Evidence suggests a link between smaller hippocampal volume (HV) and post-traumatic stress disorder (PTSD). However, there has been little prospective research testing this question directly and it remains unclear whether smaller HV confers risk or is a consequence of traumatization and PTSD.

U.S. soldiers (N = 107) completed a battery of clinical assessments, including structural magnetic resonance imaging pre-deployment. Once deployed they completed monthly assessments of traumatic-stressors and symptoms. We hypothesized that smaller HV would potentiate the effects of traumatic stressors on PTSD symptoms in theater. Analyses evaluated whether total HV, lateral (right v. left) HV, or HV asymmetry (right – left) moderated the effects of stressor-exposure during deployment on PTSD symptoms.

Findings revealed no interaction between total HV and average monthly traumatic-stressors on PTSD symptoms b = −0.028, p = 0.681 [95% confidence interval (CI) −0.167 to 0.100]. However, in the context of greater exposure to average monthly traumatic stressors, greater right HV was associated with fewer PTSD symptoms b = −0.467, p = 0.023 (95% CI −0.786 to −0.013), whereas greater left HV was unexpectedly associated with greater PTSD symptoms b = 0.435, p = 0.024 (95% CI 0.028–0.715).

Our findings highlight the importance of considering the complex role of HV, in particular HV asymmetry, in predicting the emergence of PTSD symptoms in response to war-zone trauma.

Many organizations rally to areas to provide assistance to a population during a disaster. Little is known about the ability of the materials and services provided to meet the actual needs and demands of the affected population. This study sought to identify the perceptions of representatives of the international organizations providing this aid, the international workers involved with the delivery of this aid, the workers who were employed locally by the international organizations, the recipients, and the local authorities. This study sought to identify the perceptions of these personnel relative to the adequacies of the supplies in meeting the needs and demands of the population during and following the war in Bosnia-Herzegovina.

Structured interviews were conducted with representatives of international organizations and workers providing aid and with locally employed workers, recipients of the assistance, and the authorities of the areas involved. Descriptive and inferential statistics were used to assist in the analysis of the data.

Eighty-eight interviews were conducted. A total of 246 organizations were identified as providing assistance within the area, and 54% were involved with health-related activities including: 1) the provision of medications; 2) public health measures; and 3) medical equipment or parts for the same. Internationals believed that a higher proportion of the needs were being met by the assistance (73.4 ±16.4%) than did the nationals (52.1 ±23.3%; p <0.001). All groups believed that approximately 50% of the demands of the affected population were being addressed. However, 87% of the international interviewees believed that the affected population was requesting more than it actually needed.

While 27% of the international participants believed that ≥25% of what was provided was unusable, 80% of the recipients felt that ≥25% of the provisions were not usable. Whereas two-thirds of the international participants believed that ≥25% of the demands for assistance by the affected community could not be justified, only 20% of the recipients and authorities believed ≥25% of the demands were unjustified.

Many organizations are involved in the provision of medical assistance during a disaster. However, international organizations and workers believe their efforts are more effective than do the recipients.