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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
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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“post-displacement stressors that are important for mental health include resettlement, language barriers and perceived stigma and discrimination”
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
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“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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Thompson, A. D., & Çiftçi, A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108348607.035 · Cited by 2
Psychosocial Features of Movements That Have Advanced Human Rights
Christie, D. J., Bretherton, D., & Lunn, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108348607.024 · Cited by 2
Callands, T. A., Gilliam, S. M., Sileo, K. M., Taylor, E. N., Hunter-Jones, J. J., & Hansen, N. B. (2020) · AIDS and Behavior · doi:10.1007/s10461-020-03088-6 · Cited by 2
Epilogue: The Three Solitudes of the Sociology of Mental Health
Avison, W. R. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316471289.034 · Cited by 2
Nguyen, A. J., Roe, J. J., Jeharsae, R., Samankasikorn, W., & Bullock, L. (2021) · Journal of Adolescent Research · doi:10.1177/07435584211043294 · Cited by 2
“As with other impacts of conflict, poor mental health is a result not only of direct exposure to traumatic events but also from exacerbation of daily stressors and breakdown of protective resources (Miller & Rasmussen, 2010; Slone & Mann, 2016).”
BackgroundResultSanhori, Z., Lien, L., Hauff, E., Ayazi, T., Mdala, I., & Eide, A. H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19095347 · Cited by 3
“The study has also revealed a more pronounced increase in psychological distress among individuals with disabilities, compared to individuals without disabilities, again consistent with previous studies [9,20,29].”
ResultSeeberg, J., Meinert, L., & Roepstorff, A. (2020) · UCL Press eBooks · doi:10.14324/111.9781787358232 · Cited by 5
Smith, A. J., Buadze, A., Dube, A. R., Schleifer, R., & Liebrenz, M. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.914369 · Cited by 2
Widaningtyas, A. M., & Sutanti, N. (2022) · ProGCouns Journal of Professionals in Guidance and Counseling · doi:10.21831/progcouns.v3i1.49182 · Cited by 2
“In general, psychosocial and psychoeducational approaches are the most frequently used coping strategies to help post-conflict victims (Im et al., 2018; Johnson & Chronister, 2010; Miller & Rasmussen, 2010).”
BackgroundResultLee, S., Bartels, S. A., & Glaesmer, H. (2023) · Frontiers research topics · doi:10.3389/978-2-83251-785-7 · Cited by 2
Exposure to Violence in Social Unrest, Resilience, and Mental Health of Older People in Hong Kong
Lai, D. W. L., Ou, X., Lee, V. W. P., Yan, E., Li, J. J., Liu, E. H., & Yu, W. (2023) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2023.09.008 · Cited by 2
Facing displacement and a global pandemic: evidence from a fragile state
Maio, M. D., Fasani, F., Sciabolazza, V. L., & Molini, V. (2023) · Journal of Demographic Economics · doi:10.1017/dem.2023.13 · Cited by 2
“This finding is in line with studies from different fragile countries showing that conflict-driven displacement impacts physical and mental health [Thomas and Thomas (2004), Miller and Rasmussen (2010), Daoud et al. (2012)].”
Puppetry to educate social work practitioners: Telling the refugee story
Segal, U. A., Davenport, F., Marshall, R., & Romano, D. “. (2024) · Journal of Social Work · doi:10.1177/14680173231225422 · Cited by 2
“In working with refugees, social workers have tended to address either mental health or engage in case management (Miller & Rasmussen, 2010), but more holistic approaches are essential, especially since mental health and socioeconomic stability are intertwined (Disney & McPherson, 2020).”
Larsen, K. L., & Stanley, E. A. (2024) · International Peacekeeping · doi:10.1080/13533312.2024.2321434 · Cited by 2
Metadata
- Authors
- Miller, K. E., & Rasmussen, A.
- Affiliations
- Harvard University (US)
- New York University (US)
- Corresponding author
- Miller, Kenneth E.
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 70
- Issue
- 1
- Pages
- 7-16
- ISSN
- 0277-9536 (ISSN-L)
- 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
- 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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