The effects of war on public mental health

There is no doubt that people can get affected emotionally and psychologically as aresult of exposure to war and conflicted situation.

The DSM-5 criteria for Trauma and Stress Disorder is as follw:

A. Exposure to actual or threatened death, serious injury or sexual vilation in one or more of the following ways:

1. Directly experiencing the traumatic event(s).

2. Wittnessing, in person, the event(s) as it occured to others.

3. Learning that the event(s) occurred to a close family member or close friend. Note: In cases of actual or threatened death of mamily member or friend, the event(s) have been violent or accidental.

4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains, police officers repeatedly exposed to details of child abuse).

B. Presence of nine or more of the following symptoms from any of the five categories of intrusion, negative mood, dissociation, avoidence, and arousal, begining or worsening after traumatic event(s) occurred:

Intrusion Symptoms

1. Recurrent, involuntary, and intrussive distressing memories of the traumatic event(s). Note: In children, repetitive play may occur in which themes or aspects of the traumatic event(s)occurred.

2. Recurrent distressing dreams in which the content and/or effect of dream are related to the event(s). In children, there may be frightening dreams without recognizable content.

3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. 

4. Intense or prolonged psychological distress or marked physiological reaction in response to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

Negative mood

5. Persistant inability to experience positive emotions )e.g, inability to experience happiness, satisfaction, or loving feelings).

Dissociative Symptoms

6. An altered sense of the reality of one's surroundings or oneself (e.g., seeing oneself from other's perspective, being in a daze, time solving).

7. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).

8. Effects to avoid distressing memorries, thoughts, or feelings about or closely associated with the traumatic event(s).

9. Efforts to avoid external reminders (people, places, coversation, activities, objects, situations) that arouse distressing memorries, thoughts, or feelings about or closely associated with the traumatic event(s).

10. Sleep disturbance (e.g., difficulty falling or staying asleep, restless sleep).

11. Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects.

12. Hypervigilance.

13. Problems with concentration.

14. Exagerated startle response.

D. The disturbace causes clinically significant distress or impairement in social, occupational, or other important areas of functioning.

C. Duration of the disturbance (symptoms in criteriaB) is 3 days to 1 month after the trauma exposure.

E. The disturbance is not attributible to the physiological effects of a substance (e.g., medication, or alcohol) or another medical condition (e.g., mild traumatic bran injury) and is not better explained by brief psychological disorder.

If the symptoms of Acute Stress disorder continue beyond 3 months, the diagnose changes to Posttraumatic Stress Disorder (PTSD).

The psychological consequences of the current century war, opens up the window for understanding of the needs of mental health intervention, better understanding of religion and culture, to help them cope with the trauma for better treatment and rehabilitation of the affected population.

Author

Latif Ziyar MD