{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:04:37Z","timestamp":1789452277715,"version":"build-2803163510"},"reference-count":81,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Prolonged exposure to armed conflict is associated with elevated rates of PTSD in civilian populations, such as Indian-administered Kashmir. This review aimed to systematically synthesise research on prevalence, risk factors, and correlates of PTSD among civilians in this setting and their association with armed conflict exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review following PRISMA guidelines was conducted for empirical studies published up to 2025. Sixteen quantitative studies met the inclusion criteria. Due to heterogeneity in study design, sampling, and PTSD assessment, findings were synthesised narratively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Reported PTSD prevalence varied across studies. Among community-based adult samples, prevalence ranged from 15.9% to 24.5%, with higher screening-based estimates in selected populations, including college students (up to 49.8%) and children (up to 40%) meeting a PCL-C threshold for probable PTSD. Higher prevalence was observed among women, socioeconomically disadvantaged groups, orphans, and individuals with direct conflict-related injuries. Several studies reported dose-response relationships between cumulative trauma exposure and PTSD, with PTSD symptoms commonly reported even years after exposure and comorbid with depression, anxiety, and substance misuse. Several limitations of existing literature were identified, such as considerable variation in study quality and reliance on cross-sectional research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review reveals substantial levels of PTSD among civilians in Indian-administered Kashmir. It highlights variability driven by methodological differences in measurement, sampling, and exposure assessment. Greater consistency in assessment and study design and more longitudinal studies are needed to strengthen psychiatric epidemiological evidence in armed conflict settings to inform psychiatric support approaches in prolonged armed conflict settings. The findings highlight how the scale of need for psychiatric care in Kashmir exceeds capacity, prompting a need to explore possible low-resource interventions options such as community-based and task-shared approaches, options which may also be applicable in other militarised, low-resource settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/osf.io\/3ztxq<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1919292","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:36:27Z","timestamp":1789450587000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-Traumatic Stress Disorder among civilians in Indian-administered Kashmir: a systematic review"],"prefix":"10.3389","volume":"17","author":[{"given":"Tamkeen","family":"Sakeena","sequence":"first","affiliation":[{"name":"School of Psychology, University of Nottingham","place":["Nottingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneeza","family":"Pervez","sequence":"additional","affiliation":[{"name":"Clare Hall Fellow, Faculty of Education, University of Cambridge","place":["Cambridge, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie","family":"Lolansen","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Nottingham","place":["Nottingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2017.01.002","article-title":"Redefining posttraumatic stress disorder for DSM-5","volume":"14","author":"Weathers","year":"2017","journal-title":"Curr Opin Psychol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s12207-014-9191-1","article-title":"Posttraumatic stress disorder in DSM-5: New criteria, new measures, and implications for assessment","volume":"7","author":"Weathers","year":"2014","journal-title":"psychol Injury Law"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-018-0818-6","article-title":"The neuropsychological consequences of armed conflicts and torture","volume":"18","author":"Weisleder","year":"2018","journal-title":"Curr Neurol Neurosci Rep"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/gpsych-2023-101438","article-title":"Prevalence of post\u2010traumatic stress disorder and depressive symptoms among civilians residing in armed conflict\u2010affected regions: a systematic review and meta\u2010analysis","volume":"37","author":"Ahmed","year":"2024","journal-title":"Gen Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7916\/D8C24V6P","article-title":"The mental health and psychosocial problems of survivors of torture and genocide in Kurdistan, Northern Iraq: a brief qualitative study","volume":"23","author":"Bolton","year":"2013","journal-title":"Torture"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(22)00061-5","article-title":"Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis","volume":"7","author":"Mesa-Vieira","year":"2022","journal-title":"Lancet Public Health"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-013-0762-3","article-title":"Determinants of the development of post-traumatic stress disorder, in the general population","volume":"49","author":"Perrin","year":"2014","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2021.1978417","article-title":"Prevalence of post-traumatic stress disorder in the United States: a systematic literature review","volume":"37","author":"Schein","year":"2021","journal-title":"Curr Med Res Opin"},{"key":"B9","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1002\/jts.20341","article-title":"Estimating population prevalence of posttraumatic stress disorder: an example using the PTSD checklist","volume":"21","author":"Terhakopian","year":"2008","journal-title":"J Traumatic Stress: Off Publ Int Soc For Traumatic Stress Stud"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-12-175","article-title":"What are the risk factors for the comorbidity of posttraumatic stress disorder and depression in a war-affected population? 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