Memory of war and refuge: The effects of traumatic memory on PTSD and mental health of displaced persons

Abstract

Background

Empirical data regarding the psychological sequelae of traumatic memories among displaced populations in the MENA region, particularly within the Syrian context, remains critically sparse. This study aims to identify the memories of war and displacement and their impact on mental health and PTSD symptoms among displaced persons and refugees.

Methods

An online questionnaire was administered to 356 internally displaced persons in Syria. They responded to the War and Displacement Memory Questionnaire (WDMQ), the PTSD Checklist for DSM-5 (PCL-5), and the Brief Symptom Inventory 18 (BSI-18). The ages ranged from 18 to 75 years (mean = 35.13, SD = 8.034). Females comprised 53.65% (n = 191), and males made up 46.34% (n = 165).

Results

A total of 56.74% of participants scored higher on the war and displacement memory questionnaire. War events ranked highest with an average of (4.62), followed by displacement events (4.50), the emotions associated with war or displacement (4.49), the novelty of memories and their intrusive attack (4.39), feeling nostalgic for one's home (4.17), and disturbing memories (4.00). While 48.60% of participants scored above average on the PTSD scale. Whereas, 51.40% scored higher on the mental health questionnaire. While female participants and those with primary education attained marginally higher scores on the traumatic memory scale, these disparities did not reach statistical significance. Significant correlations between traumatic memories and PCL-5 and BSI-18 were found (r = 0.680, p < 0.001; 0.466, p < 0.000, respectively). Education and memories of war and displacement predict PTSD and mental health symptoms.

Conclusion

An integrated model of memory and mental health may provide a deeper understanding of the psychological needs and clinical features linked to memories of war and displacement. These findings may be useful in better understanding the psychological effects of traumatic memory on the mental health of refugees.

Keywords

Traumatic memories PTSD war displaced persons and refugees mental health

Introduction

War is a traumatic experience for individuals, affecting their minds, emotions, and memories long after the conflict has ended. Armed conflicts and the resulting issues, such as forced displacement and migration to other countries, pose a significant challenge on a global scale.^1–6 Displaced people often face difficult circumstances that can negatively impact their mental well-being and their capacity to adjust to new environments. The effects of war trauma can persist long after the fighting stops, and they don't always improve, even when people move to safe places. When individuals experience war and are forced to relocate to another country, they may experience psychological distress, symptoms of trauma, and changes in their bodies’ stress response.^7,8 Many refugees and displaced persons suffer from long-term mental health problems, including memory problems and instability. Studies have investigated how the timing of migration and the generation to which a person belongs affect their cognitive abilities.⁹

It appears that individuals who relocate to a new country as adults don't perform as well on memory tests as those who move at a younger age. Additionally, people who are the first in their family to move to a new country often have lower problem-solving skills than those who are born in the new country.^10,11 These findings underscore the significance of early life experiences, especially those related to forced displacement, in shaping individuals’ cognitive development over time. Displacement can manifest in different forms, whether individuals are moving within their own country or seeking asylum in another country, but the psychological impact is consistently negative.^2,3

Current estimates indicate that approximately 184 million people worldwide are displaced, and many of them still feel the effects of war and migration.¹⁰ Peoples’ responses to trauma vary depending on their culture and social situation¹¹; for example, refugees often report stressors such as losing loved ones, not having enough, worrying about safety, and facing hardship.³ War-related losses and material hardships are associated with severe psychological trauma, while social and psychological problems can have complex effects.² Women who experience forced migration often report better mental and physical health than men.^12–14

Memories of war and displacement are incredibly significant as they are passed down from one generation to the next. They are remembered collectively, allowing groups of people to share stories about their experiences.^15,16 Unfortunately, when discussing refugees, their stories are often overlooked and not included in historical accounts.¹⁶ While there is a growing awareness of this issue, there is still limited knowledge about the impact of war and displacement on the mental well-being of individuals.^2,17

We want to understand how the stress and negative experiences that people go through can impact their health in the long run.¹⁸ We are aware that individuals who have been displaced often suffer from issues such as post-traumatic stress disorder, anxiety, and depression. However, there is still a lack of knowledge regarding the long-term effects on mental health when individuals are forced to carry traumatic memories with them to a new country. The lingering memories of war and displacement continue to pose challenges for these individuals.^2,19,20

Modern diagnostic models, such as those in the DSM-III and DSM-5, indicate that traumatic memories are a component of PTSD. Traumatic events create memories that surface unexpectedly and persist, leading to reactions and symptoms such as heightened alertness, irritability, and difficulty sleeping. Individuals may employ coping mechanisms, such as avoidance or emotional numbing, to manage the pain.

Cognitive theories elucidate how traumatic memories are processed and stored. According to these models, PTSD arises when individuals perceive their trauma in a manner that perpetually threatens them. Two key processes occur: traumatic memories are not integrated effectively with other memories, and they form strong emotional connections that make them easily triggered.^21–23 When these memories are triggered, symptoms manifest, and individuals become more vigilant. Attempts to alleviate the pain may hinder individuals from altering their thought patterns, thereby perpetuating the disorder.^24,25 Cognitive-behavioral treatments for PTSD aim to restructure memories and introduce new information to correct past perceptions.²⁴ These treatments, which emphasize emotion regulation, have demonstrated efficacy in symptom reduction, supporting the notion that memory plays a pivotal role in PTSD.^18,25

In the present study, we hypothesize that the memory of war and displacement negatively affects the mental health of refugees in Arab conflict zones, even after refugees overcome dangerous situations and live in a stable state in their countries or outside them, such as Syrian, Yemeni, Sudanese, Palestinian, and Lebanese refugees.

Effective mental health intervention begins with a thorough assessment; understanding the interplay between war-related memories and psychological disorders is essential. This knowledge facilitates the design of targeted clinical strategies aimed at mitigating the impact of traumatic memories among refugees. These interventions may be promising, especially since there have been previous attempts to treat traumatic memories and conditioned fear memory in patients with PTSD.^17,26

The significant question in the current study is to what extent memories of war and displacement contribute to the persistence of mental health problems and post-traumatic stress disorder. Therefore, the study reported in this paper aimed to (1) assess the levels of mental health and PTSD; (2) identify the most prevalent traumatic memories; and (3) reveal the impact of war and displacement memories on mental health and PTSD among displaced persons from conflict zones in Syria.

Methods

Participants and design

In collaboration with the War Disabled Association in Syria, the present study included 356 participants recruited through the Sham Model Schools in Idlib.

The inclusion criteria stipulated that participants (1) be between 18 and 75 years of age at the time of the study; (2) be of Syrian nationality or have resided in Syria for an extended period during the conflict; and (3) have experienced internal displacement as a direct result of the war. Additionally, the study required participants to demonstrate the cognitive and linguistic capacity to provide informed consent and recall their experiences. Those who did not meet the age requirements or who had not experienced internal displacement as a direct result of the war were excluded from the sample.

Adhering to these clearly defined criteria, participants were recruited via online platforms for forcibly displaced populations. This approach facilitated the collection of comprehensive data regarding their conflict and relocation experiences.

The sample size was determined based on an a priori power analysis conducted using G*Power 3.1. To detect a medium effect size (f² = 0.15) for a multiple linear regression with two main predictors (traumatic memories and education), an alpha level of 0.05, and a desired statistical power of 0.80, a minimum sample size of 107 participants was required. Our final sample of 356 participants significantly exceeds this threshold, providing a post-hoc power of over 0.99. This robust sample size ensures sufficient sensitivity to detect significant associations between war memories and mental health outcomes while minimizing the risk of a Type II error. This approach aimed to comprehensively explore PTSD and mental health among participants, aligning with the study’s goal of identifying the impact of war and displacement memories on PTSD and mental health.

To ensure data integrity and prevent missing values, the online survey was configured so that completion of all items was mandatory before the participant could proceed to the next section or submit their responses. Additionally, the platform allowed participants to review and change their answers at any point prior to final submission. This configuration ensured a complete dataset without compromising the participants’ ability to provide accurate and considered responses. To minimize respondent fatigue, the online survey was organized across three screens: one for informed consent, one for demographic data, and one for the three metrics. The survey consisted of 61 items covering all required data, including informed consent and demographic information, and took participants approximately 12 to 15 min to complete. Furthermore, no financial compensation or material incentives were offered to participants; participation was entirely voluntary, as outlined in the ethical considerations.

The authors assert that all procedures contributing to this work comply with the Helsinki Declaration of 1975, as revised in 2013. Ethical approval for this study was granted by the War Disabled Association in Syria, ensuring all procedures involving human subjects adhered to required research standards. Participants gave explicit consent online and were given adequate information in the questionnaire regarding the research's purpose and significance, as well as their freedom to participate or withdraw at any time.

Measurements

The War and Displacement Memory Questionnaire (WDMQ)

A 16-item self-report questionnaire was developed for this study to assess traumatic memories related to war and displacement among Arab refugees. The severity of traumatic memories was rated on 5-point Likert scale (1 = “not at all” to 5 = “very much”). The total score ranged from 16 to 80, with a higher score indicating severe traumatic memories.

The PTSD Checklist for DSM-5 (PCL-5)

A 20-item self-report scale that assesses the 20 DSM-5 symptoms of PTSD. It includes two parts: the first part identifies the worst event briefly, followed by answering four questions related to identifying traumatic events. The second part assesses PTSD according to the DSM-5 criteria, with 20 items answered on a 5-point Likert scale (1 = “not at all” to 5 = “to a very great extent”). The total score ranges from 20 to 100, with a higher total score indicating the presence of PTSD. Studies suggest that the cut-off score for probable PTSD (between 31 and 33)²⁷ serves as a primary indicator of symptomatic severity. However, it is essential to distinguish between these survey-based screening results and formal clinical diagnoses. As noted by Scott et al.,²⁸ validated questionnaires may overestimate the prevalence of PTSD by a factor of three when compared to structured clinical interviews. Given the exceptionally high psychological burden observed in this specific population, the current study utilized the sample's mean score as a relative criterion for classification. Consequently, participants scoring above the study's mean are described as exhibiting “high” PTSD symptomatology relative to the sample, rather than being clinically diagnosed based on universal thresholds.^29,30

The Brief Symptom Inventory 18 (BSI-18)

The BSI-18 contains three six-item scales: somatization, depression, and anxiety. The scale is a shorter version of the Symptom-Checklist Inventory 90-R.³¹ Participants indicate the degree to which they were bothered by specific problems occurring in the past week on a 5-point Likert scale (1 = “not at all” to 5 = “extremely”).³² The BSI-18 is commonly used in psychotherapy assessment, clinical evaluations, and research with good reliability and validity indicators.

In this study, an Arabic version of these tools was utilized after verifying their validity and reliability.

Data analysis

Statistical analysis was achieved using IBM SPSS (V 29). Descriptive statistics were computed for all demographic variables, including age, sex, education level, and marital status. Percentages, means, and standard deviations were used to determine the levels of traumatic memories and symptoms of mental health disorders. Reliability analysis was assessed using Cronbach's alpha and split-half coefficients. To evaluate the validity of the war and displacement memory questionnaire, factorial validity was examined using exploratory factor analysis (EFA) via the principal component method (with Varimax rotation and Kaiser's criterion eigenvalue >1). The relationships between traumatic memories, PTSD, and mental health were evaluated using Pearson's correlation coefficient. Linear regression analysis was used via the Inter method to explore the contribution of traumatic memories and demographic variables in predicting PTSD and mental health symptoms among displaced and refugee persons. All statistical analyses were conducted at a 95% confidence level (p < 0.05).

Results

A total of 356 displaced and refugee persons participated in this study, with ages ranging from 18 to 75 years, with an average of 36–50 years (mean = 35.13, SD = 8.034). All participants provided information as to their highest level of educational achievement and were categorized into five groups: primary, middle school, secondary school, university, and postgraduate (Table 1).

Table 1.

Descriptive statistics.

Variables		N	%	Education	N	%
Gender	Male	165	46.3	Initial school	66	18.5
Gender	Female	191	53.7	Preparatory school	94	26.4
Marital status	Single	34	9.6	Secondary	77	21.6
	Married	291	81.7	University	96	27.0
	Divorced	31	8.7	High degree	23	6.5
			Skewness		Kurtosis
	Mean	Std. Deviation	Statistic	Std. Error	Statistic	Std. Error	% of Higher score
WDMQ	63.35	12.19	−1.20	0.12	1.92	0.258	56.74%
PCL-5	60.03	19.71	0.012	0.12	−0.56	0.258	48.60
BSI-18	52.41	18.96	−0.033	0.12	−0.79	0.258	51.40

Note: WDMQ: War and Displacement Memory Questionnaire; PCL-5: PTSD Checklist for DSM-5; BSI-18: Brief Symptom Inventory 18.

The reliability coefficients (Cronbach's alpha of (α = 0.896), split-half of (0.865), and Spearman-Brown equal length of (0.927)) indicate good reliability in the (WDMQ) questionnaire. EFA revealed that the items were saturated with three factors, explaining 60.206% of the total variance. The factor loading coefficients ranged between 0.307 and 0.905. These psychometric features make the questionnaire appropriate for use in the current study.

Good reliability coefficients were also found in the PCL-5 and BSI-18 questionnaires (Cronbach's alpha of (α = 0.937), split-half of (0.896), and Spearman-Brown equal length of (0.945)) indicating good reliability in the PCL-5 questionnaire, while a Cronbach's alpha of (α = 0.939), split-half of (0.906), and Spearman-Brown Equal Length of (0.951) were found in the BSI-18 inventory.

For the total score of the WDMQ, the mean value was 63.35 (SD ± 12.19), with a range of 16 to 80. A total of 56.74% of participants scored above average on the war and displacement memory questionnaire. Women and primary school graduates showed slightly higher scores in the traumatic memories scale without significant differences between groups. The total score of the PCL-5 scale was 60.039 (SD ± 19.71), with a range of 20 to 100. Notably, 48.60% of participants achieved scores exceeding the scale's mean, indicating a high prevalence of self-reported PTSD symptomatology within the sample. Whereas the total score of the BSI-18 was 52.41 (SD ± 18.96), with a range of 18 to 90, and 51.40% scored higher on the mental health questionnaire (BSI-18). These results are also shown in Table 2.

Table 2.

Traumatic memories, PTSD, and mental health symptoms among participants.

Report
Education		Memory	PTSD	Mental health symptoms
Initial school (n = 66)	Mean (SD)	65.93 (12.62)	68.6 (19.64)	60.91 (19.89)
Preparatory school (n = 94)	Mean (SD)	64.90 (10.67)	63.65 (19.17)	57.01 (17.68)
Secondary (n = 77)	Mean (SD)	65.29 (9.98)	60.76 (18.14)	50.96 (18.02)
University degree (n = 96)	Mean (SD)	59.18 (13.53)	51.44 (18.53)	45.41 (17.84)
High degree	Mean (SD)	60.52 (13.51)	54.08 (17.84)	43.30 (15.23)
Total (n = 356)	Mean (SD)	63.35 (12.19)	60.03 (19.71)	52.41 (18.96)
Prevalence rate of traumatic memories, PTSD, and mental health symptoms
	Average	Mean	Std. Deviation	t	p
Traumatic memories	48	63.35	12.19	23.76	<0.001
PTSD	60	60.04	19.71	0.038	0.485
Mental health symptoms	54	52.41	18.9	−1.58	0.057

Note: The term “average” refers to the theoretical (expected) mean of the population, while “mean” refers to the observed sample mean.

Table 3 shows the descriptive statistics of traumatic memories among displaced and refugee persons. The results of this study reveal a high prevalence rate of traumatic memories. War events ranked highest with an average of 4.62, followed by displacement events (4.50), the emotions associated with war or displacement (4.49), the novelty of memories and their intrusive attack (4.39), feeling nostalgic for one's home (4.17), and disturbing memories (4.00), while gender differences are shown in Table 4.

Tables 3.

Descriptive statistics of traumatic memories among participants.

	Descriptive statistics
Items	Mean	Std. Deviation	The rank
1. The events of the war remain vividly embedded in my memory.	4.39	0.93	4
2. The events of displacement remain vividly embedded in my memory.	4.50	0.90	2
3. I experience feelings of distress when recalling events encountered during the war or displacement.	4.49	0.93	3
4. I find it difficult to relinquish the emotions associated with the war or displacement.	4.12	1.15	7
5. I avoid places or people that remind me of my experiences during the war.	2.67	1.46	12
6. I avoid places or people that remind me of my experiences during displacement.	2.66	1.51	13
7. I recall events that occurred during the war or displacement as if they happened yesterday.	4.15	1.11	6
8. I experience a sense of nostalgia for the place I was forced to leave due to displacement and war.	4.49	1.05	3
9. I frequently recall scenes of destruction witnessed during the war and displacement (recurring as if they are happening again now).	3.97	1.21	8
10. I feel sad when I remember the people I lost during the war or displacement.	4.62	0.91	1
11. Experiences of displacement and war continue to influence my current decisions and daily life.	3.71	1.43	10
12. I occasionally experience agitation or anxiety when reflecting on the events of the war or displacement.	3.66	1.39	11
13. I feel a sense of helplessness whenever I remember the loss of property or home during displacement or war.	3.75	1.49	9
14. The experiences of war and displacement have made me feel like a different person.	4.00	1.24	6
15. I am overwhelmed by feelings of fear when considering the possibility of these events recurring.	4.00	1.31	6
16. Memories associated with survival or escape remain persistently present in my mind.	4.17	1.13	5

Table 4.

Gender differences in traumatic memories, PTSD, and mental health symptoms.

		Mean	Std. Deviation	t	p
Memory	Male	62.48	13.43	1.25	0.106
Memory	Female	64.10	10.98	1.25	0.106
PTSD	Male	60.38	21.08	0.31	0.38
PTSD	Female	59.73	18.49	0.31	0.38
Mental health symptoms	Male	53.38	20.295	0.90	0.18
Mental health symptoms	Female	51.56	17.75	0.90	0.18

The correlations between traumatic memories (measured by the total score of the questionnaire or of factor or symptoms) and PCL-5 and BSI-18 were found to be significant (r = 0.680, p < 0.001; 0.466, p < 0.000, respectively). The results of the regression analysis are also presented in Table 5.

Tables 5.

Model summary.

Model	R	R ²	Adjusted R²	Std. error of the estimate
1	0.702^a	0.493	0.485	14.139

Note: ^aPredictors: (Constant), marital status, memory, gender, age, education.

To further investigate factors related to war and displacement memory, a series of regression analyses were conducted. These analyses aimed to identify key psychological indicators that contribute to the variation in individuals’ memories of war and forced displacement experiences. The independent variables included in the models were gender, education, social affiliation, symptoms of post-traumatic stress disorder, and mental health disorders, while the dependent variables were war and displacement memory (Tables 5 and 6).

Tables 6.

Results of regression analyses.

Model		Sum of squares		df	Mean square	F	Sig.
1	Regression	67950.0		5	13590.0	67.97	<0.001^b
	Residual	69975.44		350	199.930
	Total	137925.44		355
Coefficients ^a
Model		Unstandardized coefficients		Standardized coefficients	t	Sig.	Collinearity statistics
Model		B	Std. Error	β	t	Sig.	Tolerance	VIF
1	(Constant)	4.187	5.836		0.718	0.474	0.82	1.22
	Memory	1.047	0.064	0.647	16.45	<0.001	0.80	1.23
	Gender	0.267	1.672	0.007	0.160	0.873	0.86	1.15
	Education	−2.948	0.683	−0.182	−4.31	<0.001	0.91	1.09
	Age	2.17	1.56	−0.006	−0.139	0.89	0.83	1.20
	marital status	−1.355	1.892	−0.029	−0.71	0.47	0.82	1.22

Note: ^aDependent Variable: PTSD. ^bPredictors: (Constant), marital status, memory, gender, age, and education.

According to Regression analysis, education and memories of war and displacement predict PTSD and mental health symptoms. Tables 5 and 6 display the results of predictors for PTSD.

Discussion

Overview of findings

This study focused on the impact of memories of war and displacement on PTSD and mental health symptoms among Arab refugees. Our results indicated high levels of traumatic memories of war and displacement among participants. Using the scale average as a criterion, over half of the participants (56.74% and 51.40%) demonstrated elevated scores on the WDMQ and the Mental Health Scale, respectively. Similarly, 48.60% of the sample reported significant symptom levels on the PTSD measure. These results highlight the importance of studying the effect of traumatic memories on the mental health of displaced persons and refugees (1, 7, 8). The results of the current study confirm that continuous exposure to traumatic memories and acute stress experienced by refugees can exacerbate PTSD and mental health symptoms, while reducing exposure to traumatic events and acute stressors can help alleviate psychological distress and improve mental health outcomes. The correlations between traumatic memories and PCL-5 and BSI-18 scales were significant. This correlation was supported by the results of regression analysis, which found that traumatic memories and education significantly predicted PTSD symptoms among participants. These results validate the importance of including traumatic memories in mental health interventions during war and displacement.

Psychometric validation of the WDMQ

Our results show good reliability coefficients in the questionnaires used in the study. EFA was measured on the data from the WDMQ as exhibiting three significant factors that explained 60.21% of the total variance.

Factor selection was guided by several criteria, including eigenvalues greater than 1.0, variance plot analysis, and the interpretability of the resulting factor solution. These complementary criteria were used to ensure both the statistical efficiency and conceptual coherence of the factors. Rotation was applied using the Varimax method to achieve a clearer and more interpretable factor structure. The choice of rotation technique assumes a correlation between factors. Items were retained in the factors based on their loading coefficients exceeding an acceptable threshold (e.g., ≥0.35), considering cross-loading coefficients and conceptual significance. Based on these criteria, a three-factor solution was adopted, as it provided the most economical and interpretable representation of the data. This structure was further supported by the pattern of item loading coefficients and the conceptual significance of the selected factors.

The first factor explains ongoing war experiences that are present in the memories of displaced persons and refugees. The second factor describes the experiences of refugees among the study sample. Finally, the third factor explains the recollection of people, place, events, etc., that are remembered by displaced persons and refugees as stressful.

Symptom prevalence and diagnostic nuance

The prevalence rates of PTSD ranged between 34% and 52%. These prevalence rates are consistent with prior findings reported in the studies cited, which documented comparable levels of PTSD in similar populations.^33,34 A key consideration in interpreting our findings is the potential discrepancy between self-reported symptoms and clinical diagnoses. Recent evidence from large-scale studies²⁸ highlights that questionnaire-based assessments tend to yield substantially higher prevalence rates than clinical evaluations. This discrepancy calls for a cautious interpretation of cut-off scores in war and displacement contexts. Consequently, while the War and Displacement Memory Questionnaire (WDMQ) effectively identifies individuals with high symptom loads, further clinical validation remains necessary to establish definitive diagnostic rates.

Comparative context and secondary stressors

Statistical analyses of the data from the study presented in this paper indicated that traumatic memories relating to war and displacement were most prevalent among participants. In this regard, studies have found that Syrian displacement victims living in Turkey experienced higher levels of psychological distress and trauma symptoms compared to displaced people in Sweden. Approximately 43% of displaced Syrians suffer from PTSD.³⁵ The psychological distress experienced by displaced individuals was associated with several manifestations of war trauma, including scenes of horror, personal threats, threats to the lives of family members or friends, assault, and death.³⁵ Studies have also documented that stress levels among displaced individuals vary depending on the country in which they reside.³⁵

The present findings are consistent with prior research suggesting that the country of settlement plays a significant role in shaping individuals’ responses to traumatic experiences, likely due to differences in social support systems, integration opportunities, and post-migration stressors.^35,36 Additionally, the observed gender differences in PTSD outcomes align with existing literature indicating higher vulnerability among females, potentially due to both biological and psychosocial factors. Educational level also emerged as a relevant factor, which may reflect differences in coping strategies, access to resources, and cognitive processing of traumatic events.³⁶ Most children chose a recovery trajectory, while a minority exhibited either resistance or increased symptoms of post-traumatic stress disorder.³⁶

In contrast, differences in traumatic memories, mental health, and post-traumatic stress disorder according to education and gender variables were not significant. Our results show that women and primary school graduates exhibited slightly high, but not significant, scores on the traumatic memories scale. Studies have found that the devastating experiences of males, along with better treatment of other groups such as women and children, lead to a clear neglect of the psychological needs of men, making them more vulnerable to risks and less protection.³⁷ Men also recall earlier memories of traumatic events or accidents more than women.⁵

Strength and limitations

Like all survey studies, the main limitations of our study are that it relied on self-reports and the participants were not assessed face-to-face via clinical interview but via an online questionnaire. The cross-sectional nature of this study precludes definitive causal inferences. While we hypothesize that migration-related trauma influences cognitive outcomes, the potential for reverse causality, where current PTSD symptoms exacerbate perceived memory deficits, cannot be dismissed. Additionally, the recruitment strategy via educational institutions and online platforms may introduce a selection bias, potentially excluding individuals with severe psychopathology, limited digital literacy, or restricted internet access. This limitation restricts the generalizability of the findings to the broader refugee population. Furthermore, self-report measures, though standard in large-scale psychological research, are susceptible to subjective biases, including under- or over-reporting. The online format may further amplify these risks due to the absence of clinical observation, necessitating caution in the clinical interpretation of the data.

While the limitations associated with online surveys may apply to the present study, there are strengths that can be summarized in addressing an important topic at the theoretical and applied levels: the memory of war and displacement, or traumatic memory among refugees and displaced persons. The good psychometric properties of the War and Displacement Memory Scale are also a strength of the present study.

Conclusion

This study shows that memories of war and displacement are really important when it comes to the well-being of people who have been displaced in Arab conflict settings. Memories of war are clearly linked to people still having symptoms of PTSD and other mental health problems. This means that what people remember about war and how they think about it is crucial in understanding why they are distressed.

The results of this study support the idea that we should look at memory and mental health together when trying to understand what displaced people need. This way we can better understand the challenges that refugees face as time goes on. We need to do research on memories of war and displacement because this will help us understand how they affect mental health. The War and Displacement Memory Questionnaire is a tool that can be used in the future to assess these things. Memories of war and displacement are a part of the problem, and the War and Displacement Memory Questionnaire can help us learn more about them.

Footnotes

ORCID iD

Fahmi Hassan Fadhel

Ethical approval

All procedures involving human subjects in this study were approved by the War Disabled Association in Syria.

Informed consent

All participants gave explicit consent online.

Author contributions

All the contributors equally participated in this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The publication of this article was funded by the Qatar National Library.

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data availability

Data are available from the corresponding author upon reasonable request.

Provenance and peer review

Not commissioned, externally peer reviewed.

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