War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks

Miller, Kenneth E.; Rasmussen, Andrew

doi:10.1016/j.socscimed.2009.09.029

Cited by 1,524Posttraumatic Stress Disorder ResearchHealth and Conflict StudiesMigration, Health and Trauma

War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks

Miller, Kenneth E., Rasmussen, Andrew·2010·Social Science & Medicine

DOI 10.1016/j.socscimed.2009.09.029

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Abstract

This paper seeks to bridge the divisive split between advocates of trauma-focused and psychosocial approaches to understanding and addressing mental health needs in conflict and post-conflict settings by emphasizing the role that daily stressors play in mediating direct war exposure and mental health outcomes. The authors argue that trauma-focused advocates tend to overemphasize the impact of direct war exposure on mental health, and fail to consider the contribution of stressful social and material conditions (daily stressors). Drawing on the findings of recent studies that have examined the relationship of both war exposure and daily stressors to mental health status, a model is proposed in which daily stressors partially mediate the relationship of war exposure to mental health. Based on that model, and on the growing body of research that supports it, an integrative, sequenced approach to intervention is proposed in which daily stressors are first addressed, and specialized interventions are then provided for individuals whose distress does not abate with the repair of the social ecology.

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From Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: Systematic review and meta-analysis (2019) · cites this paper as Miller and Rasmussen, 2010
These results are in line with recommendations to adopt transdiagnostic approaches for unaccompanied minors.
“These results are in line with recommendations to adopt transdiagnostic approaches for UM [83].”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [83]

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Mental health care utilisation and access among refugees and asylum seekers in Europe: a systematic review
Satinsky, E., Fuhr, D. C., Woodward, A., Sondorp, E., & Roberts, B. (2019) · Health Policy · doi:10.1016/j.healthpol.2019.02.007 · Cited by 539 · see citing works
The mental health of civilians displaced by armed conflict: an ecological model of refugee distress
Miller, K. E., & Rasmussen, A. (2017) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796016000172 · Cited by 653 · see citing works
“Second, daily stressors ‘ represent noxious stimuli that are largely beyond people ’ s control ’ (Miller & Rasmussen, 2010 a , b : 13).”
InfluentialSelf-citation
Gender and Mental Health
Rosenfield, S., & Mouzon, D. M. (2012) · Handbooks of sociology and social research · doi:10.1007/978-94-007-4276-5_14 · Cited by 553 · see citing works
Mental health and psychosocial wellbeing of Syrians affected by armed conflict
Hassan, G., Ventevogel, P., Jefee-Bahloul, H., Barkil-Oteo, A., & Kirmayer, L. J. (2016) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796016000044 · Cited by 514 · see citing works
“…events in Syria, without taking current life circum-stances into consideration, maylead to conflating symptoms of posttraumatic stress disorder (PTSD) or clinical depression with distress generated by stressors related to the post-displacement context (Miller & Rasmussen, 2010, 2014; Patel, 2014).”
School and Community-Based Interventions for Refugee and Asylum Seeking Children: A Systematic Review
Tyrer, R. A., & Fazel, M. S. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089359 · Cited by 461 · see citing works
Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan
Eggerman, M., & Panter‐Brick, C. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.03.023 · Cited by 419 · see citing works
The Impact of Local Immigration Enforcement Policies on the Health of Immigrant Hispanics/Latinos in the United States
Rhodes, S. D., Mann‐Jackson, L., Simán, F. M., Song, E., Alonzo, J., Downs, M., Lawlor, E. R., Martínez, O., Sun, C. J., O’Brien, M. C., et al. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.302218 · Cited by 375 · see citing works
Perceptions of mental health and perceived barriers to mental health help-seeking amongst refugees: A systematic review
Byrow, Y., Pajak, R., Specker, P., & Nickerson, A. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101812 · Cited by 345 · see citing works
Longitudinal follow-up of the mental health of unaccompanied refugee minors
Vervliet, M., Lammertyn, J., Broekaert, E., & Derluyn, I. (2013) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-013-0463-1 · Cited by 323 · see citing works
A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants
Siriwardhana, C., Ali, S. S., Roberts, B., & Stewart, R. (2014) · Conflict and Health · doi:10.1186/1752-1505-8-13 · Cited by 299 · see citing works
Prevalence of mental ill health, traumas and postmigration stress among refugees from Syria resettled in Sweden after 2011: a population-based survey
Tinghög, P., Malm, A., Arwidson, C., Sigvardsdotter, E., Lundin, A., & Saboonchi, F. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-018899 · Cited by 377 · see citing works
Labeling and Stigma
Link, B. G., & Phelan, J. C. (2012) · Handbooks of sociology and social research · doi:10.1007/978-94-007-4276-5_25 · Cited by 304 · see citing works
Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries
Sijbrandij, M., Acartürk, C., Bird, M., Bryant, R. A., Burchert, S., Carswell, K., de Jong, J. T. V. M., Dinesen, C., Dawson, K. S., Chammay, R. E., et al. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1388102 · Cited by 298 · see citing works
“They include cultural integration issues, the loss of family and community support, discrimination and adverse political climate, loneliness and boredom, prohibition to work, and disruption of education for children (Kirmayer et al., 2011; Miller & Rasmussen, 2010).”
BackgroundSelf-citation
Factors associated with mental disorders in long-settled war refugees: refugees from the former Yugoslavia in Germany, Italy and the UK
Bogic, M., Ajdukovic, D., Bremner, S., Franciskovic, T., Galeazzi, G. M., Kucukalic, A., Lecic-Tosevski, D., Morina, N., Popovski, M., Schützwohl, M., et al. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.bp.110.084764 · Cited by 283 · see citing works
Research Review: Psychosocial adjustment and mental health in former child soldiers – a systematic review of the literature and recommendations for future research
Betancourt, T. S., Borisova, I., Williams, T. P., Meyers-Ohki, S. E., Rubin-Smith, J. E., Annan, J. R., & Kohrt, B. A. (2012) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2012.02620.x · Cited by 280 · see citing works
Daily stressors, trauma exposure, and mental health among stateless Rohingya refugees in Bangladesh
Riley, A., Varner, A., Ventevogel, P., Taimur Hasan, M. M., & Welton-Mitchell, C. (2017) · Transcultural Psychiatry · doi:10.1177/1363461517705571 · Cited by 276 · see citing works
“…Eide, Lien, & Hauff, 2015; Miller, Omidian, Rasmussen, Yaqubi, & Daudzai, 2008), and specifically indicating that the introduction of daily environmental stressors weakens the direct association between trauma exposure and mental health symptoms (Jordans et al., 2012; Miller & Rasmussen, 2010).”
BackgroundInfluential
Trauma, Post-Migration Stress, and Mental Health: A Comparative Analysis of Refugees and Immigrants in the United States
Sangalang, C. C., Becerra, D., Mitchell, F. M., Lechuga-Peña, S., Lopez, K., & Kim, I. (2018) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-018-0826-2 · Cited by 273 · see citing works
The impact of Immigration and Customs Enforcement on immigrant health: Perceptions of immigrants in Everett, Massachusetts, USA
Hacker, K. A., Chu, J., Leung, C., Marra, R., Pirie, A., Brahimi, M., English, M., Beckmann, J., Acevedo‐García, D., & Marlin, R. P. (2011) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.06.007 · Cited by 273 · see citing works
Housing Quality, Housing Instability, and Maternal Mental Health
Suglia, S. F., Duarte, C. S., & Sandel, M. T. (2011) · Journal of Urban Health · doi:10.1007/s11524-011-9587-0 · Cited by 265 · see citing works
Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: Systematic review and meta-analysis
Turrini, G., Purgato, M., Acarturk, C., Anttila, M., Au, T., Ballette, F., Bird, M., Carswell, K., Churchill, R., Cuijpers, P., et al. (2019) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796019000027 · Cited by 258 · see citing works
“In addition, postdisplacement stressors that are important for mental health include resettlement, language barriers and perceived stigma and discrimination (Kirmayer et al., 2011; Miller and Rasmussen, 2010).”
Background
Preventive mental health interventions for refugee children and adolescents in high-income settings
Fazel, M. S., & Betancourt, T. S. (2017) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(17)30147-5 · Cited by 257 · see citing works
A systematic review of socio-ecological factors contributing to risk and protection of the mental health of refugee children and adolescents
Scharpf, F., Kaltenbach, E., Nickerson, A., & Hecker, T. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101930 · Cited by 246 · see citing works
Intergenerational Trauma in Refugee Families: A Systematic Review
Sangalang, C. C., & Vang, C. (2017) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-016-0499-7 · Cited by 344 · see citing works
Challenging future, challenging past: the relationship of social integration and psychological impairment in traumatized refugees
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
The limits of resilience: Distress following chronic political violence among Palestinians
Hobfoll, S. E., Mancini, A. D., Hall, B. J., Canetti, D., & Bonanno, G. A. (2011) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.02.022 · Cited by 239 · see citing works
The effect of post-traumatic stress disorder on refugees' parenting and their children's mental health: a cohort study
Bryant, R. A., Edwards, B., Creamer, M., O'Donnell, M., Forbes, D., Felmingham, K. L., Silove, D., Steel, Z., Nickerson, A., McFarlane, A. C., et al. (2018) · The Lancet Public Health · doi:10.1016/s2468-2667(18)30051-3 · Cited by 200 · see citing works
“29 We also note that there might be bidirectional effects of caregiver and child mental health, and that parenting style might be shaped by the psychological state of the child; this possibility is supported by longitudinal evidence of the bidirectional influences of maternal and child mental…”
Interventions for Children Affected by Armed Conflict: a Systematic Review of Mental Health and Psychosocial Support in Low- and Middle-Income Countries
Jordans, M. J. D., Pigott, H., & Tol, W. A. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-015-0648-z · Cited by 216 · see citing works
Caregiver—child mental health: a prospective study in conflict and refugee settings
Panter‐Brick, C., Grimon, M., & Eggerman, M. (2013) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12167 · Cited by 220 · see citing works
Annual Research Review: The experience of youth with political conflict – challenging notions of resilience and encouraging research refinement
Barber, B. K. (2013) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12056 · Cited by 208 · see citing works
Understanding Culture, Resilience, and Mental Health: The Production of Hope
Panter‐Brick, C., & Eggerman, M. (2011) · Springer eBooks · doi:10.1007/978-1-4614-0586-3_29 · Cited by 204 · see citing works
Parenting in Times of War: A Meta-Analysis and Qualitative Synthesis of War Exposure, Parenting, and Child Adjustment
Eltanamly, H., Leijten, P., Jak, S., & Overbeek, G. (2021) · Trauma, Violence, & Abuse · doi:10.1177/1524838019833001 · Cited by 236 · see citing works
“In the context of war, families can be impacted by experiencing war trauma and by having to live the daily struggle of living in the aftermath of war-related experiences (Miller & Rasmussen, 2010).”
Background
Everyday life experiences and mental health among conflict-affected forced migrants: A meta-analysis
Hou, W. K., Liu, H., Liang, L., Ho, J., Kim, H., Seong, E., Bonanno, G. A., Hobfoll, S. E., & Hall, B. J. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.165 · Cited by 206 · see citing works
Trauma-focused therapy for refugees: Meta-analytic findings.
Lambert, J. E., & Alhassoon, O. M. (2015) · Journal of Counseling Psychology · doi:10.1037/cou0000048 · Cited by 199 · see citing works
Mental Health and Childhood Adversities: A Longitudinal Study in Kabul, Afghanistan
Panter‐Brick, C., Goodman, A., Tol, W. A., & Eggerman, M. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.12.001 · Cited by 203 · see citing works
Resource caravans and resource caravan passageways
Hobfoll, S. E. (2014) · Intervention · doi:10.1097/wtf.0000000000000067 · Cited by 191 · see citing works
Understanding the mental health consequences of family separation for refugees: Implications for policy and practice.
Miller, A., Hess, J. M., Bybee, D. I., & Goodkind, J. R. (2017) · American Journal of Orthopsychiatry · doi:10.1037/ort0000272 · Cited by 187 · see citing works
“While there has been a great deal of research on the role of premigration experiences in refugee mental health, only recently have researchers come to recognize how profoundly postmigration circumstance impacts refugee well-being (Miller & Rasmussen, 2010; Tempany, 2009).”
Background
The role of digital health in making progress toward Sustainable Development Goal (SDG) 3 in conflict-affected populations
Asi, Y. M., & Williams, C. (2018) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2017.11.003 · Cited by 187 · see citing works
‘I'm Telling You … The Language Barrier is the Most, the Biggest Challenge’: Barriers to Education among Karen Refugee Women in Australia
Watkins, P. G., Razee, H., & Richters, J. (2012) · Australian Journal of Education · doi:10.1177/000494411205600203 · Cited by 186 · see citing works
Mental health needs and services for migrants: an overview for primary care providers
Rousseau, C., & Frounfelker, R. L. (2018) · Journal of Travel Medicine · doi:10.1093/jtm/tay150 · Cited by 178 · see citing works
Mental health care utilisation among internally displaced persons in Ukraine: results from a nation-wide survey
Roberts, B., Makhashvili, N., Javakhishvili, J., Karachevskyy, A., Kharchenko, N., Shpiker, M., & Richardson, E. (2019) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796017000385 · Cited by 177 · see citing works
Syrian refugees in Greece: experience with violence, mental health status, and access to information during the journey and while in Greece
Farhat, J. B., Blanchet, K., Bjertrup, P. J., Veizis, A., Perrin, C., Coulborn, R. M., Mayaud, P., & Cohuet, S. (2018) · BMC Medicine · doi:10.1186/s12916-018-1028-4 · Cited by 180 · see citing works
Outcomes and moderators of a preventive school‐based mental health intervention for children affected by war in Sri Lanka: a cluster randomized trial
TOL, W. A., KOMPROE, I. H., JORDANS, M. J. D., VALLIPURAM, A., SIPSMA, H., SIVAYOKAN, S., MACY, R. D., & DE JONG, J. T. (2012) · World Psychiatry · doi:10.1016/j.wpsyc.2012.05.008 · Cited by 176 · see citing works
A behavioral intervention for war-affected youth in Sierra Leone: a randomized controlled trial
Betancourt, T. S., McBain, R., Newnham, E. A., Akinsulure-Smith, A. M., Brennan, R. T., Weisz, J. R., & Hansen, N. B. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.09.011 · Cited by 165 · see citing works
Trajectories of Internalizing Problems in War-Affected Sierra Leonean Youth: Examining Conflict and Postconflict Factors
Betancourt, T. S., McBain, R. K., Newnham, E. A., & Brennan, R. T. (2012) · Child Development · doi:10.1111/j.1467-8624.2012.01861.x · Cited by 163 · see citing works
Pathways linking war and displacement to parenting and child adjustment: A qualitative study with Syrian refugees in Lebanon
Sim, A., Fazel, M., Bowes, L., & Gardner, F. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.01.009 · Cited by 161 · see citing works
“This emphasis on daily stressors is particularly relevant to refugee settings characterized by multiple environmental stressors (Miller and Rasmussen, 2010).”
BackgroundResult
Prevalence of War-Related Mental Health Conditions and Association With Displacement Status in Postwar Jaffna District, Sri Lanka
Husain, F. S., Anderson, M., Cardozo, B. L., Becknell, K., Blanton, C., Araki, D., & Vithana, E. K. (2011) · JAMA · doi:10.1001/jama.2011.1052 · Cited by 154 · see citing works
What are the keys to a longer, happier life? Answers from five decades of health psychology research
Johnson, B. T., & Acabchuk, R. L. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.11.001 · Cited by 150 · see citing works
Fortifying the Foundations: A Comprehensive Approach to Enhancing Mental Health Support in Educational Policies Amidst Crises
Wiedermann, C. J., Barbieri, V., Plagg, B., Marino, P., Piccoliori, G., & Engl, A. (2023) · Healthcare · doi:10.3390/healthcare11101423 · Cited by 177 · see citing works
“Psychological support and trauma counseling can be provided for those directly affected or displaced by war [18,19], and peace education and conflict resolution programs can be provided [20,21].”
Background
Don't let the suffering make you fade away: An ethnographic study of resilience among survivors of genocide-rape in southern Rwanda
Zraly, M., & Nyirazinyoye, L. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.01.017 · Cited by 143 · see citing works
Unpacking Trauma Exposure Risk Factors and Differential Pathways of Influence: Predicting Postwar Mental Distress in Bosnian Adolescents
Layne, C. M., Olsen, J. A., Baker, A. S., Legerski, J., Isakson, B. L., Pašalić, A., Duraković‐Belko, E., Đapo, N., Ćampara, N., Arslanagić, B., et al. (2010) · Child Development · doi:10.1111/j.1467-8624.2010.01454.x · Cited by 142 · see citing works
Structural Violence, Poverty, and Social Suffering
Rylko‐Bauer, B., & Farmer, P. E. (2017) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199914050.013.4 · Cited by 137 · see citing works
A systematic review of factors influencing the psychological health of conflict-affected populations in low- and middle-income countries
Roberts, B., & Browne, J. P. (2010) · Global Public Health · doi:10.1080/17441692.2010.511625 · Cited by 140 · see citing works
Food Insufficiency, Depression, and the Modifying Role of Social Support: Evidence from a Population-Based, Prospective Cohort of Pregnant Women in Peri-Urban South Africa
Tsai, A., Tomlinson, M., Comulada, W., & Rotheram-Borus, M. (2016) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2015.12.042 · Cited by 110 · see citing works
“The lived experiences of these chronic, conjoint health risks as “daily stressors” (Miller & Rasmussen, 2010) may uniquely erode coping resources, ultimately converging to result in “syndemic suffering” (Mendenhall & Norris, 2015).”
Background
Protective factors and predictors of vulnerability to chronic stress: A comparative study of 4 communities after 7 years of continuous rocket fire
Gelkopf, M., Berger, R., Bleich, A., & Silver, R. C. (2011) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.10.022 · Cited by 134 · see citing works
Risk factors for PTSD, anxiety, and depression among adolescents in gaza
Kolltveit, S., Lange‐Nielsen, I. I., Thabet, A. A. M., Dyregrov, A., Pallesen, S., Johnsen, T. B., & Laberg, J. C. (2012) · Journal of Traumatic Stress · doi:10.1002/jts.21680 · Cited by 134 · see citing works
Stressful life experiences and mental health problems among unaccompanied asylum-seeking children
Jensen, T. K., Fjermestad, K. W., Granly, L., & Wilhelmsen, N. H. (2013) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104513499356 · Cited by 132 · see citing works
Treatment gap and mental health service use among Syrian refugees in Sultanbeyli, Istanbul: a cross-sectional survey
Fuhr, D. C., Acarturk, C., McGrath, M., Ilkkursun, Z., Sondorp, E., Sijbrandij, M., Ventevogel, P., Cuijpers, P., McKee, M., & Roberts, B. (2020) · Epidemiology and psychiatric sciences · doi:10.1017/s2045796019000660 · Cited by 120 · see citing works
“…are at an increased risk of mental disorders due to frequent exposure to potentially traumatic events, multiple losses, breakdown of supportive social networks and accumulation of daily life stressors related to refugee life (Miller and Rasmussen, 2010; Steel et al., 2009; Silove et al., 2017).”
Background
The effect of food insecurity on mental health: Panel evidence from rural Zambia
Cole, S. M., & Tembo, G. (2011) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.07.012 · Cited by 125 · see citing works
Mental Health of Refugees and Migrants during the COVID-19 Pandemic: The Role of Experienced Discrimination and Daily Stressors
Spiritus-Beerden, E., Verelst, A., Devlieger, I., Primdahl, N. L., Guedes, F. B., Chiarenza, A., Maesschalck, S. D., Durbeej, N., Garrido, R., de Matos, M. G., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18126354 · Cited by 124 · see citing works
“The social–ecological model of Miller and Rasmussen (2016), a frequently used theoretical model in the field of refugee studies, points to the strong mental health impact of so-called daily stressors that migrants and refugees experience during the migration trajectory and after settlement [17,18].”
Background
Changes in Post-migration Living Difficulties Predict Treatment Outcome in Traumatized Refugees
Schick, M., Morina, N., Mistridis, P., Schnyder, U., Bryant, R. A., & Nickerson, A. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00476 · Cited by 123 · see citing works
“The scientific discourse on how these aspects are causally related, however, is prototypically divided between two opposing models (8, 39, 40): The war-exposure model on the one hand focuses on traumatic experiences and consecutive PTSD.”
Background
Political violence and mental health in Nepal: prospective study
Kohrt, B. A., Hruschka, D. J., Worthman, C. M., Kunz, R. D., Baldwin, J. L., Upadhaya, N., Acharya, N. R., Koirala, S., Thapa, S. B., Tol, W. A., et al. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.111.096222 · Cited by 123 · see citing works
Refugee children and their families: supporting psychological well-being and positive adaptation following migration
Measham, T., Guzder, J., Rousseau, C., Pacione, L., Blais-McPherson, M., & Nadeau, L. (2014) · Current problems in pediatric and adolescent health care · doi:10.1016/j.cppeds.2014.03.005 · Cited by 121 · see citing works
PTSD in asylum-seeking male adolescents from Afghanistan
Bronstein, I., Montgomery, P., & Dobrowolski, S. (2012) · Journal of Traumatic Stress · doi:10.1002/jts.21740 · Cited by 121 · see citing works
Psychometric properties and longitudinal validation of the self-reporting questionnaire (SRQ-20) in a Rwandan community setting: a validation study
Scholte, W. F., Verduin, F., van Lammeren, A., Rutayisire, T., & Kamperman, A. M. (2011) · BMC Medical Research Methodology · doi:10.1186/1471-2288-11-116 · Cited by 122 · see citing works
Prevalence of anxiety, depression and post-traumatic stress disorder in the Kashmir Valley
Housen, T., Lenglet, A., Ariti, C. A., Shah, S., Shah, H., Ara, S., Viney, K. A., Janes, S., & Pintaldi, G. (2017) · BMJ Global Health · doi:10.1136/bmjgh-2017-000419 · Cited by 122 · see citing works
Addressing trauma in collaborative mental health care for refugee children
Rousseau, C., Measham, T., & Nadeau, L. (2012) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104512444117 · Cited by 114 · see citing works
Reducing refugee mental health disparities: A community-based intervention to address postmigration stressors with African adults.
Goodkind, J. R., Hess, J. M., Isakson, B. L., LaNoue, M. D., Githinji, A., Roche, N., Vadnais, K., & Parker, D. P. (2013) · Psychological Services · doi:10.1037/a0035081 · Cited by 117 · see citing works
Evidence-based psychological interventions for adult survivors of torture and trauma: A 30-year review
McFarlane, C. A., & Kaplan, I. (2012) · Transcultural Psychiatry · doi:10.1177/1363461512447608 · Cited by 113 · see citing works
Post-traumatic stress disorder and depression among Syrian refugees residing in the Kurdistan region of Iraq
Mahmood, H. N., Ibrahim, H., Goessmann, K., Ismail, A. A., & Neuner, F. (2019) · Conflict and Health · doi:10.1186/s13031-019-0238-5 · Cited by 102 · see citing works
Refugee Children: Mental Health and Effective Interventions
Pacione, L. R., Measham, T., & Rousseau, C. (2013) · Current Psychiatry Reports · doi:10.1007/s11920-012-0341-4 · Cited by 113 · see citing works
Hair cortisol concentrations in war-affected adolescents: A prospective intervention trial
Dajani, R., Hadfield, K., van Uum, S., Greff, M., & Panter-Brick, C. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.12.012 · Cited by 108 · see citing works
Emotional and behavioural problems amongst Afghan unaccompanied asylum-seeking children: results from a large-scale cross-sectional study
Bronstein, I., Montgomery, P., & Ott, E. (2013) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-012-0344-z · Cited by 107 · see citing works
Trauma and Mental Health in Resettled Refugees: Mediating Effect of Host Language Acquisition on Posttraumatic Stress Disorder, Depressive and Anxiety Symptoms
Kartal, D., Alkemade, N., & Kiropoulos, L. A. (2018) · Transcultural Psychiatry · doi:10.1177/1363461518789538 · Cited by 107 · see citing works
Parents make the difference: a randomized-controlled trial of a parenting intervention in Liberia
Puffer, E. S., Green, E. P., Chase, R. M., Sim, A. L., Zayzay, J. O., Friis-Healy, E. A., Garcia-Rolland, E., & Boone, L. (2015) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2015.12 · Cited by 106 · see citing works
Effects of maternal traumatic distress on family functioning and child mental health: An examination of Southeast Asian refugee families in the U.S.
Sangalang, C. C., Jager, J., & Harachi, T. W. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.04.032 · Cited by 106 · see citing works
“Although some scholars suggest the negative effects of conflict-based trauma diminish over time (Steel et al., 2002), others argue that the nature of trauma is complex and that post-migration adjustment stressors can compound it (Chung and Kagawa-Singer, 1993; Miller and Rasmussen, 2010).”
Background
A Teacher-Delivered Intervention for Adolescents Exposed to Ongoing and Intense Traumatic War-Related Stress: A Quasi-Randomized Controlled Study
Berger, R., Gelkopf, M., & Heineberg, Y. (2012) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2012.02.011 · Cited by 105 · see citing works
Climate change, conflict and health
Bowles, D. C., Butler, C. D., & Morisetti, N. (2015) · Journal of the Royal Society of Medicine · doi:10.1177/0141076815603234 · Cited by 105 · see citing works
The psychological impact of torture
Williams, A. C. D. C., & Merwe, J. V. D. (2013) · British Journal of Pain · doi:10.1177/2049463713483596 · Cited by 102 · see citing works
Beyond Trauma: Post-resettlement Factors and Mental Health Outcomes Among Latino and Asian Refugees in the United States
Kim, I. (2015) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-015-0251-8 · Cited by 100 · see citing works
“Attending to the overall health and mental health concerns of refugees with war-related traumatic experiences is a human rights issue [9], which should receive a great deal of attention [10].”
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“However, the emphasis on pre-migration trauma may overshadow other psychological needs of asylum seekers and the roles of displacement-related stressors [7, 8], which have been shown to be important determinants of mental health among Syrian refugees in Turkey [9].”
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Determinants of Children’s Mental Health in War-Torn Settings: Translating Research Into Action
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Trauma memories, mental health, and resilience: a prospective study of Afghan youth
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War experiences, daily stressors and mental health five years on
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Stigma and Acceptance of Sierra Leone’s Child Soldiers: A Prospective Longitudinal Study of Adult Mental Health and Social Functioning
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“The impact of interventions is expected to be enhanced when they target the most immediate and severe stressors faced by this population (Miller and Rasmussen 2010).”
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“The advantage of such models (e.g., Miller & Rasmussen, 2010; Silove, 1999) is that they target trauma and acculturative processes on an individual but also on a collective community level, therefore not only supporting the psychological well-being of individuals, but also assisting ethnic groups’…”
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Mental health and armed conflict: the importance of distinguishing between war exposure and other sources of adversity: a response to Neuner
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War experiences, daily stressors and mental health five years on
Miller, K. E., & Rasmussen, A. (2014) · Intervention · doi:10.1097/wtf.0000000000000066 · Cited by 97 · see citing works
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War exposure, daily stressors, and mental health 15 years on: implications of an ecological framework for addressing the mental health of conflict-affected populations
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Unpacking Constructs: A Network Approach for Studying War Exposure, Daily Stressors and Post-Traumatic Stress Disorder
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Effect of daily stressors and collective efficacy on post-traumatic stress symptoms among internally displaced persons in post-war northern Sri Lanka
Somasundaram, D. J., Jayasuriya, R., Perera, R., Thamotharampillai, U., Wickremasinghe, R., & Tay, A. K. (2023) · BJPsych Open · doi:10.1192/bjo.2023.563 · Cited by 13 · see citing works

Authors: Miller, K. E., & Rasmussen, A.
Affiliations: Harvard University (US)
New York University (US)
Corresponding author: Miller, Kenneth E.
ORCID: Miller, Kenneth E.
Rasmussen, Andrew
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 2010-01
Volume: 70
Issue: 1
Pages: 7-16
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/j.socscimed.2009.09.029
OpenAlex: W1984065858
Cited by: 1,524
References: 98
Citations by year: 2026: 140 · 2025: 96 · 2024: 117 · 2023: 102 · 2022: 83 · 2021: 110 · 2020: 195 · 2019: 83 · 2018: 101 · 2017: 117 · 2016: 71 · 2015: 67 · 2014: 82 · 2013: 58 · 2012: 41
FWCI: 36.01
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Fordham Research Commons (Fordham University) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords: war exposure, daily hassles, mental health, conflict settings, post-conflict societies, psychosocial approach, mediation, social ecology, mental health interventions
MeSH terms: Adaptation, Psychological, Health Status, Humans, Life Change Events, Mental Health, Models, Psychological, Social Environment, Socioeconomic Factors, Stress Disorders, Post-Traumatic, Stress, Psychological, Violence, Warfare

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War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks

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