Long-term impact of war stress in civilians from the former Yugoslavia: A two-generation neurostructural and psychological study

The long-term neurobiological and psychological effects of war-related stress on civilians remain understudied. This study focuses on survivors of the war in the former Yugoslavia (G1) who now reside in the Czech Republic and on the children of survivors (G2) who were born after the conflict. Participants from G1, G2, and a control group (CG) with no war experience underwent structural MRI, answered a semi-structured interview, and completed psychological questionnaires (PTGI, PCL-5, SWSL, MSPSS, Brief-COPE). Voxel-based morphometry was used to assess brain volume differences.Compared to CG, G1 showed reduced grey matter volume in regions associated with PTSD and autobiographical memory, including Crus II, parahippocampal gyrus, middle temporal gyrus, and fusiform gyrus. Psychologically, G1 reported higher PTSD symptoms, lower life satisfaction, and greater post-traumatic growth. G2 showed no structural brain changes but scored higher on post-traumatic growth than CG, with no significant differences in other psychological measures.The findings suggest long-lasting neuroanatomical and psychological effects of war stress in directly exposed individuals (G1). Although G2 showed no brain alterations, the increased post-traumatic growth may indicate subtle adaptation effects of growing up in a post-war environment, but not necessarily only in a maladaptive sense.