Mental Health Consequences of War Conflicts

  • Vsevolod Rozanov
  • Tanja Frančišković
  • Igor Marinić
  • Maria-Magdalena Macarenco
  • Marina Letica-Crepulja
  • Lana Mužinić
  • Ruwan Jayatunge
  • Merike Sisask
  • Jan Vevera
  • Brenda Wiederhold
  • Mark Wiederhold
  • Ian Miller
  • Georgios Pagkalos


Modern war conflicts, evolutionizing from large-scale collisions of armed forces to local, low-intensity, surrogate, terroristic and information wars, are associated with less direct mortality but with growing and long-lasting mental health consequences. These consequences can be traced in not only combatants and other military contingents and veterans but even to greater extent in the civilian populations, given that many modern war conflicts have signs of civil wars or religious conflicts. While active duty military undergo preliminary selection and resilience training, civilians in the war zone or as refugees and asylum-seeking victims are even at higher risk with the greater probability of transgenerational transmission, which implies long-lasting (decades) effects. Both military and civilians suffer from a similar set of disorders and psychological consequences caused by extreme trauma, including PTSD, depression, anxiety, addictions, somatization with chronic pain, dissociation, psychosocial dysfunctions, suicidal behavior, etc. War conflicts, terroristic acts, and information wars, amplified by technologically developing mass media, the internet and social networks, seem to add to a general feeling of instability and promote more anxiety, covering even wider contingents worldwide. Military psychiatry has accumulated knowledge and practical experience that, though not always can be applied directly, are useful for identification, management, prevention, and treatment of mental health consequences of war in wider contingents. This knowledge is a one more relevant and strong reason for advocating lowering of international tension and reducing the probability of war conflicts worldwide for the sake of preserving mental health of the humanity. It also has a potential of lowering the burden of this type of diseases worldwide.


War conflicts Modern evolution of wars Mental health consequences Combatants War veterans Civilians Refugees Information wars Population in general 


  1. 1.
    Ellard J. Principles of military psychiatry. ADF Health. 2000;1:81–4.Google Scholar
  2. 2.
    Litvintsev SV, Shamrey VK, editors. Voennaya Psychiatriya (military psychiatry). Saint-Petersburg: VMA, ELBI-SPb; 2001.Google Scholar
  3. 3.
    Roberts NP, Kitchiner NJ, Kenardy J, et al. Early psychological intervention to treat post-traumatic stress disorder. Cochrane Database Syst Rev. 2010;3:CD007944.Google Scholar
  4. 4.
    Ursano RJ, Holloway HC. Military psychiatry. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. 4th ed. Baltimore: Williams and Wilkins; 1985. p. 1902–5.Google Scholar
  5. 5.
    Vermetten E, Greenberg N, Boeschoten MA. Deployment-related mental health support: comparative analysis of NATO and allied ISAF partners. Eur J Psychotraumatol. 2014;5:23732.CrossRefGoogle Scholar
  6. 6.
    Iversen AC, Greenberg N. Mental health of regular and reserve military veterans. Adv Psychiatr Treat. 2009;15:100–6.CrossRefGoogle Scholar
  7. 7.
    Lopez-Ibor JJ, Christodoulou G, Maj M, et al. Disasters and mental health. Chichester: Wiley; 2005.Google Scholar
  8. 8.
    United Nations Chidlen’s Fund (UNICEF). The state of the world’s chidren – childhood under threat. New York: UNICEF; 2005.Google Scholar
  9. 9.
    Calderoni ME, Alderman EM, Silver EJ, et al. The mental health impact of 9/11 on inner-city high school students 20 miles north of ground zero. J Adolesc Health. 2006;39:57–65.PubMedCrossRefGoogle Scholar
  10. 10.
    Wahlström L, Michélsen H, Schulman A, et al. Different types of exposure to the 2004 tsunami are associated with different levels of psychological distress and posttraumatic stress. J Trauma Stress. 2008;21:463–70.PubMedCrossRefGoogle Scholar
  11. 11.
    Summerfield D. War and mental health: a brief overview. BMJ. 2000;321:232–5.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Battesti M. Nostalgia in the Army. Front Neurol Neurosci. 2016;38:132–42.PubMedCrossRefGoogle Scholar
  13. 13.
    Jones FD. Psychiatric lessons of war. In: Jones FD, Sparacino LR, Wilcox VL, et al., editors. Textbook of military medicine. Falls Church: Office of The Surgeon General U.S. Department of the Army; 1995. p. 1–33.Google Scholar
  14. 14.
    Wooley CF. The irritable heart of soldiers and the origins of Anglo-American cardiology: the U. S. Civil War (1861) to World War I (1918). Burlington: Ashgate; 2002.Google Scholar
  15. 15.
    Binneveld H. From shell shock to combat stress: a comparative history of military psychiatry. Amsterdam: Amsterdam University Press; 1998.Google Scholar
  16. 16.
    Gilbert M. First world war: a complete history. New York: Henry Holt and Company, LLC; 1994.Google Scholar
  17. 17.
    Helmus TC, Glenn RW. Steeling the mind: combat stress reactions and their implications for urban warfare. Santa Monica: Rand Arroyo Center; 2004.Google Scholar
  18. 18.
    Department of Veterans Affairs, Department of Defense. Clinical practice guideline: management of post-traumatic stress, version 2.0. Washington, DC: US Department of Veterans Affairs; 2010.Google Scholar
  19. 19.
    USMC and U.S. Navy (USN). Combat and operational stress control. MCRP 6-11C/NTTP 1-15M. Washington, DC: Department of the Navy, Headquarters, USMC; 2010.Google Scholar
  20. 20.
    US Department of the Army. Leaders’ manual for combat stress control. Washington, DC: Field Manual. DA; 1994a. p. 22–51.Google Scholar
  21. 21.
    US Department of the Army. Combat stress control in a theater of operations-tactics, techniques, procedures. Washington, DC: Field Manual. DA; 1994b. p. 8–51.Google Scholar
  22. 22.
    McFarlane AC. One hundred years of lessons about the impact of war on mental health; two steps forward, one step back. Australas Psychiatry. 2015;23:392–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Shamrey VK, editor. Psychiatriya Voyn I Katastroph (Psychiatry of Wars and Katastrophs). Saint Petersburg: SpetsLit; 2015.Google Scholar
  24. 24.
    Turner MA, Kiernan MD, McKechanie AG, et al. Acute military psychiatric casualties from the war in Iraq. Br J Psychiatry. 2005;186:476–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Jones N, Fear NT, Wessely S, et al. Forward psychiatry – early intervention for mental health problems among UK armed forces in Afghanistan. Eur Psychiatry. 2017;39:66–72.PubMedCrossRefGoogle Scholar
  26. 26.
    Vevera J. Traumа coping mechanisms and psychological distress among military personnel deployed in Afghanistan. Ceska Slov Psychiatr. 2012;108(suppl.1):11.Google Scholar
  27. 27.
    Jones E, Thomas A, Ironside S. Shell shock: an outcome study of a first world war ‘PIE’ unit. Psychol Med. 2007;37:215–23.PubMedCrossRefGoogle Scholar
  28. 28.
    Grinker R, Spiegel J. Brief psychotherapy in war neuroses. Psychosom Med. 1944;6:123–31.CrossRefGoogle Scholar
  29. 29.
    Shephard B. A war of nerves: soldiers and psychiatrists 1914–1994. London: Jonathan Cape Publishers; 2002.Google Scholar
  30. 30.
    Department of Defense. DoD instruction 4690.05: maintenace of psychological health in military operations. Washington, DC: Department of Defense; 2011.Google Scholar
  31. 31.
    Hobfoll SE, Watson P, Bell CC, et al. Five essential elements of immediate and mid-term mass trauma intervention: empirical evidence. Psychiatry. 2007;70:283.PubMedCrossRefGoogle Scholar
  32. 32.
    US Department of the Army. Combat stress: field manual 6–22.5. Washington, DC: Department of Defense; 2000.Google Scholar
  33. 33.
    Mitchell JT. When disaster strikes: the critical incident stress debriefing process. JEMS. 1983;8:36–9.PubMedGoogle Scholar
  34. 34.
    Everly GS, Mitchell JT. Critical incident stress management: a new era and standard of care in crisis intervention. 2nd ed. Ellicott City: Chevron; 1999.Google Scholar
  35. 35.
    Van Emmerik AA, Kamphuis JH, Hulsbosch AM. Single session debriefing after psychological trauma: a meta-analysis. Lancet. 2002;360:766–71.PubMedCrossRefGoogle Scholar
  36. 36.
    Wessely S. Risk, psychiatry and the military. Br J Psychiatry. 2005;186:459–66.PubMedCrossRefGoogle Scholar
  37. 37.
    Davydow DS, Gifford JM, Desai SV, et al. Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry. 2008;30:421–34.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Gelpin E, Bonne O, Peri T, Brandes D, et al. Treatment of recent trauma survivors with benzodiazepines: a prospective study. J Clin Psychiatry. 1996;57:390–4.PubMedGoogle Scholar
  39. 39.
    Mellman TA, Bustamante V, David D, et al. Hypnotic medication in the aftermath of trauma. J Clin Psychiatry. 2002;63:1183–4.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Solomon Z, Shlar R, Mikulincer M. Frontline treatment of combat stress reaction: a 20-year longitudinal evaluation study. Am J Psychiatr. 2005;162:2309–14.PubMedCrossRefGoogle Scholar
  41. 41.
    Gates MA, Holowka DW, Vasterling JJ, et al. Posttraumatic stress disorder in veterans and military personnel: epidemiology, screening, and case recognition. Psychol Serv. 2012;9:361–82.PubMedCrossRefGoogle Scholar
  42. 42.
    Richardson LK, Frueh BC, Acierno R. Prevalence estimates of combat-related post-traumatic stress disorder: critical review. Aust N Z J Psychiatry. 2010;44:4–19.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Tarabrina NV. Psychologiya posttravmaticheskogo stressa (psychology of post-traumatic stress). Moscow: Institute of Psychology of the Russian Academy of Sciences Publishers; 2007.Google Scholar
  44. 44.
    Jayatunge RM. Shell shock to Palali syndrome. PTSD Sri Lankan experience. Colombo: Sarasavi Publishers; 2014.Google Scholar
  45. 45.
    Post-Traumatic Stress Disorder. National Institute of Mental Health. February 2016. Retrieved Oct 2016.Google Scholar
  46. 46.
    World Health Organization. ICD-10: International statistical classification of diseases and related health problems. 10th revis. Geneva; 2005.Google Scholar
  47. 47.
    Jayatunge RM. EMDR Sri Lankan Experience. Colombo: Sarasavi Publishers; 2008.Google Scholar
  48. 48.
    Herman JL. Trauma and recovery. New York: Basic Books; 1992.Google Scholar
  49. 49.
    Boscarino JA. Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies. Ann N Y Acad Sci. 2004;1032:141–53.PubMedCrossRefGoogle Scholar
  50. 50.
    Dohrenwend B, Turner J, Turse N, et al. The psychological risks of Vietnam for U.S. veterans: a revisit with new data and methods. Science. 2006;313:979–82.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Flory JD, Yehuda R. Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations. Dialogues Clin Neurosci. 2015;17(2):141–50.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Kessler R, Sonnega A, Bromet E, et al. Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry. 1995;52:1048–60.PubMedCrossRefGoogle Scholar
  53. 53.
    Levine A, Levine L, Levine T. Posttraumatic stress disorder and cardiometabolic disease. Cardiology. 2014;127:1–19.PubMedCrossRefGoogle Scholar
  54. 54.
    McFarlane AC. The long-term costs of traumatic stress: intertwined physical and psychological consequences. World Psychiatry. 2010;9:3–10.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Rytwinski N, Scur M, Feeny N, et al. The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: a meta-analysis. J Trauma Stress. 2013;26:299–309.PubMedCrossRefGoogle Scholar
  56. 56.
    Shalev A. Posttraumatic stress disorder and stress-related disorders. Psychiatr Clin North Am. 2009;32:687–704.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    Schmidt U, Kaltwasser SF, Wotjak CT. Biomarkers in posttraumatic stress disorder: overview and implications for future research. Dis Markers. 2013;35:43–54.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Van der Kolk BA. Psychobiology of posttraumatic stress disorder. In: Panksepp J, editor. Textbook of biological psychiatry. Hoboken: Wiley-Liss; 2004.Google Scholar
  59. 59.
    Bryant RA. Early predictors of posttraumatic stress disorder. Biol Psychiatry. 2003;53:789–95.PubMedCrossRefGoogle Scholar
  60. 60.
    Van Minnen A, Zoellner L, Harned MS, et al. Changes in comorbid conditions after prolonged exposure for PTSD: a literature review. Curr Psychiatry Rep. 2015;17:549.PubMedGoogle Scholar
  61. 61.
    Allen JP, Crawford EF, Kudler H. Nature and treatment of comorbid alcohol problems and post traumatic stress disorder among American military personnel and veterans. Alcohol Res Curr Rev. 2016;38:133–40.Google Scholar
  62. 62.
    McCauley J, Kileen T, Gros D, et al. Posttraumatic stress disorder and co-occurring substance use disorders: advances in assessment and treatment. Clin Psychol (New York). 2012;19(3): 283–304.Google Scholar
  63. 63.
    Back SE, Brady KT, Sonne SC, et al. Symptom improvement in co-occurring PTSD and alcohol dependence. J Nerv Ment Dis. 2006;194:690–6.PubMedCrossRefGoogle Scholar
  64. 64.
    Jacobsen L, Southwick S, Kosten T. Substance use disorders in patients with posttraumatic stress disorder: a review of the literature. Am J Psychiatry. 2001;158:1184–90.PubMedCrossRefGoogle Scholar
  65. 65.
    Ouimette P, Read J, Wade M, et al. Modeling associations between posttraumatic stress symptoms and substance use. Addict Behav. 2010;35:64–7.PubMedCrossRefGoogle Scholar
  66. 66.
    Afari N, Ahumada S, Wright L, et al. Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis. Psychosom Med. 2014;76(1):2–11.PubMedCrossRefGoogle Scholar
  67. 67.
    Boscarino JA. A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention. Psychosom Med. 2008;70(6):668–76.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Boyko E, Jacobson I, Smith B, et al. Risk of diabetes in U.S. military service members in relation to combat deployment and mental health. Diabetes Care. 2010;33(8):1771–7.PubMedPubMedCentralCrossRefGoogle Scholar
  69. 69.
    Cohen BE, Edmondson D, Kronish IM. State of the art review: depression, stress, anxiety, and cardiovascular disease. Am J Hypertens. 2015;28:1295–302.PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    Jakovljevic M, Babic D, Crncevic Z. Metabolic syndrome and depression in war veterans with post-traumatic stress disorder. Psychiatr Danub. 2008;20:406–10.PubMedGoogle Scholar
  71. 71.
    De Assis M, de Mello M, Scorza F, et al. Evaluation of physical activity habits in patients with posttraumatic stress disorder. Clinics (Sao Paulo). 2008;63:473–8.CrossRefGoogle Scholar
  72. 72.
    Chwastiak LA, Rosenheck RA, Kazis LE. Association of psychiatric illness and obesity, physical inactivity, and smoking among a national sample of veterans. Psychosomatics. 2011;52:230–6.PubMedPubMedCentralCrossRefGoogle Scholar
  73. 73.
    Bagley SC, Munjas B, Shekelle P. A systematic review of suicide prevention programs for military or veterans. Suicide Life Threat Behav. 2010;40:257–65.PubMedCrossRefGoogle Scholar
  74. 74.
    Bruce ML. Suicide risk and prevention in veteran populations. Ann N Y Acad Sci. 2010;1208:98–103.PubMedCrossRefGoogle Scholar
  75. 75.
    Nock MK, Stein MB, Heeringa SG, et al. Prevalence and correlates of suicidal behavior among soldiers: results from the Army study to sssess risk and resilience in servicemembers (Army STARRS). JAMA Psychiat. 2014;71:514–22.CrossRefGoogle Scholar
  76. 76.
    Pietrzak RH, Goldstein MB, Malley JC, et al. Risk and protective factors associated with suicidal ideation in veterans of operations enduring freedom and Iraqi freedom. J Affect Disord. 2010;123:102–7.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Fuehrlein BS, Mota N, Arias AJ, et al. The burden of alcohol use disorders in US military veterans: results from the National Health and Resilience in Veterans Study. Addiction. 2016;111:1786–94.PubMedCrossRefGoogle Scholar
  78. 78.
    Maguen S, Madden E, Cohen BE, et al. Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care. J Psychiatr Res. 2015;68:120–4.PubMedCrossRefGoogle Scholar
  79. 79.
    Rozanov VA, Carli V. Suicide among war veterans. Int J Environ Res Public Health. 2012;9:2504–19.PubMedPubMedCentralCrossRefGoogle Scholar
  80. 80.
    NATO, Science and Technology Organization, Research Task Group 218. Military suicide prevention: report prepared for NATO leadership (STO-TR-HFM-218). Geneva: STO/NATO; 2016.Google Scholar
  81. 81.
    Nock MK, Deming CA, Fullerton CS, et al. Suicide among soldiers: a review of psychosocial risk and protective factors. Psychiatry. 2013;76:97–125.PubMedPubMedCentralCrossRefGoogle Scholar
  82. 82.
    Kang HK, Bullman TA, Smolenski DJ, et al. Suicide risk among 1.3 million veterans who were on active duty during the Iraq and Afghanistan wars. Ann Epidemiol. 2015;25:96–100.PubMedCrossRefGoogle Scholar
  83. 83.
    Zøllner L, Jørgensen HO. Risk and protective factors influencing suicidal ideation and suicidal behaviour among Danish veterans. Odense: Center for Suicide Research; 2012.Google Scholar
  84. 84.
    Ejdesgaard BA, Zøllner L, Jensen BF, et al. Risk and protective factors for suicidal ideation and suicide attempts among deployed Danish soldiers from 1990 to 2009. Mil Med. 2015;180:61–7.PubMedCrossRefGoogle Scholar
  85. 85.
    Bryan AO, Theriault JL, Bryan CJ. Self-forgiveness, posttraumatic stress, and suicide attempts among military personnel and veterans. Traumatology. 2015;21:40–6.CrossRefGoogle Scholar
  86. 86.
    Kopacz MS. The spiritual health of veterans with a history of suicide ideation. Health Psychol Behav Med. 2014;2:349–58.PubMedPubMedCentralCrossRefGoogle Scholar
  87. 87.
    Thoresen S, Mehlum L, Røysamb E, et al. Risk factors for completed suicide in veterans of peacekeeping: repatriation, negative life events, and marital status. Arch Suicide Res. 2006;10:353–63.PubMedCrossRefGoogle Scholar
  88. 88.
    Greden JF, Valenstein M, Spinner J, et al. Buddy-to-buddy, a citizen soldier peer support program to counteract stigma, PTSD, depression, and suicide. Ann N Y Acad Sci. 2010;1208:90–7.PubMedCrossRefGoogle Scholar
  89. 89.
    Anestis MD, Bryan CJ, Cornette MM, Joiner TE. Understanding suicidal behavior in the military: an evaluation of joiner’s interpersonal-psychological theory of suicidal behavior in two case studies of active duty post-deployers. J Ment Health Couns. 2009;31:60–75.CrossRefGoogle Scholar
  90. 90.
    Joiner T. Why people die by suicide. Cambridge: Harvard University Press; 2005.Google Scholar
  91. 91.
    Brenner LA, Gutierrez PM, Cornette MM, et al. A qualitative study of potential suicide risk factors in returning combat veterans. J Ment Health Couns. 2008;30:211–25.CrossRefGoogle Scholar
  92. 92.
    Bryan CJ, Morrow CE, Anestis MD, et al. A preliminary test of the interpersonal-psychological theory of suicidal behavior in a military sample. Personal Individ Differ. 2010;48:347–50.CrossRefGoogle Scholar
  93. 93.
    Coleman P. Flashback. Posttraumatic stress disorder, suicide, and the lessons of war. Boston: Beacon Press; 2006.Google Scholar
  94. 94.
    Pols H, Oak S. War and military mental health. The US psychiatric response in the 20th century. Am J Public Health. 2007;97:2132–42.PubMedPubMedCentralCrossRefGoogle Scholar
  95. 95.
    Hyams KC. Mental health screening before troop deployment: is not supported by current evidence. BMJ. 2006;333:979–80.PubMedPubMedCentralCrossRefGoogle Scholar
  96. 96.
    Rona RJ, Hooper R, Jones M, et al. Mental health screening in armed forces before the Iraq war and prevention of subsequent psychological morbidity: follow-up study. BMJ. 2006;333:991.PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    Jones E, Hyams KC, Wessely S. Screening for vulnerability to psychological disorders in the military: an historical survey. J Med Screen. 2003;10:40–6.PubMedCrossRefGoogle Scholar
  98. 98.
    Prisacaru A, Macarenco M. Psychological support for the Romanian combat troops before, during and after deployment. In: Coping with posttraumatic stress disorder in returning troops, vol. 68. Brussels: IOS Press; 2010. p. 157–65.Google Scholar
  99. 99.
    Slop H. Military psychology at the Austrian international peace support command. IAMPS 2001 Proceedings, Prague; 2001. p. 98–102.Google Scholar
  100. 100.
    Fraley RC, Fazzari DA, Bonanno GA, et al. Attachment and psychological adaptation in high exposure survivors of the September 11th attack on the World Trade Center. Personal Soc Psychol Bull. 2006;32:538–51.CrossRefGoogle Scholar
  101. 101.
    Scarpa A, Haden SC, Hurley J. Community violence victimization and symptoms of posttraumatic stress disorder: the moderating effects of coping and social support. J Interpers Violence. 2006;21:446–69.PubMedCrossRefGoogle Scholar
  102. 102.
    Stovall-McClough KC, Cloitre M. Unresolved attachment, PTSD, and dissociation in women with childhood abuse histories. J Consult Clin Psychol. 2006;74:219–28.PubMedCrossRefGoogle Scholar
  103. 103.
    Koopman C, Drescher K, Bowles S, et al. Acute dissociative reactions in veterans with PTSD. J Trauma Dissociation. 2001;2:91–111.CrossRefGoogle Scholar
  104. 104.
    Brewin C, Andrews B, Valentine J. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68:748–66.PubMedCrossRefGoogle Scholar
  105. 105.
    Bonanno GA. Loss, trauma and human resilience – how we underestimate the human capacity to thrive after extremely aversive events? Am Psychol. 2004;59:20–8.PubMedCrossRefGoogle Scholar
  106. 106.
    Meichenbaum D. Cognitive-behavior modification: an integrative approach. New York: Plenum Press; 1977.CrossRefGoogle Scholar
  107. 107.
    Meichenbaum D. Stress inoculation training: a preventative and treatment approach. In: Lehrer PM, Woolfolk RL, Sime WS, editors. Principles and practice of stress management. 3rd ed. New York: Guilford Press; 2007.Google Scholar
  108. 108.
    Druckman D, Swets JA, editors. Enhancing human performance: issues, theories, and techniques. Washington, DC: National Academies Press; 1988.Google Scholar
  109. 109.
    Wiederhold B, Wiederhold M. Virtual reality for posttraumatic stress disorder and stress inoculation training. J Cyber Ther Rehabil. 2008;1:23–35.Google Scholar
  110. 110.
    Wiederhold BK, Bullinger AH, Wiederhold MD. Advanced technologies in military medicine. NATO security through science series E human and societal. Dynamics. 2006;6:148.Google Scholar
  111. 111.
    Wiederhold MD, Wiederhold BK. Using advanced prosthetics for stress inoculation training and to teach life saving skills. San Diego: Virtual Reality Medical Center; 2010.Google Scholar
  112. 112.
    Harvey A, Bryant R. The relationship between acute stress disorder and posttraumatic stress disorder: a 2 year prospective evaluation. J Consult Clin Psychol. 1999;67:985–8.PubMedCrossRefGoogle Scholar
  113. 113.
    Bryant RA. Acute stress disorder as a predictor of posttraumatic stress disorder: a systematic review. J Clin Psychiatry. 2011;72:233–9.PubMedCrossRefGoogle Scholar
  114. 114.
    Briere J, Scott C. Principles of trauma therapy: a guide to symptoms, evaluation and treatment. London, New Delhi: Sage Publication, Inc.; 2006.Google Scholar
  115. 115.
    Gore-Felton C, Gil M, Koopman C, et al. A review of acute stress reactions among victims of violence: implications for early intervention. Aggress Violent Behav. 1999;4:293–306.CrossRefGoogle Scholar
  116. 116.
    Jarero I, Artigas L, Luber M. The EMDR protocol for recent critical incidents: application in a disaster mental health continuum of care context. J EMDR Pract Res. 2011;5:82–94.CrossRefGoogle Scholar
  117. 117.
    Jarero I, Uribe S. The EMDR protocol for recent critical incidents: brief report of an application in a human massacre situation. J EMDR Pract Res. 2011;5:156–65.CrossRefGoogle Scholar
  118. 118.
    Southwick SM, Charney DS. The science of resilience: implications for the prevention and treatment of depression. Science. 2012;338:79–82.PubMedCrossRefGoogle Scholar
  119. 119.
    Ugaide A, Richards PL, Zwi A. Health consequences of war and political violence. Encyclopedia of violence, peace and. Conflict. 1999;2:103–21.Google Scholar
  120. 120.
    Murthy RS, Lakshminarayana R. Mental health consequences of war: a brief review of research findings. World Psychiatry. 2006;5:25–30.PubMedPubMedCentralGoogle Scholar
  121. 121.
    Somasundaram DJ, Sivayokan S. War trauma in a civilian population. Br J Psychiatry. 1994;165:524–7.PubMedCrossRefGoogle Scholar
  122. 122.
    Feldman R, Vengrober A. Posttraumatic stress disorder in infants and young children exposed to war-related trauma. J Am Acad Child Adolesc Psychiatry. 2011;50:645–58.PubMedCrossRefGoogle Scholar
  123. 123.
    UNHCR. Global trends report: UNHCR; 2014.Google Scholar
  124. 124.
    Bogic M, Njoku A, Priebe S. Long-term mental health of war-refugees: a systematic literature review. BMC Int Health Hum Rights. 2015;15:29.PubMedPubMedCentralCrossRefGoogle Scholar
  125. 125.
    Priebe S, Jankovic Gavrilovic J, Bremner S et al (2013) Psyhological symptoms as long-term consequences of war experiences. Psychopathology 46:45–54.PubMedCrossRefGoogle Scholar
  126. 126.
    Lecic-Tosevski D, Pejuskovic B, Miladinovic T, et al. Posttraumatic stress disorder in a Serbian community: seven years after trauma exposure. J Nerv Ment Dis. 2013;201:1040–4.PubMedCrossRefGoogle Scholar
  127. 127.
    Lindert J. Violence exposure and mental health states. In: Lindert J, Levav I, editors. Violence and mental health. Its manifold faces. Dordrecht: Springer; 2015. p. 47–74.Google Scholar
  128. 128.
    Steel Z, Chey T, Silove D, et al. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302:537–49.PubMedCrossRefGoogle Scholar
  129. 129.
    Havari E, Peracchi F. Growing up in wartime: evidence from the era of two world wars. Econ Hum Biol. 2016;25:9–32. pii: S1570-677X(16)30122-8. [Epub ahead of print]PubMedCrossRefGoogle Scholar
  130. 130.
    Devakumar D, Birch M, Osrin D, et al. The intergenerational effects of war on the health of children. BMC Med. 2014;12:57.PubMedPubMedCentralCrossRefGoogle Scholar
  131. 131.
    Vaiserman AM. Epigenetic programming by early life stress: evidence from human populations. Dev Dyn. 2015;244:254–65.PubMedCrossRefGoogle Scholar
  132. 132.
    Nagdy M, Roser M. Terrorism. Published online at 2016. Retrieved from:[Online Resource].
  133. 133.
    Silver RC, Holman EA, Andersen JP, et al. Metnal- and physical-health effects of acute exposure to media images of the September 11, 2001 attacks and the Iraq War. Psychol Sci 24:1623–1634.PubMedCrossRefGoogle Scholar
  134. 133.
    Neria Y, Sullivan GM. Understanding the mental health effects of indirect mass trauma exposure through the media. JAMA. 2014;306:1374–5.CrossRefGoogle Scholar
  135. 134.
    Atkin AJ, Sharp SJ, Corder K, et al. Prevalence and correlates of screen time in youth: an international perspective. Am J Prev Med. 2014;47:803–7.PubMedCrossRefGoogle Scholar
  136. 135.
    Dempsey PC, Howard BJ, Lynch BM, et al. Associations of television viewing time with adults’ well-being and vitality. Prev Med. 2014;69:69–74.PubMedCrossRefGoogle Scholar
  137. 136.
    Pfefferbaum B, Newman E, Nelson SD, et al. Disaster media coverage and psychological outcomes: descriptive findings in the extant research. Curr Psychiatry Rep. 2014;16:464.PubMedPubMedCentralCrossRefGoogle Scholar
  138. 137.
    Pfefferbaum B, Jacobs AK, Houston JB, et al. Children’s disaster reactions: the influence of family and social factors. Curr Psychiatry Rep. 2015;17:57.PubMedCrossRefGoogle Scholar
  139. 138.
    Lowe SR, Galea S. The mental health consequences of mass shootings. Trauma Violence Abuse. 2015;18(1):62–82.PubMedCrossRefGoogle Scholar
  140. 139.
    Holman EA, Garfin DR, Silver RC. Media’s role in broadcasting acute stress following the Boston Marathon bombings. Proc Natl Acad Sci U S A. 2014;111:93–8.PubMedCrossRefGoogle Scholar
  141. 140.
    Cacioppo JT. Beyond bipolar conceptualizations and measures: the case of attitudes and evaluative space. Pers Soc Psychol Rev. 1997;1:3–25.PubMedCrossRefGoogle Scholar
  142. 141.
    Kramer AD, Guillory JE, Hancock JT. Experimental evidence of massive-scale emotional contagion through social networks. PNAS. 2014;111:8788–90.PubMedCrossRefGoogle Scholar
  143. 142.
    Libicky M. What is information warfare? Washington: National Defense University; 1995.CrossRefGoogle Scholar
  144. 143.
    Cronin B, Crawford H. Information warfare: its application in military and civilian contexts. Inf Soc. 1999;15:257–63.CrossRefGoogle Scholar
  145. 144.
    Fisun AY, Shamrey VK, Goncharenko AY, et al. Psychology and psychopathology on information warfare. Voen Med Zh (Military-Med J). 2014;6:4–12.Google Scholar
  146. 145.
    Murray CJL, King G, Lopez AD, et al. Armed conflict as a public health problem. BMJ. 2002;324:346–9.PubMedPubMedCentralCrossRefGoogle Scholar
  147. 146.
    Back SE, Killeen TK, Teer AP, et al. Substance use disorders and PTSD: an exploratory study of treatment preferences among military veterans. Addict Behav. 2014;39:369–73.PubMedCrossRefGoogle Scholar
  148. 147.
    Miller M, Barber C, Azrael D, et al. Suicide among US veterans: a prospective study of 500,000 middle-aged and elderly men. Am J Epidemiol. 2009;170:494–500.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Vsevolod Rozanov
    • 1
  • Tanja Frančišković
    • 2
    • 3
  • Igor Marinić
    • 4
  • Maria-Magdalena Macarenco
    • 5
  • Marina Letica-Crepulja
    • 2
    • 3
  • Lana Mužinić
    • 4
  • Ruwan Jayatunge
    • 6
  • Merike Sisask
    • 7
    • 8
  • Jan Vevera
    • 9
    • 10
  • Brenda Wiederhold
    • 11
    • 12
  • Mark Wiederhold
    • 11
  • Ian Miller
    • 13
  • Georgios Pagkalos
    • 14
  1. 1.Odessa National Mechnikov UniversityOdessaUkraine
  2. 2.Department for Psychiatry and Psychological MedicineUniversity of Rijeka School of MedicineRijekaCroatia
  3. 3.Regional Psychotrauma Centre Rijeka and Department of PsychiatryClinical Hospital Centre RijekaRijekaCroatia
  4. 4.Department of PsychiatryUniversity Hospital DubravaZagrebCroatia
  5. 5.Military and Clinical Psychologist, 348th BattalionConstantaRomania
  6. 6.Mental Health TherapistBramptonCanada
  7. 7.School of Governance, Law and Society, Tallinn UniversityTallinnEstonia
  8. 8.Estonian-Swedish Mental Health and Suicidology InstituteTallinnEstonia
  9. 9.The 7th Field Military HospitalPragueCzech Republic
  10. 10.Department of PsychiatryCharles University, Faculty of Medicine in PilsenPilsenCzech Republic
  11. 11.Virtual Reality Medical CenterSan DiegoUSA
  12. 12.Virtual Reality Medical InstituteBrusselsBelgium
  13. 13.Interactive Media InstituteSan DiegoUSA
  14. 14.424 Military Hospital of ThessalonikiThessalonikiGreece

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