World Health Organization guidelines for management of acute stress, PTSD, and bereavement: key challenges on the road ahead
Open accessAbstract
Wietse Tol and colleagues discuss some of the key challenges for implementation of new WHO guidelines for stress-related mental health disorders in low- and middle-income countries. Please see later in the article for the Editors' Summary.
AI snapshot
Written from the paper’s full text.
TL;DR
This commentary outlines the key challenges facing implementation of the new WHO guidelines for conditions specifically related to stress (acute stress symptoms, PTSD, and bereavement) in low- and middle-income countries. It argues that weak evidence for commonly used interventions, scarce mental health resources, resistance to negative recommendations, limited cultural generalizability, and ongoing adversity all constrain uptake, and proposes research and capacity-building responses.
Key findings
- The WHO Guideline Development Group found a "dearth of scientifically rigorous research" supporting many commonly used interventions; evidence was particularly poor for children and adolescents, where "for three out of 11 questions asked, no specific recommendations could be made based on existing evidence."
- For acute traumatic stress symptoms in adults, evidence was insufficient to recommend for or against problem-solving counseling, relaxation, or psycho-education.
- The guidelines recommend against benzodiazepines and antidepressants for acute stress and bereavement (strong recommendations for children/adolescents and for bereaved adults), and against universal structured psychological interventions for bereaved people without a mental disorder; the paper notes over-prescription of benzodiazepines and popularity of grief counseling despite lack of evidence.
- Task-sharing evidence from randomized controlled trials suggests non-specialists can deliver psychotherapeutic interventions, but it is "uncertain whether psychotherapeutic interventions can be feasibly scaled up and sustained in naturalistic settings" lacking researcher-level resources.
Methods
- Design: a commentary/analysis paper (not an empirical study) discussing challenges in formulating and implementing the WHO guidelines; the authors are members of the Guideline Development Group, WHO secretariat, and consultants to the guideline process.
- Evidence base described: the GDG identified recent systematic reviews or commissioned reviews where none existed; recommendations were graded using GRADE-based methodology, with "strong" versus "standard" recommendation strength (Table 1).
- No primary data, sample, or statistical analysis is reported; the paper synthesizes existing reviews and trials (e.g., on counseling, child-friendly spaces, and treatment under ongoing adversity).
Limitations
- The paper does not include a formal limitations section; it is a commentary, so its claims rest on the authors' synthesis rather than new data.
- Limitations the text itself makes evident: the underlying evidence base is described as sparse and drawn "mainly in well-resourced health settings in industrialized countries," with uncertain generalizability across sociocultural settings; knowledge on cultural concepts of distress and on treatment effectiveness under ongoing adversity is explicitly described as limited and inconsistent.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 25 cited sources checked · 0 supported · 0 flagged
- Findingreasoning
There was insufficient evidence to recommend either in favor or against the use of problem-solving counseling, relaxation, and psycho-education for managing acute traumatic stress symptoms in adults.
“At the outset, the GDG commissioned evidence searches for a broader set of psychological interventions to manage acute traumatic stress symptoms in adults, including problem-solving counseling, relaxation, and psycho-education. However, it was deemed that there was insufficient evidence to recommend either in favor or against the use of these interventions.”
Quote in the paperSubstantial claim - Findingown data
There is a dearth of scientifically rigorous research supporting many of the most commonly used interventions for managing conditions specifically associated with stress.
“First, the Guideline Development Group (GDG) (see author contributions) discovered that there is a dearth of scientifically rigorous research supporting many of the most commonly used interventions for managing conditions specifically associated with stress.”
Quote in the paperSubstantial claim - Findingnone given
Randomized trials have not yet indicated whether addressing social and psychological issues simultaneously in a multilayered, multisectoral approach is more effective than single-intervention approaches.
“However, randomized trials have not yet indicated whether this is more effective than single-intervention approaches.”
Quote in the paperSubstantial claim - Interpretationreasoning
The limited availability of mental health resources in LMICs creates a major obstacle to implementation of new mental health recommendations.
“Second, a key challenge is the limited availability of mental health resources in LMICs in general, creating a major obstacle to implementation of new mental health recommendations.”
Quote in the paperSubstantial claim - Interpretationreasoning
There may be major challenges in achieving changes in practice in low-resource settings where the evidence-based alternative suggests more time-intensive management strategies or where expectations of help-seekers favor pharmacological management.
“Overall, there may be major challenges in achieving changes in practice in low-resource settings where the evidence-based alternative suggests more time-intensive management strategies or where expectations of help-seekers favor pharmacological management, as is common in many LMICs.”
Quote in the paperSubstantial claim
- Premisecitation
In humanitarian settings in LMICs, there is a wide gap between interventions that are commonly implemented and evidence for interventions in such settings.
“In humanitarian settings in LMICs specifically, earlier systematic reviews have shown that there is a wide gap between interventions that are commonly implemented and evidence for interventions in such settings [6].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] WA Tol, 2011, Mental health and psychosocial support in humanitarian settings: linking practice and research, Lancet source
Not checked in the free run.
- Interpretationreasoning
There is uncertainty as to what extent the findings from well-resourced settings can be generalized across diverse sociocultural settings.
“There is uncertainty as to what extent the findings can be generalized across diverse sociocultural settings.”
Quote in the paperSubstantial claim- Rests on an assumption: mhGAP recommendations are based on evidence gathered mainly in well-resourced health settings in industrialized countries.
- Premisecitation
There is promising evidence from randomized controlled trials that non-specialists can successfully deliver psychotherapeutic interventions based on a task-sharing approach.
“There is promising evidence, however, based on randomized controlled trials, that non-specialists (for example, community health workers or personnel without a formal mental health background working for non-governmental organizations) can successfully deliver psychotherapeutic interventions based on a task-sharing approach [10]–[12].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10]–[12]
Not checked in the free run.
- Premisecitation
Lack of mental health resources in LMICs takes a number of forms, including limits in basic mental health infrastructure, budget, and personnel, particularly in humanitarian settings.
“Lack of resources takes a number of forms, including limits in basic mental health infrastructure, budget, and personnel, particularly in humanitarian settings [7].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] B Saraceno, 2007, Barriers to improvement of mental health services in low-income and middle-income countries, Lancet source
Not checked in the free run.
- Interpretationreasoning
It is uncertain whether psychotherapeutic interventions can be feasibly scaled up and sustained in naturalistic settings that lack the financial resources which were available to researchers when these interventions were tested.
“Nevertheless, it is uncertain whether psychotherapeutic interventions can be feasibly scaled up and sustained in naturalistic settings that lack the financial resources (e.g., for supervision) which were available to researchers when these interventions were tested.”
Quote in the paperSubstantial claim - Interpretationreasoning
The implementation of new WHO mental health guidelines for conditions and disorders specifically related to stress is likely to face obstacles, particularly in low- and middle-income countries.
“The implementation of new WHO mental health guidelines for conditions and disorders specifically related to stress is likely to face obstacles, particularly in low- and middle-income countries.”
Quote in the paperSubstantial claim - Premisecitation
Where basic mental health resources exist, there is a lack of specialized staff to provide the necessary training and supervision to ensure recommended psychotherapeutic interventions such as CBT and EMDR can be implemented.
“Where basic mental health resources do exist, there is a lack of specialized staff to provide the necessary training and supervision to ensure recommended psychotherapeutic interventions such as cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) can be implemented [9].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] World Health Organization (2005) Mental Health Atlas - Revised Edition. Geneva: WHO.
Not checked in the free run.
- Premisecitation
There is a paucity of evidence concerning the effectiveness of interventions for specific cultural idioms or concepts of distress.
“Furthermore, there is a paucity of evidence concerning the effectiveness of (a) interventions for specific cultural idioms or concepts of distress [16] and (b) existing supportive cultural practices to manage stress-related conditions, such as yoga for stress management, or cultural mourning practices for bereavement.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] BA Kohrt, 2013, Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology, Int J Epidemiol source
Not checked in the free run.
- Interpretationreasoning
Some practitioners may be reluctant to adhere to recommendations that caution against practices that are widely applied.
“Third, some practitioners may be reluctant to adhere to recommendations that caution against practices that are widely applied.”
Quote in the paperSubstantial claim - Premisecitation
One of the major shortcomings of the literature on cultural concepts of distress is the failure to include cultural concepts of distress in treatment outcome studies.
“However, one of the major shortcomings of this literature concerned the failure to include cultural concepts of distress in treatment outcome studies [16].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] BA Kohrt, 2013, Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology, Int J Epidemiol source
Not checked in the free run.
- Premisecitation
A recent meta-analysis found a particularly high level of overlap between locally defined cultural concepts of distress and a diagnosis of PTSD.
“A recent meta-analysis found a particularly high level of overlap between locally defined cultural concepts of distress and a diagnosis of PTSD.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] BA Kohrt, 2013, Cultural concepts of distress and psychiatric disorders: literature review and research recommendations for global mental health epidemiology, Int J Epidemiol source
Not checked in the free run.
- Premisecitation
Among children and adolescents with PTSD, CBT has been shown to be more effective than supportive counseling for a range of outcomes.
“For example, amongst children and adolescents with PTSD, CBT has been shown to be more effective than supportive counseling for a range of outcomes [23].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] D Gillies, 2012, Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents, Cochrane Database Syst Rev
Not checked in the free run.
- Premisecitation
Previous research has indicated that psychotherapeutic treatments by themselves may lower chances for future victimization.
“Previous research has indicated that psychotherapeutic treatments by themselves may lower chances for future victimization [39].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [39] KM Iverson, 2011, Cognitive-behavioral therapy for PTSD and depression symptoms reduces risk for future intimate partner violence among interpersonal trauma survivors, J Consult Clin Psychol source
Not checked in the free run.
- May combine two claims. 11
- Classified as probably not a substantial claim. 3
May combine two claims.
Findingown dataThe evidence is particularly poor for children and adolescents: for three out of 11 questions asked, no specific recommendations could be made based on existing evidence.
“The evidence is particularly poor for children and adolescents: for three out of 11 questions asked, no specific recommendations could be made based on existing evidence.”
Quote in the paperSubstantial claimMay combine two claims.
FindingreasoningLimited knowledge is available to guide decisions on whether to prioritize social interventions over psychotherapeutic interventions in populations exposed to ongoing adversity and whether treatments are equally effective and safe for those exposed to ongoing major stressors.
“Limited knowledge is available to guide decisions on both issues.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationGrief counseling is a popular intervention following bereavement in spite of the lack of evidence that it is necessary or effective.
“Similarly, grief counseling is a popular intervention following bereavement in spite of the lack of evidence that it is necessary or effective [15].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [15] C Wittouck, 2011, The prevention and treatment of complicated grief: a meta-analysis, Clin Psychol Rev source
Not checked in the free run.
May combine two claims.
PremisecitationMental health is often a low priority for governments and donors, and there is often a lack of political will to prioritize this area.
“Mental health is often a low priority for governments and donors, and too often there is a lack of political will to prioritize this area [8].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] J Abdulmalik, 2013, Country contextualization of the mental health gap action programme intervention guide: a case study from Nigeria, PLoS Med source
Not checked in the free run.
May combine two claims.
PremisecitationStudies have revealed over-prescription of benzodiazepines in some LMIC health care settings, supporting general impressions that in humanitarian settings the prescription of benzodiazepines for symptoms of acute stress (including insomnia) and bereavement is commonplace.
“Studies have revealed the over-prescription of benzodiazepines in some LMIC health care settings [13],[14], supporting general impressions that in humanitarian settings the prescription of benzodiazepines for symptoms of acute stress (including insomnia) and bereavement is commonplace.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [13] MJ Patel, 2013, Benzodiazepine use in medical out-patient clinics: a study from a developing country, J Pak Med Assoc
Not checked in the free run.
- cites [14] F Kapczinski, 2001, Use and misuse of benzodiazepines in Brazil: a review, Subst Use Misuse source
Not checked in the free run.
May combine two claims.
PremisecitationIn humanitarian settings, some studies have shown benefits of counseling, whereas others have not.
“In humanitarian settings, some studies have shown benefits of counseling [24],[25], whereas others have not [26]–[28].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [24] S Ayoughi, 2012, Provision of mental health services in resource-poor settings: a randomised trial comparing counselling with routine medical treatment in North Afghanistan (Mazar-e-Sharif), BMC Psychiatry source
Not checked in the free run.
- cites [25] E Nakimuli-Mpungu, 2013, The impact of group counseling on depression, post-traumatic stress and function outcomes: A prospective comparison study in the Peter C. Alderman trauma clinics in northern Uganda, J Affect Disord source
Not checked in the free run.
- cites [26]–[28]
Not checked in the free run.
May combine two claims.
PremisecitationA recent systematic review found no randomized controlled trials evaluating child-friendly spaces, and only one study applying a comparison group with pre- and post-intervention measurement of outcomes.
“A recent systematic review found no randomized controlled trials evaluating this methodology, and only one study applying a comparison group with pre- and post-intervention measurement of outcomes [29].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [29] A Ager, 2013, Child friendly spaces: a systematic review of the current evidence base on outcomes and impact, Intervention (Amstelveen) source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationInternational consensus guidelines for mental health and psychosocial interventions in humanitarian emergencies explicitly recommend identifying and building on existing supportive cultural practices where possible.
“This is a paradox because international consensus guidelines for mental health and psychosocial interventions in humanitarian emergencies explicitly recommend identifying and building on such practices where possible [17], the evident advantages being accessibility, acceptability, and sustainability.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Inter-Agency Standing Committee [IASC] (2007) IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Geneva: IASC.
Not checked in the free run.
May combine two claims.
PremisecitationA recent initiative to set research priorities for mental health and psychosocial support in humanitarian settings produced a largely practice-informed research agenda that focused on a range of disorders and conditions besides PTSD, in spite of PTSD being the subject of most attention in the literature.
“A recent initiative to set research priorities for mental health and psychosocial support in humanitarian settings, in which there was strong representation from personnel working in LMICs, produced a largely practice-informed research agenda; notably, there was little focus on topics that have dominated debates in the peer-reviewed literature.”
- Also stated in: § How Can These Obstacles Be Overcome? · plain
“For example, the agenda focused on a range of disorders and conditions besides PTSD, in spite of the latter diagnosis being the subject of most attention in the literature [30].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [30] WA Tol, 2011, Research priorities for mental health and psychosocial support in humanitarian settings, PLoS Med source
Not checked in the free run.
- Also stated in: § How Can These Obstacles Be Overcome? · plain
May combine two claims.
PremisecitationThere is some evidence that treatments can be effective in situations of ongoing adversity, whereas other studies have shown reduced treatment benefits for populations facing chronic adversity.
“With regard to the second question, there is some evidence that treatments can be effective in situations of ongoing adversity [19],[20], whereas other studies have shown reduced treatment benefits for populations facing chronic adversity [21].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [19] JK Bass, 2013, Controlled trial of psychotherapy for Congolese survivors of sexual violence, N Engl J Med source
Not checked in the free run.
- cites [20] JA Cohen, 2011, Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: a randomized controlled trial, Arch Pediatr Adolesc Med source
Not checked in the free run.
- cites [21] WA Tol, 2014, School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial, BMC Med source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.
InterpretationreasoningThe new WHO recommendations on conditions specifically related to stress present an important step forward, but there will be many challenges in implementation.
“In conclusion, although the new WHO recommendations on conditions specifically related to stress present an important step forward, there will be many challenges in implementation.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationThe WHO guidelines include recommendations not to offer benzodiazepines for acute traumatic stress symptoms and not to offer structured psychological interventions for bereavement reactions in the absence of frank mental disorder.
“These include, for example, recommendations not to offer benzodiazepines for acute traumatic stress symptoms, nor to offer structured psychological interventions for bereavement reactions in the absence of frank mental disorder.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [3] World Health Organization (2013) Guidelines for the Management of Conditions specifically related to Stress. Geneva: WHO.
Not checked in the free run.
- cites [4] WA Tol, 2013, Management of acute stress, PTSD, and bereavement: WHO recommendations, JAMA source
Not checked in the free run.
- cites [5] World Health Organization, United Nations High Commissioner for Refugees (2013) Assessment and Management of Conditions Specifically Related to Stress: mhGAP Intervention Guide Module. Geneva: WHO.
Not checked in the free run.
The paper relies on this without support.
There is a paucity of evidence concerning the effectiveness of existing supportive cultural practices to manage stress-related conditions, such as yoga for stress management or cultural mourning practices for bereavement.
“Furthermore, there is a paucity of evidence concerning the effectiveness of (a) interventions for specific cultural idioms or concepts of distress [16] and (b) existing supportive cultural practices to manage stress-related conditions, such as yoga for stress management, or cultural mourning practices for bereavement.”
The paper relies on this without support.
Populations affected by humanitarian crises in LMICs commonly live in settings of ongoing exposure to major stressors.
“Finally, implementation efforts need to be more responsive to the reality that populations affected by humanitarian crises in LMICs commonly are living in settings of ongoing exposure to major stressors.”
The paper relies on this without support.
Social and economic factors impact mental health in humanitarian settings.
“Clinical interventions are only part of the picture, given the impact of social and economic factors on mental health in these settings.”
The paper relies on this without support.
mhGAP recommendations are based on evidence gathered mainly in well-resourced health settings in industrialized countries.
“Fourth, mhGAP recommendations are based on evidence gathered mainly in well-resourced health settings in industrialized countries.”
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?
Current evidence-based treatments generally require a substantial clinical workforce not typically available in disrupted, under-resourced health systems.
“Current evidence-based treatments generally require a substantial clinical workforce not typically available in disrupted, under-resourced health systems. 4”
From Guided self-help to reduce psychological distress in South Sudanese female refugees in Uganda: A cluster randomised trial (2020) · cites this paper as [4]
In “What Are the Key Obstacles on the Road Ahead?”, the paper identifies personnel shortages in low-resource and humanitarian settings, including too few specialists to train and supervise delivery of recommended psychotherapies. But it does not say evidence-based treatments generally require a substantial clinical workforce; it also reports that non-specialists can deliver psychotherapeutic interventions. (LLM, conf=0.82)
Experimental — accuracy not yet measuredCBT with a trauma focus, EMDR and stress management interventions are generally recommended in the general population of adults with PTSD.
“CBT with a trauma focus, EMDR and stress management interventions are generally recommended in the general population of adults with PTSD”
From Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: Systematic review and meta-analysis (2019) · cites this paper as Tol et al., 2014
The 'Why New Guidelines' section (Table 1; page unavailable) recommends trauma-focused CBT for adults with acute stress symptoms, not in the PTSD recommendation shown in our copy. The 'Key Obstacles' section (page unavailable) describes CBT and EMDR as recommended psychotherapeutic interventions, but the retrieved passages do not establish the claimed recommendation for all three interventions—including stress management—for adults with PTSD. (LLM, conf=0.76)
Experimental — accuracy not yet measuredTargeted early interventions are especially important in low- and middle-income countries characterised by limited resources and overburdened mental health care facilities, because treatment of severe psychopathology is more resource intensive with higher costs and burden for the healthcare system.
“Targeted early interventions are especially important in low-and middle-income countries characterised by limited resources and overburdened mental health care facilities since treatment of severe psychopathology is more resource intensive (e.g.longer duration of treatment, medical interventions, hospitalisation, management of comorbid disorders) with higher costs and burden for the healthcare”
From Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape (2022) · cites this paper as Tol et al., 2014
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“With regard to the second question, there is some evidence that treatments can be effective in situations of ongoing adversity [19,20], whereas other studies have shown reduced treatment benefits for populations facing chronic adversity [21].”
Self-citationThe balanced care model for global mental health
Thornicroft, G., & Tansella, M. (2013) · Psychological Medicine · doi:10.1017/s0033291712001420 · Cited by 162 · cited 1× · see citing works
“This is likely to require a balanced approach in building capacity of both specialist supervisors and non-specialist health workers in community and primary health care settings [32].”
Research priorities for mental health and psychosocial support in humanitarian settings
Tol, W. A., Patel, V., Tomlinson, M., Baingana, F., Galappatti, A., Panter-Brick, C., Silove, D., Sondorp, E., Wessells, M., & van Ommeren, M. (2011) · PLoS Medicine · doi:10.1371/journal.pmed.1001096 · Cited by 138 · cited 1× · see citing works
“For example, the agenda focused on a range of disorders and conditions besides PTSD, in spite of the latter diagnosis being the subject of most attention in the literature [30].”
Self-citationManagement of Acute Stress, PTSD, and Bereavement: WHO Recommendations
Tol, W. A., Barbui, C., & van Ommeren, M. (2013) · JAMA · doi:10.1001/jama.2013.166723 · Cited by 115 · cited 1× · see citing works
“The development [3,4] and content [5] of the evidence-based recommendations and resulting intervention module are described in more detail elsewhere.”
Self-citationAbdulmalik, J., Kola, L., Fadahunsi, W., Adebayo, K., Yasamy, M. T., Musa, E., & Gureje, O. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001501 · Cited by 104 · cited 1× · see citing works
“political will to prioritize this area [8].”
Richards, J. A., Foster, C. E., Townsend, N. P., & Bauman, A. E. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-619 · Cited by 101 · cited 1× · see citing works
“In relation to the current knowledge base, there are both consistent and inconsistent findings [22].”
Use and misuse of benzodiazepines in Brazil: a review
Kapczinski, F., Amaral, O. B., Madruga, M., Quevedo, J., Busnello, J. V., & de Lima, M. S. (2001) · Substance Use & Misuse · doi:10.1081/ja-100104489 · Cited by 57 · cited 1× · see citing works
“tion of benzodiazepines in some LMIC health care settings [13,14], supporting”
A controlled trial of problem-solving counseling for war-affected adults in Aceh, Indonesia
Bass, J., Poudyal, B., Tol, W. A., Murray, L. K., Nadison, M., & Bolton, P. A. (2011) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-011-0339-y · Cited by 44 · see citing works
Self-citationAyoughi, S., Missmahl, I., Weierstall, R., & Elbert, T. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-14 · Cited by 43 · see citing works
Brief multi-disciplinary treatment for torture survivors in Nepal: a naturalistic comparative study
Tol, W. A., Komproe, I. H., Jordans, M. J. D., Thapa, S. B., Sharma, B., & De Jong, J. T. V. M. (2009) · International Journal of Social Psychiatry · doi:10.1177/0020764008091525 · Cited by 41 · cited 1× · see citing works
“In humanitarian settings, some studies have shown benefits of counseling [24,25], whereas others have not [26–28].”
Self-citationChild friendly spaces: a systematic review of the current evidence base on outcomes and impact
Ager, A., Metzler, J., Vojta, M., & Savage, K. (2013) · Intervention · doi:10.1097/01.wtf.0000431120.01602.e2 · Cited by 33 · cited 1× · see citing works
“A recent systematic review found no randomized controlled trials evaluating this methodology, and only one study applying a comparison group with pre- and post-intervention measurement of outcomes [29].”
Nakimuli-Mpungu, E., Okello, J., Kinyanda, E., Alderman, S., Nakku, J., Alderman, J. S., Pavia, A., Adaku, A., Allden, K., & Musisi, S. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.05.055 · Cited by 31 · cited 1× · see citing works
“In humanitarian settings, some studies have shown benefits of counseling [24,25], whereas others have not [26–28].”
Gillies, D. (2013) · Journal of Evidence-Based Medicine · doi:10.1111/jebm.12041 · Cited by 18 · see citing works
Benzodiazepine use in medical out-patient clinics: a study from a developing country.
Patel, M. J., Ahmer, S., Khan, F., et al. (2013) · PubMed · Cited by 8 · see citing works
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- World Health Organization (2005) Mental Health Atlas - Revised Edition. Geneva: WHO.
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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
Barbui, C., Purgato, M., Abdulmalik, J., Acarturk, C., Eaton, J., Gastaldon, C., Gureje, O., Hanlon, C., Jordans, M., Lund, C., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30511-5 · Cited by 349 · see citing works
“4,5 Although the generalisability issue is theoretically relevant for any type of intervention, for psychosocial inter ventions there are several challenges specific to LMICs, including the need for training, fidelity checks, supervision, and monitoring, concerns about cultural and social…”
Self-citationNosè, M., Ballette, F., Bighelli, I., Turrini, G., Purgato, M., Tol, W., Priebe, S., & Barbui, C. (2017) · PLOS ONE · doi:10.1371/journal.pone.0171030 · Cited by 276 · see citing works
Self-citationTurrini, 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 terms of type of psychosocial intervention, CBT with a trauma focus, EMDR and stress management interventions are generally recommended in the general population of adults with PTSD (Tol et al., 2013, 2014).”
BackgroundSelf-citationTol, W. A., Leku, M. R., Lakin, D. P., Carswell, K., Augustinavicius, J., Adaku, A., Au, T. M., Brown, F. L., Bryant, R. A., Garcia-Moreno, C., et al. (2020) · The Lancet Global Health · doi:10.1016/s2214-109x(19)30504-2 · Cited by 249 · see citing works
“4 The intervention attempted to meet these challenges by further innovation in the area of task sharing and intervention delivery (ie, decreasing requirements for training and supervision while delivering excellent intervention fidelity through use of audio recordings and a self-help book);…”
BackgroundSelf-citationProlonged grief disorder for ICD-11: the primacy of clinical utility and international applicability
Killikelly, C., & Maercker, A. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1476441 · Cited by 187 · see citing works
“When considering low- and middle-income countries, where there is a high prevalence of stress-related disorders, these challenges are compounded by a lack of resources and a potential reluctance to adopt new practices without increased support (Tol et al., 2014).”
BackgroundInfluentialMental health care for adult refugees in high-income countries
Giacco, D., & Priebe, S. (2017) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796017000609 · Cited by 131 · see citing works
“The guidelines for nonrefugee groups recommend cognitive behavioural therapy with a trauma focus, stress management and Eye Movement Desensitisation and Reprocessing (Tol et al. 2013, 2014), for which the evidence in refugees is inconclusive (Nosè et al. 2017).”
BackgroundBroadening perspectives on trauma and recovery: a socio-interpersonal view of PTSD †
Maercker, A. R. A., & Hecker, T. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.29303 · Cited by 132 · see citing works
“Therefore, the World Health Organization (WHO) increasingly advocates for larger scale programs in post-conflict regions, targeting whole communities or whole societies (Epping-Jordan et al., 2015; Tol et al., 2014).”
BackgroundFaregh, N., Lencucha, R., Ventevogel, P., Dubale, B. W., & Kirmayer, L. J. (2019) · International Journal of Mental Health Systems · doi:10.1186/s13033-019-0312-9 · Cited by 120 · see citing works
Practitioner Review: School‐based interventions in child mental health
Paulus, F. W., Ohmann, S., & Popow, C. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12584 · Cited by 114 · see citing works
Guidelines in lower‐middle income countries
Olayemi, E., Asare, E. V., & Kuma, A. B.-A. (2017) · British Journal of Haematology · doi:10.1111/bjh.14583 · Cited by 83 · see citing works
Jansen, S., White, R., Hogwood, J., Jansen, A., Gishoma, D., Mukamana, D., & Richters, A. (2015) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v6.28706 · Cited by 84 · see citing works
“In addition, practical limitations like the lack of human resources, the reluctance of some practitioners to adhere to recommendations, and the lack of systematic reviews for interventions in LMIC pose important obstacles to realistically implementing the mhGAP agenda (Tol et al., 2014).”
BackgroundInfluentialMurray, L. K., & Jordans, M. J. D. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0938-y · Cited by 72 · see citing works
“Some of these EBTs are recommended in the recent World Health Organization (WHO) Mental Health GAP (mhGAP) Guidelines [24, 25] as front-line interventions.”
BackgroundMethodTol, W. A., Augustinavicius, J., Carswell, K., Brown, F. L., Adaku, A., Leku, M. R., García-Moreno, C., Ventevogel, P., White, R. G., & van Ommeren, M. (2018) · Global Mental Health · doi:10.1017/gmh.2018.14 · Cited by 69 · see citing works
Self-citationde Jong, J. T. V. M., Berckmoes, L. H., Kohrt, B. A., Song, S. J., Tol, W. A., & Reis, R. (2015) · Current Psychiatry Reports · doi:10.1007/s11920-015-0590-0 · Cited by 72 · see citing works
Self-citationAssociation of Psychosocial Stress With Risk of Acute Stroke
Reddin, C., Murphy, R., Hankey, G. J., Judge, C. S., Xavier, D., Rosengren, A., Ferguson, J. P., Alvarez‐Iglesias, A., Oveisgharan, S., Iversen, H. K., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.44836 · Cited by 69 · see citing works
Trauma and Resilience Among Displaced Populations
Theisen-Womersley, G. (2021) · Springer eBooks · doi:10.1007/978-3-030-67712-1 · Cited by 75 · see citing works
Aizik-Reebs, A., Yuval, K., Hadash, Y., Gebremariam, S. G., & Bernstein, A. (2021) · Clinical Psychological Science · doi:10.1177/2167702621998641 · Cited by 55 · see citing works
“Relative to the scale, scope, and urgency of this still growing crisis (UNHCR, 2019), our collective capacity to care for these survivors via evidence-based mental health interventions tailored to refugees and asylum seekers is strikingly limited (Patel et al., 2018; Tol et al., 2014).”
BackgroundRuzek, J. I., & Yeager, C. M. (2017) · Global Mental Health · doi:10.1017/gmh.2017.11 · Cited by 54 · see citing works
“Given that mental health problems in LMICs are clearly related to social adversity (Tol et al. 2014; Whitley, 2015), it would seem advisable that technology-facilitated individual interventions should be seen as part of a more comprehensive, and more powerful, mental health response in LMICs that…”
BackgroundAddressing mental health care for the bereaved during the COVID ‐19 pandemic
Sun, Y., Bao, Y., & Lü, L. (2020) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13008 · Cited by 44 · see citing works
Beyond the DSM-5 Diagnoses: A Cross-Cultural Approach to Assessing Trauma Reactions
Patel, A., & Hall, B. J. (2021) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20200049 · Cited by 45 · see citing works
Vegsund, H. K., Reinfjell, T., Moksnes, U. K., Eilegård, A., Hjemdal, O., & Eilertsen, M. B. (2019) · PLoS ONE · doi:10.1371/journal.pone.0214138 · Cited by 40 · see citing works
Kane, J. C., Adaku, A., Nakku, J. E. M., Odokonyero, R. F., Okello, J., Musisi, S., Augustinavicius, J., Greene, M. C., Alderman, S., & Tol, W. A. (2015) · Implementation Science · doi:10.1186/s13012-016-0400-z · Cited by 40 · see citing works
“The mhGAP-IG was an effort to expand and strengthen mental health services in LMIC and to provide direction in the management of mental, neurological, and substance use (MNS) problems in nonspecialized health settings [17, 18].”
BackgroundInfluentialSelf-citationStene, L. E., & Dyb, G. A. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-0811-6 · Cited by 39 · see citing works
“In accordance with recent WHO guidelines, access to mental health inventions could be improved by integrating the delivery of psychotherapy by non-specialists, such as community health workers in primary care [32].”
BackgroundTol, W. A., Augustinavicius, J., Carswell, K., Leku, M. R., Adaku, A., Brown, F. L., García‐Moreno, C., Ventevogel, P., White, R. G., Kogan, C. S., et al. (2018) · World Psychiatry · doi:10.1002/wps.20537 · Cited by 39 · see citing works
Self-citationKirby, E. R., Kenny, K., Broom, A. F., MacArtney, J. I., & Good, P. D. (2017) · Palliative & Supportive Care · doi:10.1017/s1478951517000475 · Cited by 37 · see citing works
“…support services has been developed in Australia (Hall et al., 2012; Hudson et al., 2010a; 2012) and internationally (Kerslake et al., 2014; Tol et al., 2014), a growing body of work has highlighted the challenges for bereavement support services in accessing caregivers who have been…”
BackgroundRyan, G. K., Bauer, A., Endale, T., Qureshi, O., Doukani, A., Pashoja, A. C., Brar, S. K., Eaton, J., & Bass, J. (2021) · Conflict and Health · doi:10.1186/s13031-021-00363-8 · Cited by 36 · see citing works
“In low- and middle-income countries (LMICs), where mental health expenditure is typically below two dollars per capita [12], existing services are often heavily centralised, overstretched, and unable to cope with further disruptions to supply chains, destruction of infrastructure, loss of staff, and other common chall…”
BackgroundTsima, Setlhare, V., & Nkomazana, O. (2016) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s112466 · Cited by 30 · see citing works
“gathered mainly in well-resourced settings thus leading to uncertainty as to what extent the findings can be generalized across diverse sociocultural settings.(29) WHO guidelines for selected mental health disorders were regarded deficient, in terms of knowledge on existing cultural practices for improving mental heal…”
Tol, W. A., Greene, M. C., Likindikoki, S. L., Misinzo, L., Ventevogel, P., Bonz, A. G., Bass, J., & Mbwambo, J. K. K. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1338-7 · Cited by 37 · see citing works
“including a lack of trained human resources and high demands on staff in non-specialized settings [35].”
BackgroundSelf-citationGebrehiwet, M. G., Medhanyie, A. A., & Alema, H. B. (2019) · BMC Research Notes · doi:10.1186/s13104-019-4684-3 · Cited by 29 · see citing works
Nöthling, J., Abrahams, N., Jewkes, R., Mhlongo, S., Lombard, C., Hemmings, S. M. J., & Seedat, S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.032 · Cited by 28 · see citing works
Self-citationNiemi, M., Kiel, S., Allebeck, P., & Hoan, L. T. (2016) · Tropical Medicine & International Health · doi:10.1111/tmi.12674 · Cited by 26 · see citing works
“Also, timely treatment may thus be ensured through the intervention for people in greatest need [16].”
BackgroundCreative arts in psychotherapy treatment protocol for children after trauma
van Westrhenen, N., Fritz, E., Oosthuizen, H. B., Lemont, S. E., Vermeer, A., & Kleber, R. J. (2017) · The Arts in Psychotherapy · doi:10.1016/j.aip.2017.04.013 · Cited by 27 · see citing works
Filiatreau, L. M., Ebasone, P. V., Dzudié, A., Ajeh, R. A., Pence, B. W., Wainberg, M. L., Nash, D., Yotebieng, M., Anastos, K., Pefura-Yone, E. W., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.061 · Cited by 33 · see citing works
Behavior Change Apps for Gestational Diabetes Management: Exploring Desirable Features
Kytö, M., Strömberg, L., Tuomonen, H., Ruonala, A., Koivusalo, S. B., & Jacucci, G. (2021) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2021.1987678 · Cited by 16 · see citing works
Zemestani, M., Mohammed, A. F., Ismail, A. A., & Vujanovic, A. A. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.01.009 · Cited by 17 · see citing works
Yoder, H. N. C. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00758 · Cited by 14 · see citing works
The ‘good life’, personal appearance, and mental health of Congolese refugees in Rwanda and Uganda
Robinson, J. E., Chiumento, A., Kasujja, R., Rutayisire, T., & White, R. G. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114641 · Cited by 17 · see citing works
Facing Violence – A Global Challenge
Wenzel, T., Kienzler, H., & Wollmann, A. (2015) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2015.05.008 · Cited by 15 · see citing works
Mutedzi, B., Langhaug, L. F., Hunt, J., Nkhoma, K. B., & Harding, R. (2019) · Pilot and Feasibility Studies · doi:10.1186/s40814-019-0450-5 · Cited by 11 · see citing works
Maercker, A. R. A., & Heim, E. (2016) · Zurich Open Repository and Archive (University of Zurich) · doi:10.5167/uzh-150551 · Cited by 13 · see citing works
Ansiedade e baixo nível motivacional associados ao fracasso na cessação do tabagismo
Pawlina, M. M. C., Rondina, R. D. C., Espinosa, M. M., & Botelho, C. F. (2014) · Jornal Brasileiro de Psiquiatria · doi:10.1590/0047-2085000000014 · Cited by 12 · see citing works
Mental health treatment outcome expectancies in Burundi
Irankunda, P., & Heatherington, L. (2016) · Transcultural Psychiatry · doi:10.1177/1363461516652302 · Cited by 12 · see citing works
Access and use of psychotropic medicines in low-resource settings
Barbui, C. (2015) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796015000268 · Cited by 9 · see citing works
“…of the importance of mental health increases, international organisations face the challenge of providing evidence-based guidance and good practices to assist countries in the provision of mental health care (Barbui et al. 2010; Collins et al. 2011; Dua et al. 2011; Tol et al. 2011, 2014).”
BackgroundSelf-citationDowllah, I. M., & Melville, C. A. (2023) · Journal of Health Psychology · doi:10.1177/13591053231199254 · Cited by 8 · see citing works
“Psychosocial interventions have been proven to be favourable in treating PTSD in previous studies (Bisson and Andrew, 2007; Bisson et al., 2013; Cusack et al., 2016; Kruse et al., 2009; Lewis et al., 2020; Tol et al., 2013, 2014).”
Ostuzzi, G., Barbui, C., Hanlon, C., Chatterjee, S., Eaton, J., Jones, L., Silove, D., & Ventevogel, P. (2017) · BMC Medicine · doi:10.1186/s12916-017-0960-z · Cited by 8 · see citing works
Self-citationAssociation of maternal obesity and neonatal hypoxic ischemic encephalopathy
Khalak, R., & Horgan, M. J. (2019) · Journal of Perinatology · doi:10.1038/s41372-019-0559-7 · Cited by 7 · see citing works
Charak, R., Cano-González, I., Shevlin, M. E., Ben‐Ezra, M., Karatzias, T., & Hyland, P. (2021) · Traumatology An International Journal · doi:10.1037/trm0000311 · Cited by 6 · see citing works
“For example, prior studies based on samples from under-resourced regions suggest a balanced approach with capacity building in terms of specialty care and non-specialist health care workers in community and primary care settings (Thornicroft & Tansella, 2013; Tol et al., 2014).”
BackgroundMethodDisaster psychiatry in Asia: The potential of smartphones, mobile, and connected technologies
Sobowale, K., & Torous, J. B. (2016) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2016.03.004 · Cited by 8 · see citing works
“Yet, there is a dearth of research on interventions for stress, particularly in Asia (Tol et al., 2014).”
BackgroundSettling Ulysses: An Adapted Research Agenda for Refugee Mental Health
Namer, Y., & Razum, O. (2017) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2017.131 · Cited by 7 · see citing works
Ramos, L. D., Guimarães, F. S., Ventriglio, A., de Andrade, A. G., Bhugra, D., Neto, F. L., & Castaldelli-Maia, J. M. (2017) · Academic Psychiatry · doi:10.1007/s40596-017-0682-8 · Cited by 6 · see citing works
“CBTcan be held individually or in groups and often combined with several other exercises, such as writing therapy and stress management (the latter, recommended only for adults) [30, 31].”
BackgroundInfluentialSystematik und Wirksamkeit der Therapiemethoden
Maercker, A. R. A. (2019) · Springer eBooks · doi:10.1007/978-3-662-58470-5_11 · Cited by 4 · see citing works
Fréel, S., Punski‐Hoogervorst, J. L., Hoeboer, C. M., Ruzek, J. I., Beardmore, L., Olff, M., & Javakhishvili, J. D. (2026) · BMJ Global Health · doi:10.1136/bmjgh-2025-022708 · Cited by 6 · see citing works
“37 40 Previous systematic reviews and meta-analyses have typically focused on assessing intervention effective-ness—rather than scope, among either highly specific populations such as women and children, 41 42 refugees and asylum seekers, 43 or following exposure to distinct types of traumatic…”
Muñoz, M. D. L. F. R., Chrzan‐Dętkoś, M., Uka, A., García-López, H. S., Bina, R., & Le, H. (2024) · Archives of Women s Mental Health · doi:10.1007/s00737-024-01537-y · Cited by 5 · see citing works
Cunningham, T., Catallozzi, M., & ROSENTHAL, D. (2018) · Health Emergency and Disaster Nursing · doi:10.24298/hedn.2016-0014 · Cited by 3 · see citing works
“…made to incorporate psychosocial support not only for those who have experienced warfare, displacement, disease or extreme poverty firsthand, but also for those who have witnessed it vicariously by treating those who are suffering (Pearlman and Mac Ian 1995; Tol et al., 2011; Tol et al., 2014).”
BackgroundWomersley, G., & Kloetzer, L. (2018) · Revue européenne de migrations internationales · doi:10.4000/remi.10674 · Cited by 3 · see citing works
Supporting families after the unexpected death of a child
Hunt, K. J., Uhm, S., Finlay, I. G., et al. (2025) · BMJ · doi:10.1136/bmj-2024-082885 · Cited by 3 · see citing works
Los procesos de duelo en atención primaria de salud: Una actualización
Tizón, J. L. (2017) · FMC - Formación Médica Continuada en Atención Primaria · doi:10.1016/j.fmc.2016.02.011 · Cited by 3 · see citing works
Liu, Y., Han, Y., Wang, X., Chen, Y., Mo, Q., Li, L., Wang, Y., Fan, J., Yang, Y., Soondrum, T., et al. (2021) · Quality of Life Research · doi:10.1007/s11136-021-02953-8 · Cited by 2 · see citing works
Carter, S., Sadiq, S., Calear, A. L., Housen, T., Joshy, G., Fredj, N., & Lokuge, K. (2023) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2023.100503 · Cited by 2 · see citing works
Papathanasiou, C., & Kougioumtzi, A. (2024) · Mental Health Science · doi:10.1002/mhs2.86 · Cited by 2 · see citing works
GAMBARAN TINGKAT DEPRESI, KECEMASAN DAN STRESS PADA MAHASISWA JUNIOR KEPERAWATAN DI INDONESIA
Hendra, A., Heryanti, B. R., & Perdani, A. L. (2020) · Jurnal Keperawatan Komprehensif · doi:10.33755/jkk.v6i2.180 · Cited by 2 · see citing works
Medication for Sleep Problems in Posttraumatic Stress Disorder
de Jong, J., & Vermetten, E. H. G. J. M. (2017) · Springer eBooks · doi:10.1007/978-1-4939-7148-0_29 · Cited by 2 · see citing works
Self-citationAizik-Reebs, A., Yuval, K., Hadash, Y., Gebremariam, S. G., & Bernstein, A. (2020) · doi:10.31231/osf.io/jyhwa · Cited by 3 · see citing works
Wars as a Source of Maternal Stress During Pregnancy and Postpartum
Rodríguez-Muñoz, M. F., Chrzan‐Dętkoś, M., Uka, A., & Fellmeth, G. L. (2025) · Springer eBooks · doi:10.1007/978-3-032-09245-8_6 · Cited by 1 · see citing works
Mutedzi, B., Nkhoma, K. B., Langhaug, L. F., Hunt, J. L., & Harding, R. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01313-2 · Cited by 2 · see citing works
The Body as a Vessel for Trauma: The Clinical Case Study of Aisha
Visco‐Comandini, F., Barbieri, A., Mancini, F., & Ciolfi, A. (2025) · Brain Sciences · doi:10.3390/brainsci15010094 · Cited by 1 · see citing works
Systematik und Wirksamkeit der Therapiemethoden
Maercker, A. R. A. (2013) · Springer eBooks · doi:10.1007/978-3-642-35068-9_8 · Cited by 1 · see citing works
Posttraumatic stress disorder — the neuroscientific basis of evidence-based treatments
Jaskiw, G. E. (2017) · Proceedings of the Shevchenko Scientific Society Medical Sciences · doi:10.25040/ntsh2017.02.023 · Cited by 1 · see citing works
“Due to their relatively large effect sizes (~ 1.0), tolerability and favorable side-effect profi le (Cusack et al., 2016) EMDR and TFCBTs have been designated as fi rst line treatments for PTSD, ahead of pharmacological approaches (Tol et al., 2014).”
BackgroundInfluentialEvidence-Based Interventions for Posttraumatic Stress Disorder in Youth
Greca, A. M. L., Tarlow, N., & Danzi, B. A. (2020) · Issues in clinical child psychology · doi:10.1007/978-3-030-44226-2_7
Internet-based treatment of depression and anxiety among migrants and refugees in Sweden
Lindegaard, T. (2022) · Linköping studies in behavioural science · doi:10.3384/9789179291402
Theisen-Womersley, G. (2021) · Springer eBooks · doi:10.1007/978-3-030-67712-1_1
Systematics and Effectiveness of Therapy Methods
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Biyo, A. A. M. (2023) · International Journal of Science and Research (IJSR) · doi:10.21275/sr23815202045
“Internally displaced people (IDPs) often experience increased vulnerability to mental distress, trauma and reduced access to essential mental health services (IOM, 2019 (Tol et al., 2011).”
BackgroundThe Relationship of Psychoemotional Stress with the Development of Age-Related Macular Degeneration
Шустеров, Ю. А., Любченко, М. Ю., Ахмадьярова, Б. С., et al. (2024) · Офтальмология Восточная Европа · doi:10.34883/pi.2024.14.1.016
Psychosoziale Akuthilfe am Beispiel des Kriseninterventionsteams KIT-München
Hoppe, S., Wittekind, C. E., Voß, M., et al. (2025) · Trauma und Gewalt · doi:10.21706/tg-19-3-246
Poulet, E., Guillemet-Senkel, P., Jurek, L., et al. (2025) · Encyclopédie médico-chirurgicale. Psychiatrie · doi:10.1016/s0246-1072(25)44458-7
Activity dynamics in the NPY neuronal signaling of mPFC in response to an air puff
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LARICI, G., Hanzo, F., & Guarnaccia, C. (2026) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2026.100734
- Authors
- Tol, W. A., Barbui, C., Bisson, J., Cohen, J., Hijazi, Z., Jones, L., de Jong, J. T. V. M., Magrini, N., Omigbodun, O., Seedat, S., Silove, D., Souza, R., Sumathipala, A., Vijayakumar, L., Weissbecker, I., Zatzick, D., & van Ommeren, M.
- Affiliations
- Johns Hopkins University (US)
- University of Verona (IT)
- Cardiff University (GB)
- Allegheny General Hospital (US)
- International Medical Corps (US)
- Harvard University (US)
- University of Ibadan (NG)
- Stellenbosch University (ZA)
- UNSW Sydney (AU)
- Universidade de São Paulo (BR)
- Institute for Research and Development (LK)
- Society for Nutrition Education and Health Action (IN)
- University of Washington (US)
- Corresponding author
- Tol, Wietse A.
- ORCID
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-12-16
- Volume
- 11
- Issue
- 12
- Pages
- e1001769
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC4267806
- OpenAlex
- W2139088021
- Semantic Scholar
- 748bbd27e94b1901e06313025fc9376efdcaa167
- Cited by
- 83
- References
- 37
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 10 · 2020: 6 · 2019: 8 · 2018: 4 · 2017: 14 · 2016: 9 · 2015: 6 · 2014: 1 · 2013: 1
- FWCI
- 11.80
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, other-oa)
- Keele Research Repository (Keele University) (submittedVersion, cc-by)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Greater South Information System
- Funders
- World Health Organization
- United Nations High Commissioner for Refugees
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- WHO guidelines, acute stress, post-traumatic stress disorder, bereavement, guideline implementation, low- and middle-income countries, mental health services
- MeSH terms
- Bereavement, Humans, Mental Health, Stress Disorders, Post-Traumatic, Stress, Psychological, World Health Organization, Disease Management
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