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

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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

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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“For trauma-focused advocates, the critical factor is direct exposure to the violence and destruction of wardthe types of potentially traumatic exposure typically assessed by war-events checklists (e.g., physical assault, the destruction of one’s home, the disappearance or death of loved ones in the Harvard Trauma Ques…”

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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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