The DOI matches its Crossref record; 98 of the 98 references it cites were found in a registry or an index.
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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
In the citing paper
“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]
Citations
Cites
The social readjustment rating scale
Holmes, T. H., & Rahe, R. H. (1967) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(67)90010-4 · Cited by 11,502
Bonanno, G. A. (2004) · American Psychologist · doi:10.1037/0003-066x.59.1.20 · Cited by 6,851
60,000 Disaster Victims Speak: Part I. An Empirical Review of the Empirical Literature, 1981–2001
Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E., & Kaniasty, K. (2002) · Psychiatry: Interpersonal and Biological Processes · doi:10.1521/psyc.65.3.207.20173 · Cited by 3,128
Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events
Kanner, A. D., Coyne, J. C., Schaefer, C. A., & Lazarus, R. S. (1981) · Journal of Behavioral Medicine · doi:10.1007/bf00844845 · Cited by 3,128
An Anthropology of Structural Violence
Farmer, P. E. (2004) · Current Anthropology · doi:10.1086/382250 · Cited by 2,344
The neurobiology of stress and development.
Gunnar, M., & Quevedo, K. (2007) · Annual Review of Psychology · doi:10.1146/annurev.psych.58.110405.085605 · Cited by 2,011 · cited 1×
“…axis) in a state of continuous activation, which in turn has been linked (via the effects of prolonged exposure to epinephrine, norepinephrine, and glucocorticoids) to increased risk of both physical and emotional disorder (Christopher, 2004; Gunnar & Quevedo, 2007; Sapolsky, 2004).”
BackgroundPorter, M., & Haslam, N. (2005) · JAMA · doi:10.1001/jama.294.5.602 · Cited by 1,793
Mollica, R. F., Caspi-Yavin, Y., Bollini, P., Truong, T., Tor, S., & Lavelle, J. (1992) · PubMed · Cited by 1,551
Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures
Shapiro, F. (1995) · Medical Entomology and Zoology · Cited by 1,529
MOLLICA, R. F., CASPI-YAVIN, Y., BOLLINI, P., TRUONG, T., TOR, S., & LAVELLE, J. (1992) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199202000-00008 · Cited by 1,489 · cited 2×
“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…”
Handbook of Early Childhood Intervention
Zigler, E. (2000) · Cambridge University Press eBooks · doi:10.1017/cbo9780511529320 · Cited by 1,390
A critique of seven assumptions behind psychological trauma programmes in war-affected areas
Summerfield, D. (1999) · Social Science & Medicine · doi:10.1016/s0277-9536(98)00450-x · Cited by 987
Sapolsky, R. M. (1994) · Medical Entomology and Zoology · Cited by 971
Lifetime Events and Posttraumatic Stress Disorder in 4 Postconflict Settings
de Jong, J. T. V. M. (2001) · JAMA · doi:10.1001/jama.286.5.555 · Cited by 807
Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures
Lohr, J. (1996) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)90013-3 · Cited by 759
IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings
Carll, E. K. (2008) · PsycEXTRA Dataset · doi:10.1037/e518422011-002 · Cited by 681
Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.4.579 · Cited by 644
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
Ellis, B. H., MacDonald, H. Z., Lincoln, A. K., & Cabral, H. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.2.184 · Cited by 560
The Psychosocial Effects of Torture, Mass Human Rights Violations, and Refugee Trauma
Silove, D. M. (1999) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199904000-00002 · Cited by 551
Wessells, M. (2010) · 57th Annual Meeting (October 26-31, 2010) · Cited by 544
Psychological sequelae of torture and organised violence suffered by refugees from Iraq
Gorst‐Unsworth, C., & GOLDENBERG, E. (1998) · The British Journal of Psychiatry · doi:10.1192/bjp.172.1.90 · Cited by 475
The War Experiences and Psychosocial Development of Children in Lebanon
Macksoud, M. S., & Aber, J. L. (1996) · Child Development · doi:10.2307/1131687 · Cited by 468
Neuner, F., Schauer, M., Karunakara, U. K., Klaschik, C., Robert, C., & Elbert, T. R. (2004) · BMC Psychiatry · doi:10.1186/1471-244x-4-34 · Cited by 466
Mollica, R. F. (1999) · JAMA · doi:10.1001/jama.282.5.433 · Cited by 460
Shapiro, F. (2001) · Cited by 458
Mental Health, Social Functioning, and Disability in Postwar Afghanistan
Cardozo, B. L. (2004) · JAMA · doi:10.1001/jama.292.5.575 · Cited by 445
The Psychiatric Effects of Massive Trauma on Cambodian Children: I. The Children
Kinzie, J. D., Sack, W. H., Angell, R. H., Manson, S. M., & Ben, R. (1986) · Journal of the American Academy of Child Psychiatry · doi:10.1016/s0002-7138(09)60259-4 · Cited by 444
Steel, Z., Silove, D. M., Bird, K. D., McGorry, P. D., & Mohan, P. (1999) · Journal of Traumatic Stress · doi:10.1023/a:1024710902534 · Cited by 374
Trauma, War, and Violence: Public Mental Health in Socio-Cultural Context
de Jong, J. T. V. M. (2002) · Kluwer Academic Publishers eBooks · doi:10.1007/b109606 · Cited by 346
The psychosocial aspects of children exposed to war: practice and policy initiatives
Barenbaum, J., Ruchkin, V., & Schwab‐Stone, M. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1046/j.0021-9630.2003.00304.x · Cited by 341 · cited 3×
“the guidelines we propose are consistent with those suggested by Barenbaum et al. (2004), Betancourt and Williams (2008), and”
BackgroundMethodMollica, R. F., McInnes, D. K., PHAM, T., Fawzi, M. C. S., MURPHY, E., & Lin, L.-E. (1998) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199809000-00005 · Cited by 279
Stein, M., & Kennedy, C. M. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00301-3 · Cited by 267
Violence, suffering, and mental health in Afghanistan: a school-based survey
Panter‐Brick, C., Eggerman, M., Gonzalez, V., & Safdar, S. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61080-1 · Cited by 263
Somali and Oromo Refugees: Correlates of Torture and Trauma History
Jaranson, J. M., Butcher, J. N., Halcón, L. L., Johnson, D. R., Robertson, C. L., Savik, K., Spring, M., & Westermeyer, J. J. (2004) · American Journal of Public Health · doi:10.2105/ajph.94.4.591 · Cited by 263
Gearon, J. S. (2001) · Clinical Psychology Review · doi:10.1016/s0272-7358(99)00061-6 · Cited by 260
Post traumatic stress disorder reactions in children of war: a longitudinal study
Thabet, A. A. M., & Vostanis, P. (2000) · Child Abuse & Neglect · doi:10.1016/s0145-2134(99)00127-1 · Cited by 238
Rowlison, R. T., & Felner, R. D. (1988) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.55.3.432 · Cited by 236
Miller, K. E., Omidian, P. A., Quraishy, A. S., Quraishy, N., Nasiry, M. N., Nasiry, S., Karyar, N. M., & Yaqubi, A. A. (2006) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.76.4.423 · Cited by 233
Self-citationA Three-Year Follow-up of Cambodian Young People Traumatized as Children
Kinzie, J. D., Sack, W. H., Angell, R. H., Clarke, G. N., & Ben, R. (1989) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198907000-00006 · Cited by 231
An alternative approach to cross-cultural function assessment
Bolton, P., & Tang, A. M. (2002) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-002-0580-5 · Cited by 224
Daily Stressors, War Experiences, and Mental Health in Afghanistan
Miller, K. E., Omidian, P. A., Rasmussen, A., Yaqubi, A. A., & Daudzai, H. (2008) · Transcultural Psychiatry · doi:10.1177/1363461508100785 · Cited by 217
Self-citationWar exposure among children from Bosnia‐Hercegovina: Psychological adjustment in a community sample
Smith, P. A., Perrin, S. G., Yule, W., Hacam, B., & Stuvland, R. (2002) · Journal of Traumatic Stress · doi:10.1023/a:1014812209051 · Cited by 216
Too Scared To Cry: Psychic Trauma In Childhood
Terr, L. C. (1990) · Cited by 206
Miller, K. E., Weine, S. M., Ramic, A., Brkić, N., Bjedic, Z. D., Smajkic, A., Boskailo, E., & Worthington, G. J. (2002) · Journal of Traumatic Stress · doi:10.1023/a:1020181124118 · Cited by 203
Self-citationBuilding an evidence base on mental health interventions for children affected by armed conflict
Betancourt, T. S., & Williams, T. P. (2008) · Intervention · doi:10.1097/wtf.0b013e3282f761ff · Cited by 200
Miller, K. E., Kulkarni, M., & Kushner, H. (2006) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.76.4.409 · Cited by 188
Self-citationFernando, G. A., Miller, K. E., & Berger, D. E. (2010) · Child Development · doi:10.1111/j.1467-8624.2010.01462.x · Cited by 176
Self-citationThe psychiatric effects of massive trauma on Cambodian children
Kinzie, J. D. (1986) · Journal of the American Academy of Child & Adolescent Psychiatry · Cited by 172
Beyond Individual War Trauma: Domestic Violence Against Children in Afghanistan and Sri Lanka
Catani, C., Schauer, E., & Neuner, F. (2008) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.2008.00062.x · Cited by 166
Rates and impact of trauma and current stressors among Darfuri refugees in Eastern Chad.
Rasmussen, A., Nguyen, L., Wilkinson, J., Vundla, S., Raghavan, S. S., Miller, K. E., & Keller, A. S. (2010) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.2010.01026.x · Cited by 164
Self-citationChristopher, M. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2003.12.003 · Cited by 164
Toxoplasma seropositivity and depression: a case report
Kar, N., & Misra, B. (2004) · BMC Psychiatry · doi:10.1186/1471-244x-4-1 · Cited by 161
Rowlison, R. T., & Felner, R. D. (1988) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.55.3.432 · Cited by 155
Long-term effects of organized violence on young Middle Eastern refugees' mental health
Montgomery, E. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.07.020 · Cited by 152
Breslau, J. (2004) · Culture, Medicine and Psychiatry · doi:10.1023/b:medi.0000034421.07612.c8 · Cited by 151
The Human Ecology of Early Risk
Garbarino, J., & Ganzel, B. L. (2000) · Cambridge University Press eBooks · doi:10.1017/cbo9780511529320.006 · Cited by 150
Political Violence and War as Causes of Psychosocial Trauma in El Salvador
Martín-Baró, I. (1989) · International Journal of Mental Health · doi:10.1080/00207411.1989.11449115 · Cited by 138
Guatemalan Indian children and the sociocultural effects of government-sponsored terrorisms
Melville, M. B., & Lykes, M. B. (1992) · Social Science & Medicine · doi:10.1016/0277-9536(92)90209-9 · Cited by 136
The mental health of refugees: Ecological approaches to healing and adaptation.
Miller, K. E., & Rasco, L. M. (2004) · Cited by 130
Self-citationBroken Spirits: The Treatment of Traumatized Asylum Seekers, Refugees and War and Torture Victims
Wilson, J. P., & Drožđek, B. (2004) · Cited by 129
Broken Spirits: The Treatment of Traumatized Asylum Seekers, Refugees, War and Torture Victims
McGorry, P. D. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2005.01709_1.x · Cited by 129
Traumatic Experiences and the Mental Health of Senegalese Refugees
Tang, S. S. S., & Fox, S. H. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200108000-00003 · Cited by 128
de Jong, J. T. V. M., & van Ommeren, M. (2002) · Transcultural Psychiatry · doi:10.1177/136346150203900402 · Cited by 122
The impact of war on the physical and mental health of the family: The Lebanese experience
Farhood, L., Zurayk, H., Chaaya, M., Saadeh, F., Meshefedjian, G. A., & Sidani, T. (1993) · Social Science & Medicine · doi:10.1016/0277-9536(93)90344-4 · Cited by 118
Panter‐Brick, C., Eggerman, M., Mojadidi, A., & McDade, T. W. (2008) · American Journal of Human Biology · doi:10.1002/ajhb.20797 · Cited by 117
An Ecological Framework for Addressing the Mental Health Needs of Refugee Communities
(2004) · The Mental Health of Refugees · doi:10.4324/9781410610263-8 · Cited by 114
Self-citationTrauma and Cumulative Adversity in Women of a Disadvantaged Social Location.
Kubiak, S. P. (2005) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.75.4.451 · Cited by 98
Rethinking a Familiar Model: Psychotherapy and the Mental Health of Refugees
Miller, K. E. (1999) · Journal of Contemporary Psychotherapy · doi:10.1023/a:1022926721458 · Cited by 95
Self-citationChildren in political violence
Gibson, K. L. (1989) · Social Science & Medicine · doi:10.1016/0277-9536(89)90213-x · Cited by 91
Public Mental Health, Traumatic Stress and Human Rights Violations in Low-Income Countries
Joop, T. V., & Jong, M. (2006) · Kluwer Academic Publishers eBooks · doi:10.1007/0-306-47675-4_1 · Cited by 84
Traumatic stress : from theory to practice
Freedy, J. R., & Hobfoll, S. E. (1995) · Plenum Press eBooks · Cited by 83
Too Scared to Cry: Psychic Trauma in Childhood
Huszonek, J. J. (1991) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1991.45.4.619 · Cited by 81
The Sierra Leonean Refugee Experience
Fox, S. H., & Tang, S. S. S. (2000) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200008000-00003 · Cited by 75
Alleviating the Effects of War and Displacement on Children
Yule, W. (2002) · Traumatology An International Journal · doi:10.1177/153476560200800304 · Cited by 73
Traumatic stress: from theory to practice
(1996) · Choice Reviews Online · doi:10.5860/choice.33-4801 · Cited by 71
van der Veer, G. (1992) · UMI Books on Demand · Cited by 63
Mental Health in Postwar Afghanistan
Bolton, P. A. (2004) · JAMA · doi:10.1001/jama.292.5.626 · Cited by 63
Is magnitude of co-payment effect related to income? Using census data for health services research
Cherkin, D. C., Grothaus, L. C., & Wagner, E. H. (1992) · Social Science & Medicine · doi:10.1016/0277-9536(92)90064-w · Cited by 63
Sharp, J. (1994) · African Studies · doi:10.1080/00020189408707789 · Cited by 59
The Mental health of refugees: ecological approaches to healing and adaptation
(2004) · Choice Reviews Online · doi:10.5860/choice.42-2255 · Cited by 59
Psychological Symptomatology Among Palestinian Adolescents Living with Political Violence
Al‐Krenawi, A., Lev‐Wiesel, R., & Mahmud, A. S. (2006) · Child and Adolescent Mental Health · doi:10.1111/j.1475-3588.2006.00416.x · Cited by 48
Stress and health—little hassles vs. major life events
Ruffin, C. L. (1993) · Australian Psychologist · doi:10.1080/00050069308258902 · Cited by 47
de Jong, J. T. V. M. (2004) · Routledge eBooks · doi:10.4324/9780203310540-14 · Cited by 45
Jaranson, J. M., & Popkin, M. K. (1998) · Cited by 44
Miller, K. E., Fernando, G. A., & Berger, D. E. (2009) · Intervention · doi:10.1097/wtf.0b013e3283346344 · Cited by 43
Self-citationvan der Veer, G. (1992) · Cited by 42
Post-traumatic stress disorder: a reaction to state-supported child abuse and neglect
Straker, G., Moosa, F., & Sanctuaries Counselling Team (1988) · Child Abuse & Neglect · doi:10.1016/0145-2134(88)90051-8 · Cited by 41
Miller, Weine, Ramic, & Brkic (2002) · Journal of Traumatic Stress · Cited by 31
The mental health disaster in conflict settings: Can scientific research help?
Neuner, F., & Elbert, T. R. (2007) · BMC Public Health · doi:10.1186/1471-2458-7-275 · Cited by 27
Internally Displaced Angolans: A Child-focused, Community-based Intervention
Wessells, M., & Monteiro, C. (2004) · Routledge eBooks · doi:10.4324/9781410610263-10 · Cited by 26
Johnson, J. G., & Sherman, M. F. (1997) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.1997.16.4.389 · Cited by 22
Hubbard, J., & Pearson, N. (2004) · Routledge eBooks · doi:10.4324/9781410610263-11 · Cited by 16
The effects of torture and political repression in a sample of Chilean families
Codepu (1989) · Social Science & Medicine · doi:10.1016/0277-9536(89)90221-9 · Cited by 14
Helping the Victims of Disasters
McFARLANE, A. C. (1995) · Springer eBooks · doi:10.1007/978-1-4899-1076-9_12 · Cited by 12
Stovall, J. G. (1999) · Psychiatric Services · doi:10.1176/ps.50.7.975 · Cited by 10
Weinberg, G. L. (2005) · doi:10.1017/cbo9780511818639.006 · Cited by 5
Internally Displaced East Timorese: Challenges and Lessons of Large-Scale Emergency Assistance
Kostelny, K., & Wessells, M. (2004) · Routledge eBooks · doi:10.4324/9781410610263-14 · Cited by 5
Flagged first, then by citations
Cited by
Sorted by citations
Fazel, M. S., Reed, R. V., Panter‐Brick, C., & Stein, A. L. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60051-2 · Cited by 1,447
A Handbook for the Study of Mental Health Second Edition
Scheid, T. L., & Brown, T. N. (2009) · Cited by 1,320
The contemporary refugee crisis: an overview of mental health challenges
Silove, D., Ventevogel, P., & Rees, S. (2017) · World Psychiatry · doi:10.1002/wps.20438 · Cited by 775
Li, S. S. Y., Liddell, B. J., & Nickerson, A. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0723-0 · Cited by 746
Reed, R. V., Fazel, M. S., JONES, L. M., Panter‐Brick, C., & Stein, A. L. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60050-0 · Cited by 551
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review