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From Syria to Ukraine, frontline journalists give readers first-hand accounts of violence, suffering and hope in conflicts distant and near. But in so doing they challenge their own physical and emotional well-being.

Dr. Anthony Feinstein, a professor at the University of Toronto and a psychiatrist at Sunnybrook Health Sciences Centre, is a world leader on the psychological effects of war on journalists.

Together with Dr. Feinstein, the Globe and Mail has launched a year-long project:, featuring his interviews with photojournalists. The next installment is scheduled to appear later this month.

����ֱ�� News spoke to Dr. Feinstein about his unexpected findings.

When did you first become interested in the psychological effects of war on frontline journalists?
A frontline journalist was referred to my neuropsychiatric clinic at Sunnybrook Health Sciences Centre. I learned from her that large news organizations did not have a policy or mechanism to help journalists who had become traumatized by their work in war zones. This led me to apply for a grant from the Freedom Forum in Washington, D.C. From this arose the first-ever study exploring the psychological health of war journalists.

What sorts of stories have you heard? 
The stories that move me most pertain to resilience and fortitude in the face of adversity. Stories of victims of war and revolution who, despite extraordinary circumstances, keep their dignity, maintain their sense of humanity and strive, despite the odds, to keep a semblance of normality in their lives and those of their families. These accounts attest to the nobility and goodness of the human spirit even amidst the horrors of war.

Have you found a common thread linking frontline journalists?
Many threads link the psychological profiles of these journalists. The first is their resilience. The majority of frontline journalists, in excess of 80 per cent, show no features of post-traumatic stress disorder, major depression and so on. This observation should be seen in the context of individuals covering war for over two decades.

As to the minority of journalists who develop clinically significant psychological distress, the most common diagnoses confronted are those of PTSD, major depression and substance abuse. Women journalists who choose to work on the frontlines do not appear to show higher levels of trauma-related symptoms than men, suggesting that they are a highly select group.

Was there an expectation that women would show higher levels of trauma?
Women in the general population have consistently been shown to have levels of depression and anxiety twice that of men. We did not see this in the war journalist group studies – their levels of depressive, anxiety and PTSD symptoms were the same as the men.

Is journalism more dangerous than it was before?
Journalism is undoubtedly more dangerous today. More journalists are being killed in zones of conflict. New threats have emerged, namely kidnap for ransom and execution that is filmed and posted on the Internet as a means to instill fear and horror. Journalists are now high-profile targets and are firmly in the crosshairs of insurgents.  

Beyond the obvious danger of working in a war zone, what are some other stressors in the life and work of frontline journalists?
One of the biggest is how best to integrate into civil society after spending prolonged periods in war zones. Another is the challenge of keeping relationships going when away from home for such prolonged periods. There is also the stress of remaining medically well while working in zones of conflict where health care services have collapsed.

(Image at right: Fixing a Window Pane After Shootout)

How do reporters working in countries that are not at war, but have a poor safety record for journalists, fare in terms of mental health?
I completed a UNESCO-funded study of Mexican journalists a few years back and found high rates of psychological difficulties – one in four journalists had stopped working on a story because of prominent emotional difficulties. The biggest stressor the journalists confronted was the threat directed at their families by the cartel. There are, of course, other difficulties, too, most notably an inability to leave the conflict behind them given that they live in zones of conflict.

Do frontline journalists have a shorter expiry date than people in other professions?
The journalists who have been part of my studies have a remarkable career longevity. On average they have covered wars for more than 15 years. I have no doubt that this is a highly select group and that there are many journalists who cannot sustain their careers for more than one or two conflicts.

(Image below: Vukovar)

All photos © Mico Smiljanic. Visit