scale (GAD-7), and subjective unit of distress scale (SUDs) were used for assessment. A preliminary analysis indicated that 77% Ukrainian refugee minors were exposed to and experienced war-related trauma. They are at a relatively low risk of trauma symptoms, anxiety, and distress due to stable family and visa status and a comparably better environment in the ROK. Meanwhile, refugee teenagers showed higher rates of psychological distress compared with refugee children. This finding suggests that an early psychological interventions in a host country may be beneficial to prevent mental health issues in refugee minors.

Healing Through Faith: The Role of Spiritual Healers in Providing Psychosocial Support to Canadian Muslims

Studies have documented on the role of religious leaders in providing psychosocial support to their members. However, there is a dearth of research in understanding the role imams play among Muslim communities in the Canadian context. The few studies that were undertaken in Europe and the United States revealed that imams played a significant role in addressing the psychosocial needs of their congregants, and this role increased in the post-9/11 era.This study explored experiences of imams in the provision of psychosocial support to Muslim Canadians, including new immigrants and refugees. We conducted in-depth, one-on-one interviews with faith leaders in a major metropolitan Canadian city. The data was transcribed and thematically analyzed using NVIVO. The study revealed that spiritual healing is considered the first line of care for psychosocial illness, and imams are considered the primary support network. The findings revealed that war-related traumas and post-resettlement challenges have significant impact on family functions and well-being.This study highlighted the need for culturally appropriate psychosocial support services for Muslim Canadians, including new immigrants and refugees. It also calls for better collaboration between service agencies and faith-based organizations in the communities to address these specific needs.

Developing a Trauma-Informed Culturally-Based Intervention (TICBI) Approach for Refugee Resettlement Practices

Trauma-informed interventions have recently received more attention in the field of refugee resettlement and mental health. Although these interventions can be helpful to all trauma survivors, our model offers enhanced and cultural-based practice benefiting war-related trauma survivors, especially those from Post-Colonial nations. This model is based on needs identified by participants and collaboratively developed with the research team and the community. Our community-based participatory research (CBPR) began with three objectives. The first was to explore the current use of culturally-based, trauma-informed interventions and to assess service users’ (SUs) and service providers (SPs) experiences. This was accopmlished by collaborating with a local community agency. The second objective was to identify service needs and gaps. The third objective involved working with the project’s steering community members to develop a more effective model of interventions that can be used by resettlement and mental health agencies supporting refugees. During analysis, we examined the unique challenges identified by SUs and SPs to create a trauma-informed culturally-based intervention model (TICBI).We used a mixed-method study involving focus groups, individual interviews, and surveys with 23 service users (SUs) and 20 service providers (SPs). The barriers identified by the SUs included lack of access to needs-based assistance, cultural and linguistic misunderstandings, and marginalization. The barriers identified by the SPs included lack of structural/organizational support, lack of funding, large caseloads, and burnout risk.

The war next-door-A pilot study on Romanian adolescents' psychological reactions to potentially traumatic experiences generated by the Russian invasion of Ukraine.

Romania shares the longest UE border with Ukraine, and since the Russian invasion of Ukraine began, many have been involved in helping the refugees. Consequently, children and adolescents might be directly and indirectly exposed to war-related trauma. In the present exploratory research, we investigated Romanian adolescents' potential risk and protective factors related to the psychological outcomes of war exposure. Our cross-sectional study was conducted shortly after February 24th (i.e., the first invasion day). The sample included 90 Romanian adolescents aged 11 to 15 (M = 12.90, SD = 1.17), residents in Iași, Romania (i.e., 205,7 km from the Ukrainian border). Participants completed self-reported measures of peritraumatic dissociative experiences, knowledge about the conflict in Ukraine, personal, school, and family implications in volunteering/helping behavior, discussions about the conflict, threat perception (self and perceived parental threat), anxiety, social media engagement, resilience, and moral elevation. The main findings suggested that participants involved in helping behaviors toward Ukrainian refugees present higher peritraumatic dissociative experiences, anxiety symptoms, and higher moral elevation than boys and participants not involved in these behaviors. Moreover, anxiety symptoms were positively associated with threat perception, peritraumatic dissociation, and social media engagement and negatively related to resilience. Finally, we discuss the implications of our findings concerning their practical utility in managing peritraumatic exposure to war by using interventions designed to increase adolescents' resilience during difficult times.

Hibuki-therapy as a treatment method for war-related mental trauma in children

Introduction. In the context of the war of the Russian Federation against Ukraine, there is a great need for different means of dealing with children's traumas. An effective means of addressing trauma in children is art therapy, in particular, puppet therapy, which helps to build an adequate system of psychological protection. Aim: Theoretical substantiation of the model of Hibuki-therapy as a method of puppet therapy and its role in overcoming mental trauma in children. Methods. Theoretical methods: analysis, synthesis, generalization, and analogy. Results. Hibuki-therapy as a toy therapy is effective in dealing with children who experienced severe and lasting emotional shock and pain caused by an extremely upsetting experience. The author describes the process of Hibuki's becoming a therapeutic model, which draws on the premise that children who actively oppose stressful situations can relieve their fears and better adapt to life after a mental trauma. Conclusions. Hibuki-therapy can help Ukrainian children to recover from war trauma.

War exposure, post-traumatic stress symptoms and hair cortisol concentrations in Syrian refugee children

Altered secretion of cortisol, the primary effector of the hypothalamus–pituitary–adrenal axis, has been proposed as a means by which traumatic experiences compromise later mental health. However, despite the popularity of cortisol as a potential biomarker for stress and adversity, findings are inconsistent, and little is known about the impact of war-related trauma on stress physiology of children and adolescents. Here we aimed to evaluate the relationships between war exposure, current living conditions, hair cortisol concentrations (HCC) and post-traumatic stress disorder (PTSD) symptoms in a large cohort of Syrian refugee children and adolescents (6–18 years) and their caregiver. This longitudinal observational study assessed Syrian refugee children and adolescents in two waves, 1 year apart, within informal tented settlements in Lebanon. The relationships between war exposure, time since leaving Syria, PTSD symptoms and HCC were investigated using linear mixed-model regression utilising both waves of data collected (Y1: N = 1574, Y2: N = 923). Hair cortisol concentration was positively, but weakly associated with the number of war-related events experienced. This was limited to those who were at least 12 years old at the time of war exposure. Conversely, HCC decreased with time since leaving Syria. HCC was also associated with PTSD symptoms but not with the quality of their current living conditions. This study revealed that changes to hypothalamic-pituitary-adrenal axis activity may accompany both earlier war exposure and current PTSD symptoms in children and adolescents. Additionally, early adolescence may be a particularly sensitive time in terms of trauma-related changes to the hypothalamic-pituitary-adrenal axis.