Exposure to civil violence increases risk for mental health disorders, even for non-combatants

June 27, 2023

Contact: Jon Meerdink ([email protected])

ANN ARBOR — Civil violence shapes countries, costs billions of dollars, and can leave thousands dead through armed combat. But according to a new paper, its effects may range even more broadly than that.

The paper, published this month via the JAMA Network, finds that exposure to civil violence puts civilian populations at a significantly increased risk of developing a diverse range of mental health disorders. 

Willam Axinn, Ph.D., of the Institute for Social Research’s Survey Research Center is the paper’s lead author. The study examined available data from the World Mental Health (WMH) Survey Consortium for a long-term association between exposure to civil violence and mental health.

“The data were created to help countries and the World Health Organization make better policy and investment decisions with regard to care for people who are suffering from mental health issues,” he said. “What about all the civilians who are there while armed conflict is going on? And what about their families? How does civil violence affect people who are exposed to it even though they’re not fighting?”  

Axinn and his colleagues examined data which were collected as part of the World Health Organization’s WMH surveys from more than 18,000 respondents in seven countries that had experienced civil violence after World War II. The respondents also included people who emigrated from countries with civil violence in Africa and Latin America.

Of the people surveyed, more than 2,000 reported having been exposed to civil violence. Respondents who reported being exposed to civil violence had a significantly elevated onset risk of anxiety, mood, and externalizing disorders.

For the purposes of the study, a “disorder” was classified as a mental illness that negatively affected a respondent’s ability to function (following standard DSM criteria) . A respondent was classified as having been exposed to civil violence if their country was an active war zone or was considered a “region of terror.”

In light of the study’s findings, Axinn argues policy makers should be able to more appropriately plan long-term responses to conflict around the world. Establishing a connection between the civilian effects of civil violence should make it easier to devote the necessary resources to help those in need.

“Through these analyses, we can now estimate what fraction of people who are in, say, Ukraine for instance, or exposed to violent events, are going to need mental healthcare in the long term,” said Axinn.

The paper, titled “Findings From the World Mental Health Surveys of Civil Violence Exposure and Its Association With Subsequent Onset and Persistence of Mental Disorders,” is available in full online. The study on which it was based used data from the World Mental Health surveys administered between February 2001 and January 2022. 

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