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Secondary trauma exposure is associated with secondary traumatic stress and impaired mental well-being, but effects on physical health and behaviors are less understood. This study addresses this gap by examining associations between secondary trauma exposure and physical, mental and behavioral health outcomes six months after the October 7th terror attack in Israel, and whether these differed by sex. We administered a population-based survey among n = 1128 Israeli adults (50% women). Secondary trauma exposure was assessed by source: professional activity, firsthand accounts, and media (television, internet/social media, newspaper, radio). Outcomes included self-reported worsening mental and physical health, worsening sleep, and initiation of ≥2 negative health behaviors. Overall and sex-stratified logistic regression models were used to estimate average marginal effects adjusted for sociodemographic factors, social wellbeing and direct/indirect trauma. Unexpectedly, profession-related exposure was inversely associated with worsening health behaviors; in sex-stratified analyses, this trend appeared only in men and extended across outcomes (8.3–19.5% lower predicted probabilities). Exposure to firsthand accounts was associated with worsening health behaviors in men and worsening mental health in women (12.0% and 14.6% increases, respectively). Media exposure via television and internet/social media was associated with worsening sleep; exposure to multiple media sources was associated with both worsening sleep and mental health. A cumulative media-exposure effect was observed only in women. Secondary trauma exposure was associated with decline in mental health, physical health and health behaviors, beyond direct/indirect war-related trauma. Source-specific and sex-specific patterns highlight the importance of tailored strategies to reduce health consequences of secondary trauma during crises. •Assessed impact of secondary trauma on physical and mental health and behaviors.•Exposure via TV and internet/social media associated with poorer sleep overall.•Work-related exposure associated with better outcomes in men, worse in women.•Sex differences also seen for firsthand and multiple media sources trauma exposure.•Sex-specific strategies are needed to reduce health risks of secondary trauma.

Objective: The Syrian civil war has resulted in one of the largest refugee movements globally, significantly impacting Türkiye due to its geographic proximity. Surgical care represents a critical yet often overlooked aspect of healthcare services required by displaced populations. This study aimed to evaluate the demographic characteristics and surgical procedures performed on migrant patients over a ten-year period at a secondary-level hospital located on Türkiye’s southern border. Methods: A retrospective cohort study was conducted at Kilis State Hospital between March 2010 and January 2020. Surgical procedures were categorized by department, patient nationality, and type of surgery. Patients operated under the “war code” were analyzed separately to identify conflict-related injury patterns. Results: A total of 52,978 surgical procedures were performed, with 41.76% involving Syrian patients. The mean age was 31.28±20.33 years, and male patients predominated, especially among the war-injured subgroup (91.59%). The most active surgical departments were orthopedics and traumatology (20.63%), gynecology and obstetrics (17.51%), and general surgery (15.67%). Among war-related surgeries, orthopedics, neurosurgery, and plastic surgery departments played major roles. Conclusion: This study highlights the high surgical demand among migrant populations in border regions, especially in conflict settings. Strengthening healthcare infrastructure, maintaining accurate surgical records, and implementing multidisciplinary approaches are essential for meeting these needs. Our findings can inform future policies aimed at improving surgical care for displaced populations.

The Israeli escalation of violence and oppression in Gaza, particularly following the events of October 7, 2023, has deepened the trauma and exacerbated the already grievous conditions of dispossession and exploitation faced by Palestinians. The present exploratory work sought to analyze war-related traumatic experiences among Gazans following the recent Israeli genocide against Gazans. Thirty participants (mean age for males = 32.45 years, SD = 10.13; mean age for females = 30.28 years, SD = 9.15; range 19–57) were recruited via snowball sampling. Interviews were analyzed through thematic content analysis. Thematic content analysis of the interview transcripts led to the identification of five main themes: (1) challenges and difficulties faced Gazans, (2) traumatic experiences related to war, (3) feelings and emotions among Gazans living in refugee camps, (4) how do Gazans perceive the future and (5) survival coping employed by Gazans following the on-going genocide against the Gaza Strip. The findings of this study highlight the profound humanitarian crisis in Gaza, calling for urgent attention to the ongoing crisis in Gaza and advocating for comprehensive humanitarian support and psychological interventions to address the deep-seated trauma and help rebuild lives shattered by conflict.

Purpose This paper aims to discuss current work and further steps of the psychological hotline launched by the National Psychological Association of Ukraine (NPA), along with a call for action to mental health professionals worldwide. Design/methodology/approach This paper describes the training and support of the NPA’s hotline staff as well as reflections on the hotline’s work from June 2022 to April 2023. Findings With broad international support, the NPA’s psychological hotline currently operates in 21 countries providing psychological assistance and referrals to other service providers within Ukraine and abroad. The authors propose further steps of its work, including international collaboration. Originality/value Providing citizens of Ukraine with broad public access to evidence-based remote psychological support through NPA’s hotlines is a high priority considering the war’s negative impact on mental health diverse and the limited capacity of the state mental health system.

Evidence suggests that veterans with post-traumatic stress disorder (PTSD) are less likely to benefit from trauma-focused treatment than are patients with PTSD who have not been exposed to war-related trauma. However, new developments in PTSD treatment that combine several evidence-based trauma-focused therapies within a short time frame may help veterans achieve outcomes similar to those of non-veterans. In this retrospective cohort study, we examined changes in PTSD symptoms and diagnostic status after treatment between veterans and non-veterans. The treatment consisted of a four- or eight-day intensive trauma-focused treatment programme that integrated prolonged exposure, EMDR therapy, psycho-education, and physical activities. The sample consisted of 43 veterans and 43 non-veterans, matched based on age, sex, starting date, and duration of treatment. Participants were assessed pre- and post-treatment using the Clinician-Administered PTSD Scale-5 (CAPS-5). The differences in CAPS-5 scores over time and between groups were modelled using Bayesian repeated-measures ANOVA. We performed Bayesian model averaging to quantify the differences in PTSD symptom changes between groups, based on treatment response, using the exclusion Bayes factor ( ). PTSD symptoms in both veterans and non-veterans decreased between pre- and post-treatment (Cohen's  = 2.17 and 1.54, respectively). Furthermore, we found moderate evidence of no differences in CAPS-5 scores between the groups (  = 4.8) or between the groups over time (  = 4.9). Although a greater proportion of veterans showed improvement according to the reliable change index than non-veterans (83.7% and 74.4%, respectively), there was no difference between the groups in terms of loss of diagnostic status after treatment (74.4% for veterans and 76.7% for non-veterans). This study provides evidence that veterans with war-related PTSD can benefit from brief intensive, trauma-focused treatment and does not support the notion that veterans need a different treatment approach in such settings.

Posttraumatic stress disorder is common in civilians who are currently experiencing, or who have experienced, war. Most previous studies have focused on adult populations and, despite the recognised detrimental effect of war trauma on adolescent mental health, there remains a paucity of evidence on the prevalence of war-related PTSD in adolescents. This pre-registered (https://osf.io/dqg2z) systematic review and meta-analysis aims to understand the prevalence of PTSD, as well as both risk and protective factors for developing PTSD, in adolescents aged 10-24 years from across the world who are experiencing, or have experienced, war-related traumatic events, described in papers published in a 10 year period (2013-2023). We also examine how the choice of PTSD diagnostic assessment tool influences prevalence rates. Medline (PubMed), PsycINFO (EBSCOhost), and PTSDpubs (ProQuest) were searched, which resulted in 21 papers eligible for inclusion. Data was searched, extracted and synthesised using the software tool Covidence. The age range of adolescents in the included papers was 11-19 years. The average prevalence of PTSD was 29.4% (95% CI [18.7%, 43.0%]), although prevalence rates across studies were highly inconsistent (I = 99.4%). Prevalence rates were significantly higher in studies conducted longer after war exposure, and the PTSD diagnostic assessment tool used influenced prevalence. There is high prevalence of PTSD in adolescents during and after war. The prevalence of war-related PTSD increases with time in the post-war period, highlighting the need for access to psychological services following war. This study underscores the importance of defining age ranges and using validated and culturally sensitive assessment tools when interpreting prevalence rates of PTSD in adolescents.

IBPA Benjamin Franklin Award™ gold winner, poetry category Sierra Leone's devastating civil war barely caught the attention of Western media, but it raged on for over a decade, bringing misery to millions of people in West Africa from 1991 to 2002. The atrocities committed in this war and the accounts of its survivors were duly recorded by international organizations, but they run the risk of being consigned to dusty historical archives.    Derived from public testimonies at a UN-backed war crimes tribunal in Freetown, this remarkable poetry collection aims to breathe new life into the records of Sierra Leone's civil war, delicately extracting heartbreaking human stories from the morass of legal jargon. By rendering selected trial transcripts in poetic form, Shanee Stepakoff finds a novel way to communicate not only the suffering of Sierra Leone's people, but also their courage, dignity, and resilience. Her use of innovative literary techniques helps to ensure that the voices of survivors are not forgotten, but rather heard across the world.    This volume also includes an introduction that explores how the genre of \"found poetry\" can serve as a uniquely powerful means through which writers may bear witness to atrocity. This book's unforgettable excavation and shaping of survivor testimonies opens new possibilities for speaking about the unspeakable.

On 13-14 April 2024, Iran launched ∼300 drones and missiles at Israel, in an unprecedented attack. As most studies examine the effects of trauma months or years later, less is known about its effects days later. To fill this gap, this study gauged the population response, five days after the attack. Specifically, we examined the prevalence and factors associated with two precursors for later development of PTSD, peritraumatic distress (PD) and generalized anxiety disorder (GAD). Five-hundred and fifty-three participants (M  = 57.51, SD = 13.67 years, range [30-90], 48.3% females) reported their distal and proximal exposure to traumatic events, probable PTSD due to Israel-Hamas-War, sleeping troubles, and media information consumption during the event. Logistic regressions indicated that, after adjusting for demographics, clinical levels of PD and GAD (respectively, using the accepted cutoffs) were significantly linked to probable PTSD due to the Israel-Hamas War (PD:OR = 4.066, 95%CI: 2.236-7.393, < .001; GAD:OR = 2.397, 95%CI: 1.285-4.471, = .006), sleeping troubles (PD:OR = 1.248, 95%CI: 1.186-1.314, < .001; GAD:OR = 1.325, 95%CI: 1.242-1.413, < .001) and media consumption (PD:OR = 1.442, 95%CI:1.17-1.777, = .001; GAD:OR = 1.515, 95%CI: 1.144-2.007, = .004), but not to previous trauma (life-long exposure or Israel-Hamas war). Results suggest that previous psychopathology, stress-related reactions (sleeping) and actions (media consumption), rather than previous exposures to traumatic events are the primary indices related to PD and GAD in the first days after exposure to war-related traumatic events. Findings highlight the importance of early detection of reactions and symptoms following trauma exposure. The main limitation of the study is its cross-sectional design. Future longitudinal studies are needed to understand the developmental trajectory of these effects.

In this article, we aimed to evaluate results of patients who acquired various injuries during Libya civil war who then were transferred to our facility with genitourinary trauma for further assessment and treatment. A total of 121 wounded patients, including 21 (17.3%) with 1 or more combined urogenital injuries, were treated at Yeni Yüzyıl University Private Gaziosmanpaşa Hospital from October 2014 to September 2016. Of the 21 patients, 13 (61.9%) were injured by explosive weapons, while the rest 8 (38.1%) had bullet wounds. The 21 urogenital injuries were to the kidney in 7 cases (33.4%), ureter in 5 (23.8%), bladder in 5 (23.8%), scrotum in 2 (9.5%), and penis in 2 (9.5%). There was associated damage to organs other than the urogenital system in 21 patients (100%). Two patients had nephrectomies performed on-site medical facility. The rest of patients had no urogenital organ resections. Urogenital trauma had higher rates of liver damage, generalized infection, blood transfusions, and longer hospital stay. Knowing that war related surgery patients should be approached as a distinct and non-standard category, every case must be evaluated individually. Patients should be evaluated in a multidisciplinary approach and physicians should be aware of infections affecting morbidity and mortality.

Background The escalation of violence and oppression in Gaza, particularly following Hamas’ military attack on Israeli settlements in the Gaza envelope on October 7, 2023, has intensified trauma and related disorders, especially sleep disturbances, exacerbating the already dire conditions of dispossession and exploitation faced by Palestinians. Aims The present exploratory research sought to explore the impact of war-related trauma following the recent Israeli war on the Gaza Strip on sleep disturbance among Gazans. Methods Thirty participants 14 females and 16 males, aged between 18 and 58 years (mean age for males = 31.43 years, SD = 11.12; mean age for females = 31.23 years, SD = 10.13) were recruited via snowball sampling. Interviews were analyzed through thematic content analysis. Results Thematic content analysis of the interview transcripts led to the identification of five main themes. ( 1), sleepless nights amid constant fear (2), children’s sleep shattered by trauma. (3), the impact of overcrowded shelters on sleep. (4), mothers as guardians of sleepless nights. (5), health consequences of chronic sleep deprivation . The findings highlight the negative impact of war-related trauma on the sleep of Gazans, leading to various disturbances such as nightmares, particularly among children. Conclusions Our findings illuminate the pervasive impact of war-related trauma on the sleep patterns of Gazan refugees. This study highlights the critical importance of integrating psychological support and targeted interventions into community health initiatives, particularly for vulnerable groups such as children. Future research should focus on developing culturally sensitive interventions to mitigate the adverse effects of trauma on sleep and overall well-being in conflict-affected population.