Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Psychiatry. Nov 19, 2026; 16(11): 124924
Published online Nov 19, 2026. doi: 10.5498/wjp.124924
Published online Nov 19, 2026. doi: 10.5498/wjp.124924
Beyond direct trauma: Vicarious exposure, media-induced stress, and external stress overload as emerging public mental health challenges
Davoud Amiri, Department of Psychiatry, Affiliated with Uppsala Region, Uppsala 75310, Uppland, Sweden
Lamberto Briziarelli, Department of Public Health, University of Perugia, Perugia 06100, Umbria, Italy
Sara Amiri, Department of Business and Economics, Uppsala University, Uppsala 75310, Uppland, Sweden
Barry Karlsson, Department of Medical Sciences, Uppsala University, Uppsala 75310, Uppland, Sweden
Swetang J Shah, Department of Child Psychiatry, Bay Area Community Health, San Jose, CA 95127, United States
Hadi Rahimi Danesh, Department of Psychology, Shahid Beheshti University of Medical Sciences, Tehran 1619614153, Iran
Author contributions: Amiri D conceptualized the article, developed the framework, conducted the literature synthesis, and drafted the manuscript; Briziarelli L, Amiri S, Karlsson B, Shah SJ and Rahimi Danesh H contributed to critical revision, interpretation of the literature, and refinement of the manuscript; all authors reviewed and approved the final version.
AI contribution statement: Artificial intelligence (ChatGPT, OpenAI) was used during manuscript preparation for language editing, improvement of readability, grammar, and stylistic refinement. All scientific content, interpretation, revision, and final approval of the manuscript were performed by the authors, who take full responsibility for the accuracy and integrity of the work.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Corresponding author: Davoud Amiri, MD, PhD, Researcher, Department of Psychiatry, Affiliated with Uppsala Region, Drottninggatan 12, Uppsala 75310, Uppland, Sweden.
Received: June 26, 2026
Revised: July 25, 2026
Accepted: September 8, 2026
Published online: November 19, 2026
Processing time: 125 Days and 10.9 Hours
Revised: July 25, 2026
Accepted: September 8, 2026
Published online: November 19, 2026
Processing time: 125 Days and 10.9 Hours
Core Tip
Core Tip: This review proposes external stress overload as a clinical framework for understanding how repeated indirect exposure to threatening information may contribute to distress in contemporary digital environments. The model integrates evidence on vicarious trauma, media-induced stress, doomscrolling, uncertainty, rumination, impaired recovery, and stress biology. It is not presented as a new diagnosis, but as a working concept that may help clinicians assess when media exposure, poor recovery, and repeated checking become maintaining factors for anxiety, sleep disturbance, emotional dysregulation, and functional impairment.