The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: A review
Abstract
This review provides a comprehensive and critical summary of the literature as to the development and maintenance of post-traumatic stress disorder (PTSD) following civilian war trauma and torture. Prevalence rates are reviewed and predictors are discussed in terms of risk factors, protective factors, and factors that maintain PTSD. Most epidemiologically sound studies found relatively low rates of PTSD. There is good evidence of a dose-response relationship between cumulative war trauma and torture and development and maintenance of PTSD. There is also some evidence that female gender and older age are risk factors in development of PTSD. Some refugee variables may exacerbate symptoms of PTSD and contribute to their maintenance. Preparedness for torture, social and family support, and religious beliefs may all be protective against PTSD following war trauma and torture. Applicability of the concept of PTSD to non-western populations and areas for much needed further study are discussed.
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Cites
A cognitive model of posttraumatic stress disorder
Ehlers, A., & Clark, D. M. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00123-0 · Cited by 6,147 · see citing works
Psychological responses to war and atrocity: The limitations of current concepts
Bracken, P. J., Giller, J. E., & Summerfield, D. (1995) · Social Science & Medicine · doi:10.1016/0277-9536(94)00181-r · Cited by 571 · see citing works
Mental Health, Social Functioning, and Disability in Postwar Afghanistan
Cardozo, B. L. (2004) · JAMA · doi:10.1001/jama.292.5.575 · Cited by 445 · see citing works
Mollica, R. F., McInnes, K., Pool, C., & Tor, S. (1998) · British Journal of Psychiatry · doi:10.1192/bjp.173.6.482 · Cited by 425 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & van Ommeren, M. (2009) · JAMA · doi:10.1001/jama.2009.1132 · Cited by 2,246 · see citing works
Long-term mental health of war-refugees: a systematic literature review
Bogic, M., Njoku, A., & Priebe, S. (2015) · BMC International Health and Human Rights · doi:10.1186/s12914-015-0064-9 · Cited by 1,166 · see citing works
Bonanno, G. A., Romero, S. A., & Klein, S. I. (2015) · Psychological Inquiry · doi:10.1080/1047840x.2015.992677 · Cited by 551 · see citing works
Carswell, K., Blackburn, P., & Barker, C. (2011) · International Journal of Social Psychiatry · doi:10.1177/0020764009105699 · Cited by 349 · see citing works
Morina, N., Akhtar, A., Barth, J., & Schnyder, U. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00433 · Cited by 339 · see citing works
Kashdan, T. B., Morina, N., & Priebe, S. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2008.06.006 · Cited by 237 · see citing works
Schick, M., Zumwald, A., Knöpfli, B., Nickerson, A., Bryant, R. A., Schnyder, U., Müller, J., & Morina, N. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.28057 · Cited by 233 · see citing works
Mental and physical health in Rwanda 14 years after the genocide
Munyandamutsa, N., Mahoro Nkubamugisha, P., Gex-Fabry, M., & Eytan, A. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0494-9 · Cited by 149 · see citing works
Trajectories of grief, depression, and posttraumatic stress in disaster‐bereaved people
Lenferink, L. I. M., Nickerson, A., Keijser, J., Smid, G. E., & Boelen, P. A. (2020) · Depression and Anxiety · doi:10.1002/da.22850 · Cited by 140 · see citing works
Teodorescu, D.-S., Heir, T., Siqveland, J., Hauff, E., Wentzel-Larsen, T., & Lien, L. (2015) · BMC Psychology · doi:10.1186/s40359-015-0064-5 · Cited by 105 · see citing works
Helpman, L., Zhu, X., Suarez-Jimenez, B., Lazarov, A., Monk, C., & Neria, Y. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0854-y · Cited by 82 · see citing works
Murphy, S., Elklit, A., Dokkedahl, S., & Shevlin, M. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.32678 · Cited by 71 · see citing works
Meffert, S. M., Abdo, A. O., Alla, O. A. A., Elmakki, Y. O. M., Omer, A. A., Yousif, S., Metzler, T. J., & Marmar, C. R. (2014) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0023540 · Cited by 67 · see citing works
Peltonen, K., & Kangaslampi, S. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1558708 · Cited by 61 · see citing works
“In particular, a strong association between violence-related traumatic events and post-traumatic symptoms has been established (Evans, Davies, & DiLillo, 2008; Johnson & Thompson, 2008).”
BackgroundBöttche, M., Heeke, C., & Knaevelsrud, C. (2016) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-016-2337-4 · Cited by 53 · see citing works
Keyes, K. M., Shmulewitz, D., Greenstein, E., McLaughlin, K., Wall, M., Aharonovich, E., Weizman, A., Frisch, A., Spivak, B., Grant, B. F., et al. (2014) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.10.014 · Cited by 21 · see citing works
Meffert, S., Marmar, C., & Metzler, T. (2009) · PsycEXTRA Dataset · doi:10.1037/e517292011-807 · Cited by 7 · see citing works
Lange, A. B., Mortensen, E. L., Palic, S., Sonne, C. K., & Carlsson, J. (2023) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2023.100586 · Cited by 3 · see citing works
Identifying resilience-promoting factors for refugee survivors of torture
Pannu, P., Burt, K., & Fondacaro, K. (2022) · Torture Journal · doi:10.7146/torture.v32i3.128843 · Cited by 3 · see citing works
- Authors
- Johnson, H., & Thompson, A.
- Affiliations
- University of Sheffield (GB)
- Corresponding author
- Johnson, Howard
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2008-01
- Volume
- 28
- Issue
- 1
- Pages
- 36-47
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2047054062
- Cited by
- 530
- References
- 4
- Citations by year
- 2026: 10 · 2025: 14 · 2024: 41 · 2023: 32 · 2022: 25 · 2021: 32 · 2020: 41 · 2019: 22 · 2018: 31 · 2017: 30 · 2016: 50 · 2015: 43 · 2014: 24 · 2013: 27 · 2012: 25
- FWCI
- 3.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- post-traumatic stress disorder, war trauma, torture, PTSD risk factors, protective factors, cumulative trauma, PTSD prevalence, refugee mental health, social support, religious beliefs, gender differences, age as risk factor, non-Western populations
- MeSH terms
- Adult, Age Factors, Aged, Cross-Cultural Comparison, Female, Humans, Life Change Events, Male, Models, Psychological, Refugees, Risk Factors, Sex Factors, Stress Disorders, Post-Traumatic, Torture, Veterans, Warfare, Prevalence, Survivors
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