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Cited by 29Posttraumatic Stress Disorder ResearchChild Abuse and TraumaMigration, Health and Trauma

“Hidden” and diverse long-term impacts of exposure to war and violence

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Drožđek, Boris, Rodenburg, Jan, Moyene-Jansen, Agnes·2020·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2019.00975PMC PMC6978278
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Abstract

Nowadays, the PTSD diagnosis is often a prerequisite for the survivor's access to specialized treatment services and for obtaining legal recognition or financial compensation when exposed to violence. However, some survivors do not meet all necessary criteria for the PTSD diagnosis, particularly not in the long term. Therefore, they run the risk of being misdiagnosed, inadequately helped or undertreated, and may remain legally unrecognized and unprotected. In this article the "hidden" long-term impacts of exposure to war and violence, beyond the PTSD diagnosis, are presented, discussed, and illustrated with case presentations. They include dissociative states, attachment problems, personality changes, guilt, shame, rage, identity issues, moral injury, substances abuse, damaged core beliefs, and bodily sensations linked to stress activation. These phenomena are not persistent, but fluctuate over the survivor's life trajectories. Moreover, the "hidden" impacts are framed within theoretical models for understanding long-term impacts of exposure to violence. The models help us grasp the dynamics of interactions between resilience, psychological damage, context and time. These interactions are non linear, and contingently result in development of psychopathological phenomena when reaching a threshold during a process of accumulating potentially traumatic experiences over a survivors' lifetime. Understanding psychological impacts of exposure to violence as a spectrum of interchangeable phenomena over a lifetime, and learning to recognize the "hidden" manifestations of psychological trauma will help to improve mental and legal assistance to the survivors both on a short and long term.

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  • Fromm classified malignant (destructive) aggression into three main types: sadistic aggression, narcissistic (or collective narcissistic) aggression, and necrophilic aggression.

    “In his exploration of human aggression and destructiveness, Fromm classified malignant (destructive) aggression into three main types: sadistic aggression, narcissistic (or collective narcissistic) aggression, and necrophilic aggression.”

    From Toward a humanized technology: a reinterpretation of Erich Fromm’ s humanistic peace psychology (2026) · cites this paper as Drožđek et al., 2020

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Cited by

Sorted by citations

Authors
Drožđek, B., Rodenburg, J., & Moyene-Jansen, A.
Affiliations
Parnassia Groep (NL)
Corresponding author
Drožđek, Boris
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2020-01-17
Volume
10
Pages
975-975
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2019.00975
PMC
PMC6978278
OpenAlex
W3000050444
Cited by
29
References
7
Citations by year
2026: 11 · 2025: 5 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 3 · 2020: 3
FWCI
1.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
war trauma, violence exposure, long-term psychological effects, hidden trauma, PTSD diagnosis, dissociation, attachment problems, guilt and shame, RAGE, identity problems, moral injury, substance abuse, core beliefs, resilience, cumulative trauma, trauma recognition, war survivors

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