Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Advertisement

Scientific Reports
  • View all journals
  • Search
  • My Account Login
  • Content Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • RSS feed
  1. nature
  2. scientific reports
  3. articles
  4. article
Long-term neurostructural and psychological effects of war stress in two generations of civilians from the former Yugoslavia
Download PDF
Download PDF
  • Article
  • Open access
  • Published: 17 March 2026

Long-term neurostructural and psychological effects of war stress in two generations of civilians from the former Yugoslavia

  • Monika Fňašková  ORCID: orcid.org/0000-0001-7058-15231,3,
  • Pavel Říha  ORCID: orcid.org/0000-0002-1322-20381,3,
  • David Ulčák  ORCID: orcid.org/0009-0004-9077-29591,3,
  • Marek Preiss  ORCID: orcid.org/0000-0002-4463-63131,2,4,
  • Markéta Nečasová  ORCID: orcid.org/0009-0004-9611-06141,
  • Nikola Wolframová  ORCID: orcid.org/0009-0009-1163-27601,
  • Vojtěch Svoboda  ORCID: orcid.org/0000-0001-8603-820X1,5,
  • Martin Lamoš  ORCID: orcid.org/0000-0003-1276-43421,3 &
  • …
  • Ivan Rektor  ORCID: orcid.org/0000-0002-9635-74041,3 

Scientific Reports , Article number:  (2026) Cite this article

  • 515 Accesses

  • Metrics details

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Neuroscience
  • Psychology

Abstract

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.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Abbreviations

G1:

First generation

G2:

Second generation

CG:

Control group

CG1:

Control group for G1

CG2:

Control group for G2

MRI:

Magnetic resonance imaging

PTSD:

Post-traumatic stress disorder

ICD-11:

International classification of diseases, 11th revision

PTGI:

Post-traumatic growth inventory

PCL-5:

PTSD checklist for DSM-5

SWSL:

Satisfaction with life scale

MSPSS:

Multidimensional scale of perceived social support

Brief-COPE:

Brief coping orientation to problems experienced inventory

References

  1. Comtesse, H., Powell, S., Soldo, A., Hagl, M. & Rosner, R. Long-term psychological distress of Bosnian war survivors: an 11-year follow-up of former displaced persons, returnees, and stayers. BMC Psychiatry. 19, 1 (2019).

    Google Scholar 

  2. Priebe, S. et al. Psychological Symptoms as Long-Term Consequences of War Experiences. Psychopathology 46, 45–54 (2013).

    Google Scholar 

  3. Ćopić, S. Wife Abuse in the Countries of the Former Yugoslavia. Feminist Rev. 76, 46–64 (2004).

    Google Scholar 

  4. Jovanović, R. & Bermúdez, Á. The next generation: Nationalism and violence in the narratives of Serbian students on the break-up of Yugoslavia. Stud. Ethn. Nationalism. 21, 2–25 (2021).

    Google Scholar 

  5. Müller-Suleymanova, D. Shadows of the past: violent conflict and its repercussions for second-generation Bosnians in the diaspora. J. Ethnic Migration Stud. 49, 1786–1802 (2023).

    Google Scholar 

  6. Frans, Ö., Rimmö, P. A., Åberg, L. & Fredrikson, M. Trauma exposure and post-traumatic stress disorder in the general population. Acta Psychiatry. Scand. 111, 291–290 (2005).

    Google Scholar 

  7. Priebe, S. et al. Psychological Symptoms as Long-Term Consequences of War Experiences. Psychopathology 46, 45–54 (2012).

    Google Scholar 

  8. Yehuda, R. et al. Post-traumatic stress disorder. Nat. Reviews Disease Primers. 1, 15057 (2015).

    Google Scholar 

  9. Morina, N., Stam, K., Pollet, T. V. & Priebe, S. Prevalence of depression and posttraumatic stress disorder in adult civilian survivors of war who stay in war-afflicted regions. A systematic review and meta-analysis of epidemiological studies. J. Affect. Disord. 239, 328–338 (2018).

    Google Scholar 

  10. Cloitre, M. & Complex, P. T. S. D. assessment and treatment. Eur. J. Psychotraumatology. 12, 1866423 (2021).

    Google Scholar 

  11. Bremner, J. D. Traumatic stress: effects on the brain. Dialog. Clin. Neurosci. 8, 445–461 (2006).

    Google Scholar 

  12. Fňašková, M. et al. Lifelong impact of extreme stress on the human brain: Holocaust survivors study. Neurobiol. Stress. 14, 100318 (2021).

    Google Scholar 

  13. Lupien, S. J., Mcewen, B. S., Gunnar, M. R. & Heim, C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat. Reviews Neuroscience; Lond. 10, 434–445 (2009).

    Google Scholar 

  14. McEwen, B. S., Nasca, C. & Gray, J. D. Stress Effects on Neuronal Structure: Hippocampus, Amygdala, and Prefrontal Cortex. Neuropsychopharmacol 41, 3–23 (2016).

    Google Scholar 

  15. See, C. R. Z. et al. A whole-brain voxel-based analysis of structural abnormalities in PTSD: An ENIGMA-PGC study. Eur. Psychiatry. 68, e97 (2025).

    Google Scholar 

  16. Clausen, A. N., Billinger, S. A., Sisante, J. F. V., Suzuki, H. & Aupperle, R. L. Preliminary evidence for the impact of combat experiences on gray matter volume of the posterior insula. Front. Psychol. 8, (2017).

  17. Young, D. A. et al. Association among anterior cingulate cortex volume, psychophysiological response, and PTSD diagnosis in a Veteran sample. Neurobiol. Learn. Mem. 155, 189–196 (2018).

    Google Scholar 

  18. Sandi, C. Stress and cognition. Wiley Interdisciplinary Reviews: Cogn. Sci. 4, 245–261 (2013).

    Google Scholar 

  19. Kühn, S. et al. The brain at war: effects of stress on brain structure in soldiers deployed to a war zone. Transl Psychiatry. 11, 1–9 (2021).

    Google Scholar 

  20. Yehuda, R. et al. Hippocampal volume in aging combat veterans with and without post-traumatic stress disorder: relation to risk and resilience factors. J. Psychiatr Res. 41, 435–445 (2007).

    Google Scholar 

  21. Pavić, L. et al. Smaller right hippocampus in war veterans with posttraumatic stress disorder. Psychiatry Research: Neuroimaging. 154, 191–198 (2007).

    Google Scholar 

  22. Cooper, H. The Second Generation ‘Syndrome’. J. Holocaust Educ. 4, 131–146 (1995).

    Google Scholar 

  23. Preiss, M. et al. Posttraumatic Stress and Posttraumatic Growth in Three Generations of Czech and Slovak Holocaust Survivors. J. Trauma. Stress. 35, 159–167 (2022).

    Google Scholar 

  24. Scharf, M. Long-term effects of trauma: Psychosocial functioning of the second and third generation of Holocaust survivors. Dev. Psychopathol. 19, (2007).

  25. van IJzendoorn, M. H., Bakermans-Kranenburg, M. J. & Sagi-Schwartz, A. Are Children of Holocaust Survivors Less Well-Adapted? A Meta-Analytic Investigation of Secondary Traumatization. J. Trauma. Stress. 16, 459–469 (2003).

    Google Scholar 

  26. Sarigedik, E., Naldemir, I. F., Karaman, A. K. & Altinsoy, H. B. Intergenerational transmission of psychological trauma: A structural neuroimaging study. Psychiatry Research: Neuroimaging. 326, 111538 (2022).

    Google Scholar 

  27. Bowers, M. E. & Yehuda, R. Intergenerational Transmission of Stress in Humans. Neuropsychopharmacology 41, 232–244 (2016).

    Google Scholar 

  28. Dias, B. G. & Ressler, K. J. Parental olfactory experience influences behavior and neural structure in subsequent generations. Nat. Neurosci. 17, 89–96 (2014).

    Google Scholar 

  29. Schick, M., Morina, N., Klaghofer, R., Schnyder, U. & Müller, J. Trauma, mental health, and intergenerational associations in Kosovar families 11 years after the war. Eur. J. Psychotraumatol. 4, (2013).

  30. Schmahmann, J. D. The Role of the Cerebellum in Cognition and Emotion: Personal Reflections Since 1982 on the Dysmetria of Thought Hypothesis, and Its Historical Evolution from Theory to Therapy. Neuropsychol. Rev. 20, 236–260 (2010).

    Google Scholar 

  31. Adamaszek, M. et al. Consensus Paper: Cerebellum and Emotion. Cerebellum 16, 552–576 (2017).

    Google Scholar 

  32. Sokolov, A. A., Miall, R. C. & Ivry, R. B. The Cerebellum: Adaptive Prediction for Movement and Cognition. Trends Cogn. Sci. 21, 313–332 (2017).

    Google Scholar 

  33. Blithikioti, C. et al. Cerebellar Contributions to Traumatic Autobiographical Memory in People with Post-Traumatic Stress Disorder. Cerebellum 23, 2332–2340 (2024).

    Google Scholar 

  34. Van Overwalle, F., Ma, Q. & Heleven, E. The posterior crus II cerebellum is specialized for social mentalizing and emotional self-experiences: a meta-analysis. Soc. Cogn. Affect. Neurosci. 15, 905–928 (2020).

    Google Scholar 

  35. Huggins, A. A. et al. Smaller total and subregional cerebellar volumes in posttraumatic stress disorder: a mega-analysis by the ENIGMA-PGC PTSD workgroup. Mol. Psychiatry. 29, 611–623 (2024).

    Google Scholar 

  36. Lew, C. H. & Semendeferi, K. 4.16 - Evolutionary Specializations of the Human Limbic System. in Evolution of Nervous Systems (Second Edition) (ed Kaas, J. H.) 277–291 (Academic, Oxford, doi:https://doi.org/10.1016/B978-0-12-804042-3.00115-9. (2017).

    Google Scholar 

  37. Nardo, D. et al. Gray matter density in limbic and paralimbic cortices is associated with trauma load and EMDR outcome in PTSD patients. J. Psychiatr. Res. 44, 477–485 (2010).

    Google Scholar 

  38. Kunimatsu, A., Yasaka, K., Akai, H., Kunimatsu, N. & Abe, O. MRI findings in posttraumatic stress disorder. J. Magn. Reson. Imaging. 52, 380–396 (2020).

    Google Scholar 

  39. Steward, T., Das, P., Malhi, G. S., Bryant, R. A. & Felmingham, K. L. Dysfunctional coupling of the parahippocampal cortex and inferior frontal gyrus during memory suppression in posttraumatic stress disorder. Eur. Neuropsychopharmacol. 41, 146–151 (2020).

    Google Scholar 

  40. Brewin, C. R., Gregory, J. D., Lipton, M. & Burgess, N. Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychol. Rev. 117, 210–232 (2010).

    Google Scholar 

  41. Li, L. et al. Grey matter reduction associated with posttraumatic stress disorder and traumatic stress. Neuroscience Biobehavioral Reviews. 43, 163–172 (2014).

    Google Scholar 

  42. Mueller, E. M. & Pizzagalli, D. A. One-year-old fear memories rapidly activate human fusiform gyrus. Soc. Cognit. Affect. Neurosci. 11, 308–316 (2016).

    Google Scholar 

  43. Weiner, K. S. & Zilles, K. The anatomical and functional specialization of the fusiform gyrus. Neuropsychologia 83, 48–62 (2016).

    Google Scholar 

  44. Badura-Brack, A. S. et al. Decreased somatosensory activity to non-threatening touch in combat veterans with posttraumatic stress disorder. Psychiatry Research: Neuroimaging. 233, 194–200 (2015).

    Google Scholar 

  45. Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K. & Domino, J. L. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation. J. Trauma. Stress. 28, 489–498 (2015).

    Google Scholar 

  46. Priebe, S. et al. Consequences of Untreated Posttraumatic Stress Disorder Following War in Former Yugoslavia: Morbidity, Subjective Quality of Life, and Care Costs. Croatian Med. J. 50, 465–475 (2009).

    Google Scholar 

  47. Dekel, S., Ein-Dor, T. & Solomon, Z. Posttraumatic growth and posttraumatic distress: A longitudinal study. Psychol. Trauma: Theory Res. Pract. Policy. 4, 94–101 (2012).

    Google Scholar 

  48. Holmes, E. A., Moulds, M. L. & Kavanagh, D. Memory Suppression in PTSD Treatment? Science 318, 1722–1722 (2007).

    Google Scholar 

  49. Kelmendi, K. & Hamby, S. Resilience After Trauma in Kosovo and Southeastern Europe: A Scoping Review. Trauma Violence Abuse. 24, 2333–2345 (2023).

    Google Scholar 

  50. Wasiak, K. Between Trauma and Nostalgia: Second Generation Memory of the War in Bosnia and Herzegovina. Historia i Polityka. 53, 71–83 (2023).

    Google Scholar 

  51. Audergon, A. Collective trauma: the nightmare of history. Psychother. Politics Int. 2, 16–31 (2004).

    Google Scholar 

  52. Sangalang, C. C. The scars of war last for centuries: how we understand collective trauma needs to change. Nature 641, 589–591 (2025).

    Google Scholar 

  53. Wechsler, D. Wechsler Adult Intelligence Scale – Třetí revize (WAIS-III): Czech version. (2010).

  54. Říčan, P. Test intelektového potenciálu. (1971).

  55. Tedeschi, R. G. & Calhoun, L. G. The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. J. Trauma. Stress. 9, 455–471 (1996).

    Google Scholar 

  56. Diener, E., Emmons,Robert, A., Larsen, Randy, J., Griffin, S. & and The Satisfaction With Life Scale. J. Pers. Assess. 49, 71–75 (1985).

    Google Scholar 

  57. Zimet, G. D., Dahlem,Nancy, W., Zimet, Sara, G., Farley, G. K. & and The Multidimensional Scale of Perceived Social Support. J. Pers. Assess. 52, 30–41 (1988).

    Google Scholar 

  58. Carver, C. S. You want to measure coping but your protocol’ too long: Consider the brief cope. Int. J. Behav. Med. 4, 92–100 (1997).

    Google Scholar 

Download references

Acknowledgements

We thank Anne Johnson for grammatical assistance. We acknowledge the core facility MAFIL of CEITEC MU.

Funding

Supported by the Ministry of Health of the Czech Republic in cooperation with the Czech Health Research Council under project No. NU22-04-00661. We acknowledge the core facility MAFIL supported by the Czech-BioImaging large RI project (LM2023050 funded by MEYS CR), part of the Euro-BioImaging (www.eurobioimaging.eu) ALM and Multimodal Imaging Node (Brno, CZ), for their support with obtaining scientific data presented in this paper.

Author information

Authors and Affiliations

  1. Centre for Neuroscience, Central European Institute of Technology (CEITEC), Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic

    Monika Fňašková, Pavel Říha, David Ulčák, Marek Preiss, Markéta Nečasová, Nikola Wolframová, Vojtěch Svoboda, Martin Lamoš & Ivan Rektor

  2. National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic

    Marek Preiss

  3. First Department of Neurology, Faculty of Medicine, St Anne’s University Hospital, Masaryk University, Brno, Czech Republic

    Monika Fňašková, Pavel Říha, David Ulčák, Martin Lamoš & Ivan Rektor

  4. University of New York in Prague, Londynska 41, 120 00, Prague, Czech Republic

    Marek Preiss

  5. Utrecht University, Heidelberglaan 8, 3584 CS, Utrecht, The Netherlands

    Vojtěch Svoboda

Authors
  1. Monika Fňašková
    View author publications

    Search author on:PubMed Google Scholar

  2. Pavel Říha
    View author publications

    Search author on:PubMed Google Scholar

  3. David Ulčák
    View author publications

    Search author on:PubMed Google Scholar

  4. Marek Preiss
    View author publications

    Search author on:PubMed Google Scholar

  5. Markéta Nečasová
    View author publications

    Search author on:PubMed Google Scholar

  6. Nikola Wolframová
    View author publications

    Search author on:PubMed Google Scholar

  7. Vojtěch Svoboda
    View author publications

    Search author on:PubMed Google Scholar

  8. Martin Lamoš
    View author publications

    Search author on:PubMed Google Scholar

  9. Ivan Rektor
    View author publications

    Search author on:PubMed Google Scholar

Contributions

M.F. (corresponding author): Project Administration, Investigation, Resources, Data Curation, Writing Original Draft, Visualisation, P.Ř. - Methodology, Software, Formal Analysis, Investigation, Visualisation, M.P. - Conceptualisation, Methodology, Validation, D. U. Investigation, Visualisation, M.N. - Investigation, N.W. Investigation, V. S. Investigation, M.L. Supervision, I.R. - Conceptualisation, Supervision.

Corresponding author

Correspondence to Monika Fňašková.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval statement

Ethical approval for this study was obtained from the ethics committee of Masaryk University (approval code EKV-2021-076) on June 24, 2021.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary Material 1 (download DOCX )

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fňašková, M., Říha, P., Ulčák, D. et al. Long-term neurostructural and psychological effects of war stress in two generations of civilians from the former Yugoslavia. Sci Rep (2026). https://doi.org/10.1038/s41598-026-44241-w

Download citation

  • Received: 02 July 2025

  • Accepted: 10 March 2026

  • Published: 17 March 2026

  • DOI: https://doi.org/10.1038/s41598-026-44241-w

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Keywords

  • MRI
  • Stress
  • Civilians
  • War
  • Crus II
  • Posttraumatic growth
Download PDF

Advertisement

Explore content

  • Research articles
  • News & Comment
  • Collections
  • Subjects
  • Follow us on Facebook
  • Follow us on X
  • Sign up for alerts
  • RSS feed

About the journal

  • About Scientific Reports
  • Contact
  • Journal policies
  • Guide to referees
  • Calls for Papers
  • Editor's Choice
  • Journal highlights
  • Open Access Fees and Funding

Publish with us

  • For authors
  • Language editing services
  • Open access funding
  • Submit manuscript

Search

Advanced search

Quick links

  • Explore articles by subject
  • Find a job
  • Guide to authors
  • Editorial policies

Scientific Reports (Sci Rep)

ISSN 2045-2322 (online)

nature.com footer links

About Nature Portfolio

  • About us
  • Press releases
  • Press office
  • Contact us

Discover content

  • Journals A-Z
  • Articles by subject
  • protocols.io
  • Nature Index

Publishing policies

  • Nature portfolio policies
  • Open access

Author & Researcher services

  • Reprints & permissions
  • Research data
  • Language editing
  • Scientific editing
  • Nature Masterclasses
  • Research Solutions

Libraries & institutions

  • Librarian service & tools
  • Librarian portal
  • Open research
  • Recommend to library

Advertising & partnerships

  • Advertising
  • Partnerships & Services
  • Media kits
  • Branded content

Professional development

  • Nature Awards
  • Nature Careers
  • Nature Conferences

Regional websites

  • Nature Africa
  • Nature China
  • Nature India
  • Nature Japan
  • Nature Middle East
  • Privacy Policy
  • Use of cookies
  • Legal notice
  • Accessibility statement
  • Terms & Conditions
  • Your US state privacy rights
Springer Nature

© 2026 Springer Nature Limited

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing