Profiling PTSD Severity Among Emergency HealthCare Workers in Post-Conflict Afghanistan

Despite the formal end of the conflict, healthcare workers (HCWs) in Afghanistan continue to face chronic exposure to trauma, placing them at heightened risk for psychological distress and post-traumatic stress disorder (PTSD) symptoms. This study aimed to identify key psychological predictors of PTSD severity in this population, and to examine whether resilience, self-compassion, and perceived social support mediate or moderate the relationship between trauma exposure and post-traumatic symptoms. Fifty-four HCWs working at the Emergency NGO Surgical Center for War Victims in Kabul and Lashkar-Gah, Afghanistan, completed an online survey assessing trauma exposure, PTSD symptoms, anxiety, depression, resilience, self-compassion, and perceived social support. Multiple regression analyses and mediation analyses via Structural Equation Modeling (SEM) were conducted to examine predictors and mediation effects. Higher levels of depression, anxiety, and trauma load were significantly associated with greater PTSD severity, while higher resilience was linked to lower symptom severity. Among all variables, depressive symptoms emerged as the strongest predictor. SEM supported this finding, revealing that depression significantly mediated the relationship between trauma load and PTSD symptoms. No significant mediating effects were found for anxiety, resilience, perceived social support, or self-compassion. These findings highlight the central role of depression in the development and maintenance of PTSD symptoms among HCWs exposed to chronic instability trauma. The results underscore the need for trauma-informed, culturally sensitive interventions that include early detection and treatment of depressive symptoms to mitigate the psychological burden on humanitarian staff in conflict settings.