Mental Problems Experienced by Individuals Victims of War and Terrorism and Practices for these Problems

Öz

The acts of war and terrorism, which have affected a large part of humanity in the world and in our country for many years, are social problems that have arisen by human hands, directly affecting the lives of innocent people, causing massive feelings of fear, anxiety and horror. Every conflict, every war causes irreparable problems in terms of physical, social, environmental and mental health, causing a great social crisis and trauma. Persons exposed to acts of war and terrorism are at risk for psychosocial effects such as anxiety, depression, and post-traumatic stress disorder as well as physical injury. These events bring along various problems in many areas such as social life, economy and health, not only for those directly affected, but also for the whole society. It is possible to encounter psychological problems due to trauma in aid teams affected by these actions or in people who are exposed to the effects of related events through media and communication tools. There is no relationship between direct or remote exposure to the effects of war and terrorist acts and the severity of mental problems. In other words, it is known that mental problems occur in people who are directly exposed to these events, even in people who are spatially distant from these traumatic events. In this compilation article, it is aimed to examine the psychological effects of people who are exposed to acts of war and terrorism and the examples of interventions made for these problems by presenting them in the light of current information.

Anahtar Kelimeler

• war
• terror
• mental health

Savaş ve Terör Mağduru Bireylerin Yaşadıkları Ruhsal Sorunlar ve Bu Sorunlara Yönelik Uygulamalar

Öz

Uzun yıllardır dünyada ve ülkemizde insanlığın büyük bir kısmını etkileyen savaş ve terör eylemleri, masum insanların yaşamını doğrudan etkileyen, kitlesel açıdan korku, endişe ve dehşet duyguları yaşatan, insan eliyle ortaya çıkan toplumsal sorunlardır. Her çatışma, her savaş fiziksel, sosyal, çevresel ve ruhsal sağlık açısından onarılamaz sorunlara yol açarak büyük bir toplumsal kriz ve travmaya neden olur. Savaş ve terör eylemlerine maruz kalan kişiler fiziksel yaralanmanın yanı sıra kaygı, depresyon, travma sonrası stres bozukluğu gibi psikososyal etkiler açısından risk altındadır. Bu olaylar sadece doğrudan etkilenenler için değil toplumun tamamı için sosyal yaşam, ekonomi, sağlık gibi birçok alanda çeşitli sorunları beraberinde getirmektedir. Bu eylemler nedeniyle doğrudan etkilenen yardım ekiplerinde ya da ilgili olayların etkilerine medya ve iletişim araçları aracılığıyla maruz kalan kişilerde, travmaya bağlı ruhsal sorunlara rastlamak mümkündür. Savaşın ve terör eylemlerinin etkisine doğrudan ya da uzaktan maruz kalma ile ruhsal sorunların şiddeti arasında bir ilişki bulunmamaktadır. Yani bu travmatik olaylardan mekansal olarak uzakta olan kişiler de dahi olaylara direkt olarak maruz kalan kişilerde görülen ruhsal sorunların ortaya çıktığı bilinmektedir. Derleme niteliğindeki bu makalede, savaş ve terör eylemlerine maruz kalan kişilerin ruhsal açıdan etkilenme durumları ve bu sorunlara yönelik yapılan müdahalelere ilişkin örneklerin güncel bilgiler ışığında ortaya konarak irdelenmesi amaçlanmaktadır.

Anahtar Kelimeler

• savaş
• terör
• ruh sağlığı

Kaynakça

1. Musisi S, Kinyanda E. Long Term Impact of War, Civil War, and Persecution in Civilian Populations Conflict and Post-Traumatic Stress in African Communities. Front. Psychiatry. 2020 11:20.
2. Wenzel T, Schouler OM, Stompe T. Editorial: long term impact of war, civil war and persecution in civilian populations. Front Psychiatry. 2021 12:733493.
3. Uppsala Conflict Data Programme UCDP. Organized violence in 2019. 2020. https://ucdp.uu.se/ year/2019. Erişim tarihi 20 Ocak 2023.
4. The UN Refugee Agency UNHCR. Forced displacement in 2019. Copenhagen: UN High
5. Commissioner for Refugees [Internet]. 2020. Erişim Tarihi: 2 Şubat 2023. Erişim Adresi: https://www.unhcr.org/statistics/unhcrstats/60b638e37/ global-trends-forced-displacement-2020.html.
6. Brück T, d’Errico M. Food security and violent conflict: introduction to the special issue. World Dev. 2019 117:167–71.
7. Tay AK, Riley A, Islam R, Welton-Mitchel C, Duchesne B, Waters V, et al. The culture, mental health and psychosocial wellbeing of Rohingya refugees: a systematic review. Epidemiol Psychiatr Sci. 2019 28(5):489– 94.
8. Rubin, GJ, Wesselly S. The Psychological and Psychiatric Effects of Terrorisim Lessons From London. Psychiatric Clin North Am. 2013 36(3):339-350.

9. Vieira CM, Haas AD, Garcia DB, Roa-Diaz ZM, Minder B, Gamba M, et al. Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis. Lancet Public Health. 2022 7:e469–81.
10. Uwishema O, Sujanamulk B, Abbass M, Fawaz R, Jawed A, Aboudib K, et al. Russia-Ukraine conflict and COVID-19: a double burden for Ukraine’s healthcare system and a concern for global citizens, Postgrad Med J 2022 98(1162):569-571.
11. Chaaya C, Thambi VD, Sabuncu, Ö, Abedi R, Osman AOA, Uishema O, et al. Ukraine – Russia crisis and its impacts on the mental health of Ukrainian young people during the COVID-19 pandemic. Ann Med Surg (Lond). 2022 79:104033.
12. Cai H, Bai W, Zheng Y, Cheung T, Su Z, Jackson T, et al. International collaboration for addressing the mental health crisis among child and adolescent refugees during the Russia-Ukraine war. Asian J Psychiatr. 2022 72:103109.
13. Bryant RA, Schnurr PP, Pedlar D. Mental Health Research and Innovation Collaboration in military and veteran mental health. Addressing the mental health needs of civilian combatants in Ukraine. Lancet Psychiatry. 2022 9(5):346–347.
14. World Health Orgnization. Scaling-up mental health and psychosocial services in war-affected regions: best practices from Ukraine. Wold Health Organization. [Internet]. 2022. Erişim Tarihi: 22 Ocak 2023. Erişim Adresi: https://www.who.int/news-room/feature-stories/detail/scaling-up-mental-health-and-psychosocial-services-in-war-affected-regions--best-practices-from-ukraine.
15. Ferrando L, Galea S, Corton ES, Mingote C, Camba EG, Liria AF et all. Long-term psychopathology cahnges among the injured and members of the community after a massive terrorist attack. Eur Psychiatry. 2011 26(8):513-517.
16. Neria Y, Gross R, Olfson M, Gameroff MJ, Wickramaratne P, Das A, et all. Posttraumatic stress disorder in primary care one year after the 9/11 attacks. Gen Hosp Psychatry. 2006 28(3):213-222.
17. Jacobsen MH, Norman C, Nguyen A, Brackbill RM. Longitidunal Dterminants of depression amanog World Trade Center Health Registery enrollles, 14-15 years after the 9/11 attacks. J Affect Disord. 2018 15(229):483-490.
18. Gibert L, Verdonk C, Tarquinio C, Falissard B, Wissam El-Hage, Trausselard M. 2015 Paris terrorist attacks: Care guidance for the massive influx of psychologically traumatized civilian casualties. Helping victims to develop their capacity to create a safe and protective environment by leveraging social resources like family, and inner resources like mindfulness should optimize global resilience. J Trauma Dissociation. 2020 4(1):pp.100079.
19. Morina N, Stam K, Pollet TV, Priebe S. Prevelenace of Deprression and posttraumatic stress disorder in adult civilian survivors of war who stay in war-afflicted regions. A systematic review and meta-anlysis of eprdemiological studies. J Affect Disord. 2018 15(239):328-338.
20. U.S Department of Veterans Affairs. PTSD: National Center for PTSD. [Internet]. 2023. Erişim Tarihi: 23 Şubat 2023. Erişim Adresi: https:// www.ptsd.va.gov/understand/common/common_veterans.asp. Boscarino JA, Adams RE, Galea S. Alcohol use in New York after the terrorist attacks: A study of the effects of sychological trauma on drinking behavior. Addict Behav. 2006 32:6060-621.
21. Kerridge BT, Khan MR, Rehm J, Sapkota A. Terrorism, çivil war and related violence and substance use disorders morbidity and mortality: A global analysis. J Epidemiol Glob Health. 2014 4(1):61-72.
22. Pfefferbaum B, Tucker P, North CS, Slaughter HJ, Nitiema P. Children of terrorism survivors: Physiological reactions seven years foloowing a terrorist incident. Compr Psychiatry. 2014 55(4):749-754.
23. Abiola T, Udofia O, Sheikh tl, Yusuf DA. Fear of future terrorism: Asssociated psychiatric burden. Asian J Psychiatr. 2018 38:53-56.
24. Rubin GJ, Wessely S. The Psychological and Psychiatric Effects of Terrorism. Psychiatr Clin North Am. 2013 36(3):339-50.
25. U.S. Department of Veterans Affairs. PTSD: National Center for PTSD: Military Sexual Trauma. [Internet]. 2022. Erişim Tarihi 23 Şubat 2023. Erişim Adresi: https://www.ptsd.va.gov/understand/types/sexual_ trauma_military.asp.
26. Aker AT, Sorgun E, Mestçioğlu Ö, Karakaya I, Kalender D, Acar G. İstanbul’daki Bombalama Eylemlerinin Erişkin ve Ergenlerdeki Travmatik Stres Etkileri. Türk Psikoloji Dergisi. 2008 23(61):63-71.
27. Akbayrak N, Oflaz F, Aslan O, Özcan CT, Tastan S, Çiçek HS. Post-traumatic stress disorder symptoms among military health professionals in Turkey. Mil Med. 2005 170(2):125-129.
28. Gültekin E, Ekici N, Tepe F. Terör Mağduru Polislerde Travma Sonrası Stres Bozukluğu Belirtilerinin Değerlendirilmesi. Uluslararası Güvenlik ve Terörizm Dergisi. 2011 2(1):23-35.
29. Heckendorf H. Lehr D, Bob L. Effectiveness of an internet-based self-help intervention versus public mental health advice to reduce worry during the COVID- 19 pandemic: a Pragmatic, parallel-group, randomized controlled trial. Psychother Psychosom. 2022 91(6):398- 410.
30. Stowell DR, Owens GP, Burnett, A. A pilot horticultural therapy program erving veterans with mental health issues: Fesaibilty and outcomes. Complement Ther Clin Pract. 2018 32:74-78.
31. Beidel DC, Frueh BC, Neer SM, Bowers CA, Trachik B, Uhde TW, et all. . Trauma management therapy with virtual-reality augmented exposure therapy for combat-related PTSD: A randomized controlled trial. J Anxiety Disorder. 2019 61:64-74.
32. Peck KR, Coffey SC, McGuire AP, Voluse AC, Connolly KM. A. Cognitive processing therapy-based programs for veterans diagnosed with co-occurring posttraumatic stress disorder and substance use disorde: the relationship between trauma-related cognitions and outcomes of a 6 week treatment program. J Anxiety Disord. 2018 59:34-41.