Armed conflict exposure and mental health: examining the role of imperceptible violence.

Armed conflict exposure is associated with multiple mental health problems. However, more needs to be known about the differential effects of particular modalities of armed conflict violence and war methods on mental health. This study a) examined the modalities of violence employed in the Colombian armed conflict and b) assessed their association with mental health problems in armed conflict survivors. Using armed conflict data from the Colombian Armed Conflict Events Information System, we identified three violence modalities: armed confrontations, indiscriminate attacks, and selective violence. Descriptive statistics showed that selective violence generated most (86%) of the 333,219 victims of the Colombian armed conflict between 1996 and 2016. A subsample of armed conflict survivors (n = 551) from the 2015 Colombian Mental Health Survey was used to assess the association of each modality of violence with depression and anxiety, Post Traumatic Stress Disorder (PTSD), and substance abuse. Adjusted Odds Ratios (aOR) (p < .05, 95% CI) showed that survivors of selective violence crimes such as forced disappearance of loved ones, kidnapping, sexual violence, and massacres were at increased risk of experiencing Common Mental Health Disorders, PTSD symptoms, and hazardous drinking. Identifying those at elevated risk for developing mental health problems and substance misuse among survivors of armed conflict may help to use limited resources more effectively.