Psychiatry and global conflict: a review of war-related psychological impacts, ethical dilemmas, and future directions
DOI:
https://doi.org/10.25118/2763-9037.2025.v15.1473Keywords:
psychiatry and war, psychological warfare, global conflict dynamics, mental health in war, Third World War psychology, world war IIIAbstract
The intricate relationship between psychiatry and global conflict remains an underexplored yet critical area of study, particularly in the context of a potential Third World War. This literature review delves into the psychological roots of conflict, examining how individual and collective psychopathologies contribute to war dynamics and escalation. It highlights the ethical dilemmas faced by mental health professionals in balancing clinical responsibilities with geopolitical influences, including the use of psychiatric knowledge in psychological warfare. The review also explores the mental health implications of prolonged global tensions and technological advancements, such as the rise of cyber-warfare and its psychological impact on populations. Emphasizing the role of psychiatry in fostering peace, this work proposes innovative strategies for leveraging mental health interventions to mitigate conflict and promote resilience in societies facing existential threats. The findings underscore the potential of psychiatry to play a transformative role in preventing and managing the psychological dimensions of future global conflicts.
Downloads
Metrics
References
1. Kloocke R, Schmiedebach HP, Priebe S. Psychological injury in the two World Wars: changing concepts and terms in German psychiatry. Hist Psychiatry.2005;16(61 Pt 1):43-60. https://doi.org/10.1177/0957154X05044600 PMid:15981365
2. Freis, D. Central European Psychiatry: World War I and the Interwar Period. Oxford Research Encyclopedia of Psychol. 2021. https://doi.org/10.1093/acrefore/9780190236557.013.836
3. Kurapov A, Kalaitzaki A, Keller V, Danyliuk I, Kowatsch T. The mental health impact of the ongoing Russian-Ukrainian war 6 months after the Russian invasion of Ukraine. Front Psychiatry. 2023; 14:1134780. https://doi.org/10.3389/fpsyt.2023.1134780 PMid:37575573 PMCid:PMC10412819
4. Abudayya A, Bruaset GTF, Nyhus HB, Aburukba R, Tofthagen R. Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: A scoping review. Ment Health Prev. 2023; 32: 200305. https://doi.org/10.1016/j.mhp.2023.200305
5. McFarlane AC. The impact of war on mental health: lest we forget. World Psychiatry. 2015;14(3):351-3. https://doi.org/10.1002/wps.20253 PMid:26407792 PMCid:PMC4592659
6. Krueger KL, Diabes MA, Weingart LR. The psychological experience of intragroup conflict. Res Organ Behav. 2022; 42:100165. https://doi.org/10.1016/j.riob.2022.100165
7. Govrin A. The Cognition of Severe Moral Failure: a Novel Approach to the Perception of Evil. Front Psychol. 2018;9:1-9. https://doi.org/10.3389/fpsyg.2018.00557 PMid:29731732 PMCid:PMC5920199
8. Gebert D, Heinitz K, Buengeler C. Leaders' charismatic leadership and followers' commitment: the moderating dynamics of value erosion at the societal level. Leadersh Q. 2016;27(1):98-108. https://doi.org/10.1016/j.leaqua.2015.08.006
9. Roche P, Shimmin C, Hickes S, Khan M, Sherzoi O, Wicklund E, Lavoie JG, Hardie S, Wittmeier KDM, Sibley KM. Valuing All Voices: refining a trauma-informed, intersectional and critical reflexive framework for patient engagement in health research using a qualitative descriptive approach. Res Involv Engagem. 2020;6:1-13. https://doi.org/10.1186/s40900-020-00217-2 PMid:32699647 PMCid:PMC7370500
10. Mawson AR. Understanding mass panic and other collective responses to threat and disaster. Psychiatry. 2005;68(2):95-113. https://doi.org/10.1521/psyc.2005.68.2.95 PMid:16247853
11. Mejia CR, Alvarez-Risco A, Chamorro-Espinoza S, Castillón-Lozano JA, Paucar MC, Padilla-F VJ, Armada J, Vilela-Estrada MA, Serna-Alarcón V, Del-Aguila-Arcentales S, Yáñez JA. Crisis due to war: anxiety, depression and stress in the population of 13 Latin American countries. Front Psychiatry. 2023;14:1218298. https://doi.org/10.3389/fpsyt.2023.1218298 PMid:37547209 PMCid:PMC10398955
12. Wirkner J, Brakemeier E. The crisis is over, long live the crisis: mental health in emerging adulthood during the course of the COVID-19 pandemic. Front Psychol. 2024;15:1283919. https://doi.org/10.3389/fpsyg.2024.1283919 PMid:38356763 PMCid:PMC10864646
13. Coulombe S, Pacheco T, Cox E, Khalil C, Doucerain MM, Auger E, Meunier S. Risk and Resilience Factors During the COVID-19 Pandemic: A Snapshot of the Experiences of Canadian Workers Early on in the Crisis. Front Psychol. 2020;11:580702. https://doi.org/10.3389/fpsyg.2020.580702 PMid:33343455 PMCid:PMC7744587
14. Sharma M, Alemayehu M, Girma E, Milkias B, Stevenson A, Gelaye B, Koenen KC, Teferra S. The cumulative impact of trauma, chronic illness, and COVID-19 stress on mental health in a case-control study of adults with psychotic disorders in Ethiopia. Compr Psychiatry. 2024;134:152508. https://doi.org/10.1016/j.comppsych.2024.152508 PMid:38917710
15. Schwarzer R. Stress, resilience, and coping resources in the context of war, terror, and migration. Curr Res Behav Sci. 2024; 57: 101393. https://doi.org/10.1016/j.cobeha.2024.101393
16. Sukiasyan S. The Mental Health of Refugees and Forcibly Displaced People: a narrative review. Consort Psychiatr. 2024;5(4):78-92. https://doi.org/10.17816/CP15552 PMid:39980620 PMCid:PMC11839216
17. Stoffel JM, Cain J. Review of Grit and Resilience Literature within Health Professions Education. Am J Pharm Educ. 2018;82(2):6150. https://doi.org/10.5688/ajpe6150 PMid:29606705 PMCid:PMC5869747
18. Moore MJ, Shawler E, Jordan CH, Jackson CA. Veteran and military mental health issues [Internet]. StatPearls; 2023. https://www.ncbi.nlm.nih.gov/books/NBK572092/
19. World Health Organization. Infodemics and misinformation negatively affect people's health behaviours, new WHO review finds [Internet]. Geneve: WHO; 2022 Sep 1. https://www.who.int/europe/news-room/01-09-2022-infodemics-and-misinformation-negatively-affect-people-s-health-behaviours--new-who-review-finds
20. Jahn FS, Skovbye M, Obenhausen K, Jespersen AE, Miskowiak KW. Cognitive training with fully immersive virtual reality in patients with neurological and psychiatric disorders: A systematic review of randomized controlled trials. Psychiatry Res. 2021;300:113928. https://doi.org/10.1016/j.psychres.2021.113928 PMid:33857847
21. Cohen TR, Insko CA. War and Peace: Possible Approaches to Reducing Intergroup Conflict. Perspect Psychol Sci. 2008;3(2):87-93. https://doi.org/10.1111/j.1745-6916.2008.00066.x PMid:26158875
22. González I, Moyano M, Lobato RM, Trujillo HM. Evidence of Psychological Manipulation in the Process of Violent Radicalization: An Investigation of the 17-A Cell. Front Psychiatry. 2022;13:789051. https://doi.org/10.3389/fpsyt.2022.789051 PMid:35280161 PMCid:PMC8905186
23. Barman D, Guo Z, Conlan O. The Dark Side of Language Models: Exploring the potential of LLMs in multimedia disinformation generation and dissemination. Mach Learn Appl. 2024;16: 100545. https://doi.org/10.1016/j.mlwa.2024.100545
24. Arincorayan D, Applewhite L, Almeida V, DiJoseph E, Romero C. The psychosocial challenges of conducting counterinsurgency operations. US Army Med Dep J. 2014 Oct-Dec:14-21. PMID: 25830794.
25. Hoffman DH, Carter DJ, Lopez CRV, Benzmiller HL, Guo AX, Latifi SY, Craig DC. Independent review relating to APA ethics guidelines, national security interrogations, and torture: Final report of the Independent Reviewer. Chicago: Sidley Austin LLP; 2015 Jul 2. https://www.psychiatry.org/File%20Library/About-APA/Meet-Our-Organization/DB-SA/scope/Hoffman-APA-Report.pdf
26. Warner CH, Appenzeller GN, Grieger TA, Benedek DM, Roberts LW. Ethical considerations in military psychiatry. Psychiatr Clin North Am. 2009;32(2):271-81. https://doi.org/10.1016/j.psc.2009.02.006 PMid:19486813
27. Samochowiec J, Frydecka D, Skonieczna-Żydecka K, Schouler-Ocak M, Carpinello B, Chkonia E, Dom G, Falkai P, Misiak B, Pinto da Costa M, Wise J, de Picker L, Vahip S, Wasserman D, Galderisi S, Bieńkowski P. Ethical dilemmas in contemporary psychiatry: Findings from a survey of National Psychiatric Associations in Europe. Eur Psychiatry. 2023;66(1):e94. https://doi.org/10.1192/j.eurpsy.2023.2470 PMid:37909413 PMCid:PMC10755573
28. Quinn M, Dickinson S, Shukla S. Training Military Psychiatrists to Adapt and Overcome: How COVID-19 Highlighted the Unique Flexibility of Military Psychiatry in Training and in the Fleet. Curr Psychiatry Rep. 2022;24(8):369-374. https://doi.org/10.1007/s11920-022-01342-3 PMid:35699916 PMCid:PMC9192931
29. Yang S, Schneider B, Wynn GH, Howe E3rd. Ethical Considerations in the Treatment of PTSD in Military Populations. Focus. 2017;15(4):435-440. https://doi.org/10.1176/appi.focus.20170035 PMid:31975876 PMCid:PMC6519518
30. Kosenko O, Steger F. Politicization of psychiatry and the improvement of ethical standards in the 1970s. Front Psychiatry. 2023;14:1151048. https://doi.org/10.3389/fpsyt.2023.1151048 PMid:37351001 PMCid:PMC10282144
31. Keepers GA, Fochtmann LJ, Anzia JM, Benjamin S, Lyness JM, Mojtabai R, Servis M, Walaszek A, Buckley P, Lenzenweger MF, Young AS, Degenhardt A, Hong SH. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. Am J Psychiatry. 2020;177(9):868-872. https://doi.org/10.1176/appi.ajp.2020.177901 PMid:32867516
32. Alavi S. The evolution of cyber conflicts and its impact on international security: a comprehensive analysis [Master's thesis Internet]. Pádua: Università degli Studi di Padova; 2024. https://thesis.unipd.it/retrieve/9ecfb519-e683-4fb6-8a26-a8d1d129bc21/Thesis-SeyedhamidrezaAlavi.pdf
33. Marukhovskа-Kartunova O, Marukhovskyi O, Aleksandrova M, Ivanova I, Lebedenko N. Digital journalism and the role of social media in shaping public perception of Russian aggression in Ukraine. Rev Amazon Investig. 2023;12(69):143-153. https://doi.org/10.34069/ai/2023.69.09.12
34. Alonso-Martín-Romo L, Oliveros-Mediavilla M, Vaquerizo-Domínguez E. Perception and opinion of the Ukrainian population regarding information manipulation: a field study on disinformation in the Ukrainian war. Prof Inf. 2023;32(4)1-13. https://doi.org/10.3145/epi.2023.jul.05
35. Valeriano B, Jensen BM, Maness RC. Cyberattacks, psychological distress, and military escalation: an internal meta-analysis. Journal of Global Security Studies. 2023;8(1):1-19. https://doi.org/10.1093/jogss/ogac042
36. Danyk Y, Briggs C. Modern Cognitive Operations and Hybrid Warfare. Journal of Strategic Security. 2023;16(1):35-50. https://doi.org/10.5038/1944-0472.16.1.2032
37. Mazepus H, Osmundsen M, Bang Petersen M, Toshkov D, Dimitrova A. Information battleground: Conflict perceptions motivate the belief in and sharing of misinformation about the adversary. PloS one. 2023; 18(3): e0282308. https://doi.org/10.1371/journal.pone.0282308 PMid:36947501 PMCid:PMC10032542
38. Baggiarini B. Algorithmic war and the dangers of in-visibility, anonymity, and fragmentation. Australian Journal of International Affairs. 2024;78(2): 257-65. https://doi.org/10.1080/10357718.2024.2333824
39. Austin B, Fischer M. Transforming war-related identities individual and social approaches to healing and dealing with the past. Berlin: Berghof Foundation; 2016.
40. Judt, T. Postwar: A history of Europe since 1945. Londres: Penguin Books; 2005.
41. Hughes J, Kostovicova D. Introduction: rethinking reconciliation and transitional justice after conflict. Ethn Racial Stud. 2018;41(4): 617-23. https://doi.org/10.1080/01419870.2017.1406129
42. O'Connor C, Chatwin C. The role of technology in post-conflict reconstruction. J Peacebuilding & Development. 2021;16(2):217-32. https://doi.org/10.1177/15423166211012345
43. Rawat A, Witt E, Roumyeh M, Lill I. Advanced Digital Technologies in the Post-Disaster Reconstruction Process: A Review Leveraging Small Language Models. Buildings. 2024;14(11):3367. https://doi.org/10.3390/buildings14113367
44. Betancourt TS, Khan KT. The mental health of children affected by armed conflict: Protective processes and pathways to resilience. Int Rev Psychiatry. 2008;20(3):317-28. https://doi.org/10.1080/09540260802090363 PMid:18569183 PMCid:PMC2613765
45. Carpiniello B. Psychopathological consequences of war and armed conflicts. Eur Psychiatry. 2023;66(Suppl 1):S49. https://doi.org/10.1192/j.eurpsy.2023.178 PMCid:PMC10417663
46. Graham KR. British subversive propaganda during the Second World War: Germany, National Socialism and the Political Warfare Executive. Londres: Palgrave Macmillan; 2021. https://doi.org/10.1007/978-3-030-71664-6
47. Khujumi IJ, Kour P. Psychological Wellbeing, Social support, And Resilience Among Population in Areas of Conflict. Educational Administration: Theory and Practice. 2024;30(4):8661-71. https://doi.org/10.53555/kuey.v30i4.2795
48. Gross ML, Canetti D, Vashdi DR. The psychological effects of cyber terrorism. Bull At Sci. 2016;72(5):284-91. https://doi.org/10.1080/00963402.2016.1216502 PMid:28366962 PMCid:PMC5370589
49. Staub E. Building a peaceful society: Origins, prevention, and reconciliation after genocide and other group violence. Am Psychol. 2013;68(7):576-89. https://doi.org/10.1037/a0032045 PMid:24128319
50. Christodoulou G. Preservation of peace as a target of mental health promotion. Psychiatriki. 2016;27(4):241-42. https://doi.org/10.22365/jpsych.2016.274.241 PMid:28114087
51. Christy S, Siriwardhana C, Lohmann J, Roberts B, Smith S. Quality of mental health questionnaires in conflict-affected adult populations in low and middle income countries: a systematic review. J Migr Health. 2021;4,100068. https://doi.org/10.1016/j.jmh.2021.100068 PMID:34901899 PMCID:PMC8640451
52. WHO EPI-WIN Webinar: Global Health and Peace Initiative webinar series: WHO's Global Health and Peace Initiative (GHPI): overview and case study from Cameroon. Geneve: WHO; 2024,Oct. 8. https://www.who.int/news-room/events/detail/2024/10/08/default-calendar/who-epi-win-webinar-global-health-and-peace-initiative-webinar-series-who-s-global-health-and-peace-initiative-ghpi-overview-and-case-study-from-cameroon#:~:text=To%20respond%20to%20the%20complex,health%20needs%20in%20fragile%2C%20conflict%2D
53. Pallavicini F, Argenton L, Toniazzi N, Aceti L, Mantovani F. Virtual reality applications for stress management training in the military. Aerosp Med Hum Perform. 2016;87(12):1021-30. https://doi.org/10.3357/AMHP.4596.2016 PMid:28323588
54. Yuan Q, Chen Y, Liu S, Huang Q, Liao M, Zhou J, Li Z, Li Y. UN peacekeeper health and risk factors: a systematic scoping review. Glob Health Res Policy. 2024;9(1):13. https://doi.org/10.1186/s41256-024-00351-4 PMid:38600572 PMCid:PMC11005225
55. Fritsche I, Jonas E, Kessler T. Collective reactions to threat: Implications for intergroup conflict and for solving societal crises. Soc Issues Policy Rev. 2011;5(1):101-36. https://doi.org/10.1111/j.1751-2409.2011.01027.x
56. Aggarwal NK. Roles That Psychiatrists Can Play in International Negotiations to Reduce Conflict. JAMA Psychiatry. 2024;81(8):745-46. https://doi.org/10.1001/jamapsychiatry.2024.1379 PMid:38865143
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Kirolos Eskandar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Debates em Psiquiatria allows the author (s) to keep their copyrights unrestricted. Allows the author (s) to retain their publication rights without restriction. Authors should ensure that the article is an original work without fabrication, fraud or plagiarism; does not infringe any copyright or right of ownership of any third party. Authors should also ensure that each one complies with the authorship requirements as recommended by the ICMJE and understand that if the article or part of it is flawed or fraudulent, each author shares responsibility.
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) - Debates em Psiquiatria is governed by the licencse CC-By-NC
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
