Citation

Miller KE, Rasmussen A. Soc. Sci. Med. 2010; 70(1): 7-16.

Affiliation

Harvard School of Public Health, Research Program on Children and Global Adversity, François-Xavier Bagnoud Center for Health and Human Rights, 651 Huntington Avenue, Boston, MA 02115, USA. kenski63@gmail.com

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.socscimed.2009.09.029

PMID

19854552

Abstract

This paper seeks to bridge the divisive split between advocates of trauma-focused and psychosocial approaches to understanding and addressing mental health needs in conflict and post-conflict settings by emphasizing the role that daily stressors play in mediating direct war exposure and mental health outcomes. The authors argue that trauma-focused advocates tend to overemphasize the impact of direct war exposure on mental health, and fail to consider the contribution of stressful social and material conditions (daily stressors). Drawing on the findings of recent studies that have examined the relationship of both war exposure and daily stressors to mental health status, a model is proposed in which daily stressors partially mediate the relationship of war exposure to mental health. Based on that model, and on the growing body of research that supports it, an integrative, sequenced approach to intervention is proposed in which daily stressors are first addressed, and specialized interventions are then provided for individuals whose distress does not abate with the repair of the social ecology.

Language: en