literature review on conflict

Conflict, Conflict Management and Negotiations: A Mini Literature Review

19 Pages Posted: 8 Aug 2022 Last revised: 18 Sep 2022

Phakamile Thwala

University of South Africa (UNISA)

Date Written: July 19, 2022

Personalities and group interests are central to conflict management and negotiations. Conflict arises out of different opinions, beliefs, and ideologies. The purpose of this study is to conduct a mini- literature review on conflict, conflict management, and negotiations. The literature review affirms that conflict is unavoidable. A significant shift has been identified from the older theories that sought to eliminate conflict to present-day learning and development perspectives upheld by modern theorists. There is a difference between conflict management and conflict resolution whilst negotiations are interrelated with conflict management and conflict resolution.

Keywords: Conflict, Conflict management, Negotiations

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Conflict personalization: a systematic literature review and the development of an integrative definition

International Journal of Conflict Management

ISSN : 1044-4068

Article publication date: 27 September 2023

Issue publication date: 13 February 2024

• Supplementary Material

Scholars and practitioners alike wish to understand what makes workplace conflict beneficial or injurious to, for example, performance and satisfaction. The authors focus on parties’ personal experience of the conflict, which is complementary to studying conflict issues (i.e. task- or relationship-related conflict). Although many authors discuss the personal experience of conflict, which the authors will refer to as conflict personalization, different definitions are used, leading to conceptual vagueness. Therefore, the purpose of this paper is to develop an integrative definition of the concept of conflict personalization.

Design/methodology/approach

The authors conducted a systematic literature review to collect definitions and conceptualizations from 41 publications. The subsequent thematic analysis revealed four building blocks that were used to develop an integrative definition of conflict personalization.

The authors developed the following definition: Conflict personalization is the negative affective as well as cognitive reaction to the self being threatened and/or in danger as a result of a social interaction about perceived incompatibilities.

Practical implications

The integrative definition of this study enables the development of a measurement instrument to assess personalization during workplace conflict, paving the way for developing effective research-based interventions.

Originality/value

Conceptual vagueness hampers theoretical development, empirical research and the development of effective interventions. Although the importance of conflict personalization is mentioned within the field of workplace conflict, it has not been empirically studied yet. This paper can serve as the basis for future research in which conflict issue and personal experience are separated.

• Conflict personalization
• Workplace conflict

Hoogenboom, L.M. , Dijkstra, M.T.M. and Beersma, B. (2024), "Conflict personalization: a systematic literature review and the development of an integrative definition", International Journal of Conflict Management , Vol. 35 No. 2, pp. 309-333. https://doi.org/10.1108/IJCMA-09-2022-0142

Emerald Publishing Limited

Copyright © 2023, Lilian M. Hoogenboom, Maria T.M. Dijkstra and Bianca Beersma.

Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial & non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

Introduction

Whenever people work together, conflicts, defined as “the interaction of interdependent parties who perceive incompatibility and the possibility of interference from others as a result of this incompatibility” ( Folger et al. , 2021 , p. 4), are bound to arise. Indeed, worldwide, people spend about 2 h on average per week dealing with workplace conflict ( CPP, 2008 ). Thus, it is not surprising that there is widespread interest in understanding the consequences of workplace conflict and how conflict can be managed to reduce negative outcomes and stimulate positive outcomes by academics as well as practitioners (see Avgar and Colvin, 2016 for a comprehensive collection of studies).

We aim to contribute to a better understanding of the consequences of workplace conflict by building consensus on the definition of conflict personalization, originally defined by Hample and Dallinger (1995) as “a feeling of being personally engaged in a punishing life event” (p. 306). We focus on the personal experience of conflict, which we consider to be complementary to studying conflict issues (i.e. the Conflict Type Approach, CTA, Jehn , 1995, 1997 ). Through a systematic literature review, we take stock of the various definitions and conceptualizations of conflict personalization that have been published in the scientific literature. Via a thematic analysis of these definitions and conceptualizations, we gather the crucial building blocks for a more precise, integrative definition of conflict personalization. We conclude the paper by developing an integrative definition of conflict personalization and offering suggestions for future research.

Workplace conflict and its outcomes

To explain when and why workplace conflict has positive and negative consequences, throughout the past decades, numerous empirical studies were published that rely on the CTA. In short, the CTA is based on a categorization of conflict issues and distinguishes between workplace disagreements about the task at hand (referred to as task conflict) and disagreements that are unrelated to the task (referred to as relationship conflict) [ 1 ]. Within the conflict literature, this task versus relationship distinction is also referred to as substantive versus affective conflict ( Davis and Harveston, 2001 ; Rahim, 2002 ) or cognitive versus affective conflict ( Mooney et al. , 2007 ; Parayitam and Dooley, 2009 ; Ullah, 2022 ).

According to the CTA, workplace conflict that revolves around the work task(s) may have positive outcomes, such as creative solutions to problems and high-quality decisions ( Nemeth, 1995 ; Schulz-Hardt et al. , 2006 ), whereas relationship conflict (i.e. non-task conflict) on interpersonal issues like values and norms ( Jehn, 1995 ) should have negative outcomes. Indeed, studies have shown time after time that relationship conflicts result in negative outcomes like decreased satisfaction and well-being and increased turnover ( De Dreu and Weingart, 2003 ; De Wit et al. , 2012 ; Dijkstra et al. , 2005 ; Jehn et al. , 2006 ). However, results with regards to task conflict are less clear; two meta-analyses showed that task conflict can have positive, negative or no effects at all on group performance, suggesting moderating factors play an important role ( De Dreu and Weingart, 2003 ; De Wit et al. , 2012 ).

Interestingly, whereas task- and relationship-related conflicts are conceptualized as two separate types of conflict, numerous studies have shown that the two types of conflict are actually strongly intertwined (i.e. moderately to highly correlated; for an overview, see De Wit et al. , 2012 ), and the extent to which relationship co-occurs with task conflict has been discussed as an explanation for why task conflict should have harmful or beneficial outcomes (i.e. “pure” task conflict should have positive effects, whereas task conflict mixed with relationship conflict should have negative effects, De Dreu and Weingart, 2003 ; De Dreu, 2008 ).

Unfortunately, the way in which task- and relationship-related conflict is commonly defined and measured complicates understanding and interpreting the above-described results. That is, whereas almost every definition of task conflict emphasizes the perception of disagreement about viewpoints, disagreements, ideas, goals, issues and decisions that are related to the task and/or task behavior ( De Dreu and Weingart, 2003 ; Jehn et al. , 1997 ; Simons and Peterson, 2000 ) without referencing emotions, definitions of relationship conflict do refer to (the perception of) disagreement but are predominantly formulated in terms of expressions like anger, frustration, distrust ( Mortensen and Hinds, 2001 ), tension, animosity, annoyance ( Jehn et al. , 1997 ) and friction ( Jehn, 1994 ). This is undesirable, as negative emotionality could just as well occur during task conflicts ( Bendersky et al. , 2014 ; Dijkstra et al. , 2005 ; Jehn et al. , 2008 ).

The entanglement of issue and emotion with respect to relationship conflict appears in its operationalization as well. Whereas task conflict is “cleanly” measured through items that assess the extent of conflict about the task, relationship conflict is measured by one item that refers to the conflict issues at stake and three items that concern emotionality (i.e. “friction,” “tension,” and “emotional conflict,” Jehn, 1995 ) [ 2 ]. As a result of the confounding of relationship conflict and emotionality, if conflict parties report a high level of relationship conflict, this can mean different things. First, it might mean that parties experience a lot of non-task-related conflict. Second, it might mean that the experienced conflict, irrespective of whether it is task-related or not, is highly emotional. Third, it might mean that parties refer to the experience of a lot of non-task-related conflict and that this conflict is experienced as highly emotional.

We propose that to better understand when and why workplace conflicts have positive or negative consequences, it is important to disentangle effects of the conflict issue from the personal experience of workplace conflict. Other scholars have emphasized the importance of factors that are distinct from the conflict issue as well, such as emotionality ( Yang and Mossholder, 2004 ), psychological safety ( Bradley et al. , 2012 ), trust ( Simons and Peterson, 2000 ) and positive emotions ( Todorova et al. , 2014 ). Their findings showed that the effects of workplace conflict are not solely dependent on what the conflict is about. In line with these findings, workplace conflicts could be placed within a framework consisting of two orthogonal dimensions; one dimension representing the extent to which the conflict concerns the work task and the other dimension representing the conflict experience, or the extent to which the conflict is personalized.

To illustrate how workplace conflict can be understood in terms of issue and personal experience as two separate dimensions, think, for example, about a disagreement regarding a budget proposal. Such a conflict would be considered to score high on the extent to which it is about the work task. But, with regards to the extent to which it is personalized, it could be a conflict that is personalized to a low, medium or even high extent. Now consider a disagreement during a coffee break on what constitutes (in)appropriate humor at work, a conflict that would be considered to score non-task on the extent to which it is about the work task. Again, this conflict could be personalized to a low, medium or higher extent. Thus, irrespective of the degree to which a conflict is about the work task, it can be personalized to a certain degree.

Even though attention to the personal experience of conflict as a separate dimension that can be distinguished from the conflict issue is quite novel in the scholarly field of workplace conflict, it is considered an important factor in non-academic management books. For instance, Fisher and Ury (1999) advise their readers to separate the people from the problem, which, they argue, is challenging as people have “egos that are easily threatened” (p. 19). And Runde and Flanagan (2010) advise readers to “stay in the now, (…) it is not personal” (p. 228) (also see Falcone, 2009 ; Pitagorsky, 2012 ; Regier, 2017 ). Additionally, there is quite a lot of material available online on ways to stop taking things personally at work in general ( Bridges, 2018 ; Strauss Cohen, 2018 ) and, for example, more specifically, as a skill of an effective leader ( Chen, 2013 ).

Despite the widespread advice to “not take conflict personally,” and the available literature on this subject in the field of argumentation and communication ( Hample and Cionea, 2010 ; Hample and Dallinger, 1995 ; Worley and Aloia, 2019 ), the scientific field of workplace conflict management seems to be lagging behind in offering clarity on its meaning, antecedents and consequences. As the above overview suggests that the personal experience of conflict is seen as an important factor that affects conflict outcomes, we feel that it deserves more scientific attention.

Personalization of workplace conflict

The personal experience during conflict due to one’s perceptions can be understood in terms of conflict personalization . In their core publication, Hample and Dallinger (1995) refer to conflict personalization as taking conflict personally , which they defined in the following ways: “a negative emotional reaction to participating in conflict” (p. 297), and “a feeling of being personally engaged in a punishing life event” (p. 306).

Although these definitions have subsequently been adopted by some scholars in research on interpersonal conflict ( Aloia and Worley, 2019 ; Kim et al. , 2015 ), others have explained taking conflict personally differently. Avtgis (2002) , for example, described taking conflict personally in terms of “a predisposition towards interpreting conflict as a punishing or unpleasurable event” (p. 228), whereas Brisini and Solomon (2020) described it as “a form of cognitive bias in which individuals feel victimized by a conflict” (p. 4402).

Yet, other scholars, rather than define or describe conflict personalization, have referred to the idea of conflict personalization. For instance, Jehn and Mannix (2001) suggest that it is only possible to enjoy benefits of task- and process-related conflict if group members are “not taking these conflicts personally and do not engage in relationship conflict” (p. 248). In addition ( Simons and Peterson, 2000 ) state that if group members trust each other, they will not misinterpret the task conflict as a personal attack; so trust prevents the detrimental co-occurrence of task- and relationship-related conflict (see also De Wit et al. , 2012 ). Furthermore, Mooney et al. (2007) argue that judgments and attributions of team members cause them to react personally and emotionally when they debate different views about a task. As such, rejection of a task-related opinion might be interpreted as a personal attack that threatens their identity ( De Wit et al. , 2013 ; Swann et al. , 2004 ).

Conceptual vagueness

The above short overview shows that conflict scholars have, implicitly or explicitly, used conflict personalization as an explanation for conflict being productive or destructive. Even though there is no heated debate in the literature on how to define conflict personalization, our overview does show that there is conceptual vagueness and that an agreed-upon, precise and integrative definition of conflict personalization currently does not exist. Conceptual vagueness will obstruct three important research goals: theory development, empirical study and effective intervention development.

Firstly, to produce meaningful theory in a given scientific field, a precise definition of the construct that the theory applies to is required to function as a building block for theory, and scholars need a common language to discuss and build on ideas ( Podsakoff et al. , 2016 ; Locke, 2003 ). The more precise the definition, the more precise and refined the theory can be. A lack of definitional clarity makes it difficult to distinguish the concept from similar concepts, undermining discriminant validity and increasing the risk of proliferation of different terms for the same concept ( Podsakoff et al. , 2016 ). For example, conflict personalization and relationship conflict – discussed earlier in the introduction – could be confused with each other if not adequately defined due to the personal element that is part of both. Scholars, both experienced and new to conflict personalization, risk building upon one variant of a definition. The foundation of the conflict personalization literature should take the form of one precise definition, instead of multiple possibilities to choose from.

Secondly, the absence of a precise conceptual definition negatively affects the quality of empirical research, as specifying and testing antecedents, consequences and correlates of a concept becomes sensitive to errors ( Podsakoff et al. , 2016 ; Strunz, 2012 ). A vague definition only provides general information about the nature of the variable, leading to a mismatch between concept and measures and/or manipulations (construct validity) and/or contamination of measures and manipulations ( Podsakoff et al. , 2016 ; Locke, 2003 ).

For instance, when conflict personalization is understood by some in terms of a negative reaction to conflict ( Hample et al. , 2009 ) but by others as a cognitive bias ( Brisini and Solomon, 2020 ), accurately operationalizing the concept becomes difficult. Should respondents be questioned about whether they have a negative reaction to conflict or, rather, whether they experience any cognitive bias?

Thirdly, the absence of a uniform, precise definition limits the ability of scholars to develop effective interventions for organizations. Interventions based on academic research, so-called evidence-based management, derive their principles from research evidence, which is translated into practices aimed at solving organizational problems. For the principles to be credible, the evidence needs to be clear, and research findings need to be interpretable by both researchers and practitioners ( Rousseau, 2006 ). When practitioners wish to engage in evidence-based managerial practices, should they focus on preventing negative reactions to conflict, train employees to avoid cognitive biases or choose yet another approach?

In summary, precise definitions enable meaningful theorizing, clear operationalizations and clear interventions. In this paper, we therefore aimed to increase clarity on what conflict personalization is. To do so, our paper is divided into two parts. First, we conducted a systematic review of the published scientific literature on the personalization of conflict to find out how conflict scholars have defined and conceptualized the concept. This process revealed the building blocks for an integrative definition. Second, using the results of our systematic review, we constructed an integrative definition of conflict personalization.

identify potential attributes;

organize the attributes by theme; determine which are necessary, sufficient and/or shared;

develop a preliminary definition; and

refine the conceptual definition.

Following such a process ensures a systematic and careful approach, which increases the quality of the definition as it allows for more objectivity and reflection. In this method section, we delineate steps 1) and 2). The subsequent steps 3) and 4) are discussed in the definition development section, the second part of our paper.

Literature search

To identify potential attributes of the concept of conflict personalization, we systematically took stock of the published scientific literature on conflict personalization, based on the guidance provided by Denyer and Tranfield (2009) for management and organizational studies specifically. Online searches for eligible studies on the databases Web of Science, PsycINFO and SCOPUS were performed in March 2021. The search terms were the following: taking conflict personally (without double quotes to allow for multiple sequences), “personalization of conflict,” “conflict personalization” and “personal attack.” Alerts were activated for all four searches to allow for the inclusion of newly published articles in our review, which led to the inclusion of one recent publication ( Young et al. , 2023 ). We included peer-reviewed articles, scholarly books and book chapters and excluded editorials, conference proceedings, theses, dissertations, working paper series and book reviews.

Subsequently, we did a forward and backward search of the two publications on conflict personalization, which were cited over 50 times by May 2021. These were the papers by Hample and Dallinger (1995) and Mooney et al. (2007) . In total, the abstracts of 763 records were imported into review software Rayyan ( Ouzzani et al. , 2016 ).

within the publication, reference is made to the personal experience of conflict;

the publication concerns published scientific literature; and

the publication included at least an English abstract or summary.

At the end of the review process, 41 articles remained. These articles were read thoroughly, with a focus on definitions and conceptualizations of conflict personalization. Please see Supplementary Material Figure 1 for a PRISMA Flow Diagram.

Explicit definitions and conceptualizations

We found that, instead of explicit definitions, many articles offered rather broad conceptualizations and descriptions of conflict personalization. Thus, focusing only on those articles that did provide an explicit definition would result in a very narrow overview, one that reveals only part of the scholarly view on conflict personalization and potentially would paint an incorrect picture of how conflict scholars view the construct.

We therefore decided to include all statements that functioned as a description of conflict personalization, but to differentiate between explicit definitions and conceptualizations in our coding. A definition is a statement of the exact meaning of a thing or what a word means ( OED Online , 2022a ), and in line with this, we coded all statements about the nature of conflict personalization that included a conjugation of the verb define as well as statements preceded by the word is as explicit definitions. A conceptualization is the process of forming a concept or idea of something ( OED Online , 2022b ), and in line with this, we coded all other descriptions of the concept of conflict personalization that did not fit our criteria for explicit definitions as conceptualizations. For each article, every relevant text fragment that either explicitly defined or conceptualized conflict personalization was transferred as a separate citation into a column in a spreadsheet file.

The occurrence of both explicit definitions and conceptualizations brings to mind the work of Aristotle on essence and accident ( Copi, 1954 ; Lewis, 1984 ). To answer the question “what is it,” according to Aristotle, the essential and the accidental should be distinguished from one another: “a thing’s essential features are taken to be those without which it cannot exist, its accidental features those it has but can exist without” ( Gorman, 2005 , p. 276). For example, a table’s essence could be “a flat surface, resting on one or more legs,” while accidents would be “made of wood,” “round” or “high.” A table could be made of wood, but if it is made of metal, it is still a table. It seems that when defining conflict personalization, scholars have used either its essence, accidents or both in their (either explicit or implicit) definitions, which could partly explain the conceptual vagueness that arose over the past decades.

Thematic analysis

threat/danger;

trait/state; and

Finally, a sixth theme other was used to accommodate text that did not define or conceptualize conflict personalization. Eventually, some text was excluded because it concerned synonyms for the term conflict personalization ( N = 13, e.g.: “personalized disagreements,” Guenter et al. , 2016 ), circumstances and effects of conflict personalization ( N = 6, e.g. “climate,” Dallinger and Hample, 1995 ) or considered outliers that did not fit with any theme and were therefore not considered important (“self-fulfilling prophecy,” Simons and Peterson, 2000 ; “likes to engage in arguing while the other is a conflict avoider,” Honeycutt et al. , 2016 ; “able to respect,” Sung Eun Chung and Meneely, 2012 ). Afterwards, each text fragment that was not coded as “other” was read again and assigned to one or more of the five themes to generate a thematic map of the data.

Following our initial coding, we conducted an additional coding phase. During our analysis of the theme affect , we noticed that multiple text fragments specified a negative connotation and decided to code for this negative affect as a subtheme. Similarly, within the theme cognition , we noticed multiple mentioning of (mis)attribution and thus coded for this attribution as a subtheme too. The five themes and two subthemes were given a broad and as neutral as possible definition based on the Oxford English Dictionary and Merriam-Webster Dictionary to prevent a lengthy (theoretical) deliberation on every concept. These definitions are part of the synthesis of our findings.

After the organization of potential attributes by theme, we determined which are necessary, sufficient and/or shared (step 2) ( Podsakoff et al. , 2016 ). We applied the essence/accidents approach described above ( Copi, 1954 ; Gorman, 2005 ; Lewis, 1984 ). For each theme and potential attribute within that theme, we considered whether it was part of the essence, i.e. conflict personalization cannot exist without, or merely an accident, commonly true but not necessary to occur to speak of conflict personalization.

The quantitative results of our thematic analysis are presented in Table 1 . The percentages refer to the frequency of mentioning of a theme – or a subtheme – in the explicit definitions and conceptualizations. A high percentage means that the theme is discussed in a lot of publications, but not necessarily that there is consensus on how the theme is related to conflict personalization. The table is followed by a synthesis of these results. The themes will be discussed in order of frequency of occurrence within the text fragments, and each section infers whether and in what way the theme should be considered an essential building block in defining conflict personalization (step 2, Podsakoff et al. , 2016 ). The data set with all text fragments, coding and thematic analysis can be found in Supplementary Material.

Theme 1 – affect.

The thematic analysis revealed that in all the explicit definitions (100%) and in 78% of the conceptualizations, affect – an emotion, feeling or mood occurring in response to a stimulus ( OED Online , 2022c ) – was used to explain what conflict personalization is (see Table 1 ).

Affect was understood in similar ways across the definitions and conceptualizations, and we did not find explicit definitions or conceptualizations that opposed one another with regards to the role of affect. For example, affect was part of the following text fragments: “How people experience (the effects of) arguing emotionally” ( Labrie et al. , 2020 , p. 255), “tension and discomfort” ( Nicotera and Mahon, 2013 , p. 102) and “variability in an individual’s affective reactions to (…) interpersonal conflict” ( Worley and Aloia, 2019 , p. 141).

With respect to the nature of affect, there was no reference to positive affect, but negative affect was frequently associated with conflict personalization. Therefore, we looked for consensus on affect being inherently negative during conflict personalization in a subtheme analysis. For the explicit definitions, there was no difference between main- and subtheme; 100% of them referred to negative affect. But the conceptualizations did differ; 63% referred to negative affect specifically (vs. 78% to affect, see Table 1 ).

In conclusion, affect is part of the essence of conflict personalization, as most publications refer to it. More specifically, we would argue that affect should be limited to negative affect, based on our findings and the fact that no publications referred to positive affect.

However, there does not seem to be enough support to limit a definition of conflict personalization to negative affective reactions in terms of specific emotions. In other words, those references to specific emotions concern accidents of conflict personalization; they are likely to occur but not necessary. Eight publications refer to the same set of negative emotions during conflict personalization introduced by Dallinger and Hample (1995) (see Supplementary Material) and state that when personalizing conflict, a person feels “threatened, anxious, damaged, devalued, and insulted” (p. 273). In addition, there was one conceptualization in which the negative affect theme was represented by three of these five emotions: threatened, anxious and devalued ( Worley and Aloia, 2019 ). Still, the other 17 publications within the negative affect category refer to more general, rather than specific, negative affect, for instance, “stronger and more negative emotional reactions to arguments” ( Hample et al. , 2009 , p. 77).

The above is an exemplar of why it is important to separate essence from accidents. A disadvantage of incorporating a set of specific emotions in a definition is that it excludes other reactions, i.e. if a person would feel sadness in response to conflict rather than threat, anxiety or devaluation, this person would technically not qualify as having a negative affective reaction to conflict. In addition, it is not clear how many of the specific affective reactions one needs to experience to count as conflict personalization. We therefore conclude that there is sufficient support to further specify affective reaction by adding the connotation negative and using that as a building block as it concerns the essence of conflict personalization, but not enough support for, nor clear advantages of, indicating a particular kind of negative affective reaction.

Theme 2 – threa t/ danger.

The perception of a threat – a sense of oppression or menace ( OED Online , 2022d ) – and/or danger – a liability or exposure to harm or injury ( OED Online , 2022e ) – was an important theme in the explicit definitions (80%) and was reasonably well supported in the conceptualizations (61%) (see Table 1 ). We found various possibilities to further specify the general notion of perception of threat/danger.

Within the explicit definitions, the word “punished” is used to describe what a person feels during conflict personalization ( Brisini and Solomon, 2020 ; Miller and Roloff, 2014 ). Among the conceptualizations, there is the mention of feeling threatened ( Hample and Dallinger, 1995 ; Kim et al. , 2015 ), “defensiveness in the face of an argument” ( Hample et al. , 2009 , p. 77), as a reaction “as though they had been personally assaulted” ( Lewiński et al. , 2018 , p. 235), and the perception that the comment made by the other is harmful ( Kim et al. , 2009 ) or stemming from ulterior motives ( Xie and Luan, 2014 ) and thereby constitutes a personal attack.

Now, we can deduce if and how threat/danger is part of the essence of conflict personalization. Based on the occurrence of the theme (see Table 1 ), perception of threat and/or to be in danger is an essential element of conflict personalization. However, although the more specific descriptions of threat and danger above are useful in describing the perception of threat/danger and can potentially be used for future operationalization, we would argue that these concern accidents of conflict personalization and should not be part of its definition. The differences between the examples are substantial, which makes it difficult to integrate them, and there is no clear majority of definitions and/or conceptualizations that support a particular description. Additionally, further specifying perception of threat/danger creates a similar problem as discussed earlier with respect to specific affective reactions: it would create a definition that excludes too much. For instance, if conflict personalization is only defined in terms of feeling punished, a person that feels personally assaulted would not qualify as someone who perceives a threat or danger.

Theme 3 – cognition.

Concerning cognition – conscious intellectual activity ( Merriam-Webster.com Dictionary , 2023a ) – as an explanation of conflict personalization, we discovered a notable difference between explicit definitions and conceptualizations. Only 10% of the explicit definitions referred to cognition, whereas we found references to cognition in 76% of the conceptualizations (see Table 1 ). One would expect that conceptualizations follow a definition with respect to the most important attributes of a concept. Probably, in the case of cognition, a dissimilarity between definition and conceptualizations has developed, and cognition has mostly been used to further explain conflict personalization. However, if cognition is a defining attribute of conflict personalization, it should be incorporated into the definition.

When reviewing the conceptualizations within the cognition theme, we discovered variety in the way in which scholars talk about the cognitive aspect of conflict personalization. Firstly, conflict personalization is seen as a cognitive experience ( Hample et al. , 2019 ), cognitive appraisal ( Curran and Allen, 2016 ) or cognitive reaction ( Demir and Hample, 2019 ; Hample et al. , 2021 ; Santibáñez et al. , 2021 ). Secondly, some refer to expectations ( Kim et al. , 2020 ; Worley and Aloia, 2019 ) and the application of past experiences ( Aloia and Worley, 2019 ; Hample and Cionea, 2010 ). Third, we found mention of pessimism about the future of the relationship ( Hample and Richards, 2019 ; Kim et al. , 2015 ; Xie et al. , 2015 ). So, we did not find majority support for a particular clarification of cognitive reaction.

More particularly, attribution – the ascribing of an effect to a cause ( OED Online , 2022f ) – was mentioned in multiple publications and therefore specifically analyzed as a subtheme. Although attribution was not part of any explicit definition, 34% of the conceptualizations did include some reference to the idea that people personalize a conflict when they attribute certain goals or intentions to the other party (see Table 1 ).

In more general terms, there is mention of attributing “the contradictions to personal rather than institutional or situational factors” ( Malterud and Nicotera, 2020 , p. 389). Also, people are believed to personalize a conflict when they attribute the activity of the other to an intention to harm ( Hample and Richards, 2019 ; Kim et al. , 2009 ).

Additionally, we found mention of misattribution in publications that discuss why people experience a conflict as a personal attack. For instance, according to Guenter et al. (2016) , people try to make sense of the behavior of their colleagues in order to give an appropriate response. When they “wrongly ascribe malicious intentions” (p. 573), criticism or a difference of opinion is misattributed as a personal attack. Xie and Luan (2014) maintain that when people misattribute conflicting behavior as unjustifiable or stemming from ulterior motives, they experience a personal attack. Similarly, Peterson and Harvey (2009) state that people can misinterpret others’ comments or actions as a personal attack, even if the conflict is beneficial to the quality of decision-making.

Based on these findings, there seems to be sufficient support for including cognitive reaction as a building block for developing a definition of conflict personalization; it is part of the essence. However, the results do not give reason to specify a particular cognitive reaction. Although (mis)attribution was used in some publications to explain conflict personalization, we conclude that these are accidents and not part of the essence. When someone personalizes a conflict, it is possible that actions of the other party are (mis)attributed as intentionally hurtful, but that is not necessarily the case. In other words, during conflict personalization, people have a cognitive reaction of some sort (i.e. it is part of the essence), but what that reaction looks like can vary to such an extent that it is incorrect to say that a particular cognitive reaction should always occur to speak of conflict personalization at all.

Theme 4 – trait and state.

Regarding conflict personalization as a personality trait – a particular feature of mind or character ( OED Online , 2022g ) – and/or state – the mental or emotional condition of a person at a particular time ( OED Online , 2022h ) – we found reference to the subject in 10% of the explicit definitions and 41% of the conceptualizations (see Table 1 ).

Even though the frequency with which this theme occurs in the definitions and conceptualizations is lower than the frequency with which some of the previous themes are mentioned, in general there is agreement within this theme that conflict personalization is both an enduring preposition or readiness to take conflict personally – a trait – and a temporary feeling that is immediately stimulated by the present conflict situation – a state ( Avtgis, 2002 ; Dallinger and Hample, 1995 ; Hample, 2015 ; Solomon and Brisini, 2019 ). It is also considered “relationship-dependent, where it is relatively stable within a specific relationship but can wax or wane in other relational contexts” ( Young et al. , 2023 , p. 186).

Yet, some publications were less clear on whether conflict personalization is a trait or state; their descriptions could fit both. For example, Nicotera et al. (2014) refer to it as a “set of attitudes predisposing one to internalize conflict” (p. 252) and Mooney et al. (2007) as a “tendency (…) to take cognitive debates personally” (p. 752). Additionally, Hample et al. (2009) refer to “communication-relevant predispositions and behaviors” (p. 77).

We critically assessed whether trait and state are part of the essence of conflict personalization (i.e. are vital attributes) and should be included in the integrative definition. After consideration, we decided that the theme trait and state is not a building block, even though for conflict personalization to occur, a trait and/or state will be present. Including trait and state would not differentiate conflict personalization from other reactions to social interactions, as all reactions presumably have their basis in either or both personality traits and temporary states. So, although personal characteristics trait and/or state could be argued to be part of the essence of conflict personalization, as they are human characteristics and humans experience conflict personalization, it is not necessary to include the terms in the definition. Still, in empirically studying conflict personalization, it could be useful to incorporate both trait and state variables to better understand when and how people personalize their workplace conflicts.

Theme 5 – the self.

With respect to a focus on the self – the union of elements (such as body, emotions, thoughts and sensations) that constitute the individuality and identity of a person ( Merriam-Webster.com Dictionary , 2023b ) – we found that 10% of the explicit definitions and 34% of the conceptualizations referred to this theme (see Table 1 ). Even though the number of text fragments that refer to this subject is lower than most of the other themes, there was agreement within those publications that do discuss this theme on the role of the self in conflict personalization.

During our review, we found various examples that enlighten the role of the self during conflict personalization. For instance, Wallenfelsz and Hample (2010) explicitly define conflict personalization as “the feeling that conflict is a negative life event that is aimed at the self” (p. 471). Within the conceptualizations, there is mention of the self in terms of a focus on the self and self-defense ( Hample and Dallinger, 1995 ) and a situation wherein “face becomes an issue, overwhelming the substantive grounds of conflict” ( Dallinger and Hample, 1995 , p. 306). Similarly, Curran and Arroyo (2018) argue that conflict personalization is perceived as a personal attack on the self, during which people focus less on the content of a conflict (see also Hample and Irions, 2015 ; Lewiński et al. , 2018 ; Rapanta and Hample, 2015 ). Hample and Anagondahalli’s (2015) conceptualization holds that people experience conflict as a person-centered matter rather than an issue-centered matter. Guenter et al. (2016) argue that people tend to identify with the position they take in the argument, and by doing so, this position becomes part of someone’s self-concept. As a result, criticism of a position is seen as a threat to the self-concept.

We conclude that the self is an important differentiating characteristic in defining conflict personalization and should be considered as part of the essence. After all, if the self is not included in the definition, it is unclear what is perceived to be threatened and/or in danger, and the definition would thus allow for other possibilities, such as physical danger. So, we argue that if people experience the conflict as revolving around their self, it is personalized. In addition, by including the self as a building block, we can make a more precise distinction between a merely negative affective and cognitive reaction to conflict and the point at which a conflict truly becomes personalized.

Concluding remarks

Through our systematic literature review and thematic analysis, we have established five themes that reflect the various elements of conflict personalization: affect, perception of threat/danger, cognitive reaction, trait/state and the self (in order of frequency). We argued that only four of these are essential building blocks for our integrative definition of conflict personalization: negative affective reaction, perception of threat/danger, cognitive reaction and the self.

An integrative definition of conflict personalization.

At this point, we enter the second part of our study, in which we use the four building blocks derived from our review to construct an integrative definition of conflict personalization. We did so based on several definitional guidelines, which safeguarded the process itself and provided argumentation for the choices we made.

Construction of a definition

In the introduction of this paper, we gave an elaborate description of the phenomenon that we consider conflict personalization . Creating clarity and agreement on what observations of reality are to be defined is an important step in definition development ( Locke, 2003 ). In short, the personal experience of workplace conflicts can differ from conflict to conflict and from person to person.

the term that is defined;

the class or “genus” to which the term belongs; and

the differentiating characteristics or “difference.”

For example, a planet (term) is a celestial body (class) moving in an elliptical orbit around a star (differentiating characteristics).

The term we wish to define is conflict personalization (1). The class to which conflict personalization belongs would be the intraindividual reactions in social interaction(s) about perceived incompatibilities (2) ( Folger et al. , 2021 ). Finally, by distinguishing essence from accident, we can uncover the necessary attributes of conflict personalization. Through the thematic analyses, we have determined the essence , i.e. the differentiating and fundamental characteristics (3) of conflict personalization: negative affective reaction, perception of threat/danger, cognitive reaction and the self. These are the building blocks that can be used to construct an integrative definition.

We propose the following integrative definition of conflict personalization: Conflict personalization is the negative affective as well as cognitive reaction to the self being threatened and/or in danger as a result of a social interaction about perceived incompatibilities. The building blocks of negative affective and cognitive reaction have been included without any modification. But we decided to integrate perception of threat and/or danger and the self into a threa t/ danger to the self because it clarifies what is perceived as being threatened/in danger and explains the role of the self during conflict.

To assess the quality of this definition, we have reviewed the development process and final text using several practical criteria. In his work on logic, Copi (1972) argues that a definition should state the generally agreed meaning and should not be too broad or too narrow. These criteria are met through a systematic literature review and thematic analysis to determine the degree of consensus on inclusion of specific attributes of conflict personalization. Also, Chan et al. (2006) emphasize that conditions and/or effects cannot be part of a definition, as that would decrease the internal validity of subsequent empirical research. Therefore, we made sure that the thematic analysis was focused on finding building blocks only, and text on antecedents and consequences of conflict personalization was excluded.

In addition, a proper definition should not be circular or tautological ( Copi, 1972 ; Podsakoff et al. , 2016 ), and this criterium is fulfilled by making sure there are no synonyms of conflict personalization in the definition, like “taking conflict personally” or “personalized disagreement.” Moreover, a definition should not be expressed in ambiguous, obscure or figurative language and should not be negative where it can be affirmative ( Copi, 1972 ). We ensured that the wording was clear by working with the more general terms from the thematic analysis and offering a dictionary entry for each of them. Also, the definition is framed in an affirmative way; wording such as “to not feel safe” with respect to the self was avoided.

In this paper, our aim was to construct an integrative definition of conflict personalization as an essential step to understanding why some workplace conflicts are beneficial and others are injurious to individual and organizational processes and outcomes, such as performance and satisfaction. Typically, workplace conflict is studied by categorizing it on the basis of the issue the conflict is about; the distinction that is most frequently used by conflict researchers distinguishes task conflict (i.e. disagreement about the job at hand) from relationship conflict (i.e. disagreement about personal issues; see Jehn , 1995, 1997 ). However, as the findings on the positive and negative effects of workplace conflicts remain mixed in studies examining task- and relationship-related conflict as independent variables ( De Dreu and Weingart, 2003 ; De Wit et al. , 2012 ) and the entanglement of issue and emotion within the definition and operationalization of relationship conflict ( Bendersky et al. , 2014 ; Jehn et al. , 2008 ), we argued that the personal experience of conflict could be important and deserves more attention.

Our systematic review of the literature demonstrated that there exists conceptual vagueness on what conflict personalization entails. Notably, even in publications by Hample, whose work contains a number of studies on conflict personalization, there is variation in how the concept is defined (see, for example, Hample et al. , 2019 ; Hample and Anagondahalli, 2015 ; Hample and Dallinger, 1995 ; Hample and Richards, 2015 ). Through our systematic review of the literature, a thematic analysis and a thorough definition development process, we developed an integrative definition of conflict personalization: Conflict personalization is the negative affective as well as cognitive reaction to the self being threatened and/or in danger as a result of a social interaction about perceived incompatibilities.

The overarching contribution we offer with this integrative definition of conflict personalization is that it constitutes clarity for conflict scholars with regards to what conflict personalization is. We hope this will contribute to broadening the scholarly perspective on workplace conflict, which in turn can lead to a better understanding of the consequences of workplace conflict.

Theoretical implications

First, via our integrative definition of conflict personalization, we aimed to provide the field of workplace conflict with a clear, univocal concept that can be integrated into current theory and empirical studies. Although conflict personalization is generally presented and discussed as if it has a single meaning, our review showed that there was, in fact, substantial variation in how authors explained the construct. We offer a solution to this by presenting an integrative definition.

Second, we integrate the fields of argumentation and communication with the field of workplace conflict. Most empirical work on conflict personalization has been published in journals on argumentation and communication, mainly with a focus on how differences between nationalities are associated with conflict personalization ( Hample et al. , 2021 ; Hample and Anagondahalli, 2015 ), conflict personalization during family conflicts ( Curran and Allen, 2016 ; Aloia and Worley, 2019 ) and conflict personalization in non-specified interpersonal conflicts ( Wallenfelsz and Hample, 2010 ; Worley and Aloia, 2019 ). However, to our knowledge, scholars that focus on interpersonal workplace conflict have not integrated conflict personalization in their empirical studies, even though some do refer to the concept ( Bradley et al. , 2012 ; Jehn and Mannix, 2001 ; Mooney et al. , 2007 ). Developing an integrative definition is an essential first step towards integrating conflict personalization in studies on workplace conflict.

Third, our definition enables studying conflict issue and conflict experience as orthogonal dimensions of workplace conflict. The integrative definition of conflict personalization is an important first step towards this, as it will allow scholars to develop measurement scales that enable studying effects of the personal experience of specific conflicts on outcomes separately from the effects of conflict issues. A person’s take on the conflict matters, and the personal experience of a conflict is not necessarily in line with the conflict issue. Workplace conflicts could be placed within a two-dimensional framework based on the more objectively determined extent of revolving around the work task (applying the emotion-free definition and scales of relationship conflict, see Jehn et al. , 2008 , and note 2 on page 6) and the relatively subjective extent of conflict personalization. We expect a significant improvement in understanding the course and outcomes of workplace conflict.

Limitations

Despite the best efforts, each academic study has its limitations. Firstly, during a literature search, there is always a risk of missing certain publications that could have been relevant. In some publications, clearer abstracts and/or keywords are provided than in others, which impacts their findability. We have mitigated this risk by using multiple search engines, subscribing to an alert for new publications and incorporating a systematic inclusion/exclusion phase during which all abstracts were carefully read.

Second, when conducting a thematic analysis like ours, there is a risk of bias, as the researcher has an active role in identifying patterns and themes, determining which ones are interesting, and the way they are reported. Themes do not just reside in or emerge from the data, waiting for the researcher to discover them. We reduced this risk by following a step-by-step guide for thematic analysis ( Braun and Clarke, 2006 ), continuously discussing the coding decisions within our team and substantiating our conclusions by disclosing all our preliminary coding and subsequent categorization into themes (see Supplementary Material).

Third, in constructing a definition, there is – again – the risk of bias through opinion and preferences of the researcher. The goal is to offer a definition that is as concise as possible while also integrating all relevant characteristics. Basing our choices on a blueprint of how a definition should be structured ( Copi, 1972 ), which elements to include, and how to evaluate the quality of the definition ( Locke, 2003 ; Podsakoff et al. , 2016 ) provided a foundation for a more objective approach and facilitated sharing and evaluating the thought process.

Applying the definition in future research

The definition that resulted from our literature review and thematic analysis can function as the basis for developing a measurement scale that captures the dimensions of negative affective reaction, cognitive reaction and the perceived threat/danger to the self by containing subscales for each of these key themes. This would also allow researchers to examine whether certain elements of conflict personalization are more or less strongly related to conflict processes and outcomes.

Even though the existing Hample and Dallinger (1995) Taking Conflict Personally Scales (TCP Scales) are widely used, they do not fully reflect the essential attributes of conflict personalization as revealed by our systematic literature review. According to Hample, the four subscales direct personalization, persecution feelings, stress reaction and like/dislike valence are emotional reactions, and the two other subscales negative relational effects and positive relational effects (i.e. relationship projections) are cognitive reactions ( Hample, 2015 ). Below, we briefly compare the essential attributes of our integrative definition of conflict personalization to these TCP scales.

With respect to negative affect, the TCP scales do tap into stress but do not offer items on other negative affective reactions like sadness, fear or hurt. For cognitive reaction, the TCP scales only yield information on the expectations about the effects of the conflict on the relationship. Yet, our thematic analysis showed that cognition is considerably broader and could include – for example – past experiences, cognitive bias or attribution (accidents of conflict personalization). We did not find consensus on a particular cognitive reaction that always occurs during conflict personalization (i.e. the essence of conflict personalization). Therefore, we propose to study if further specification of “cognitive reaction” is possible based on additional (empirical) data collected after this first operationalization phase.

Concerning the perceived threat and/or danger to the self, there are no items in the TCP Scales that focus on the self as such. Even though some items of the Persecution Feelings scale hint on the self, such as: “I think that people often attack me personally” ( Hample and Dallinger, 1995 , p. 313), these scales are meant to assess an emotional reaction and cannot grasp the self-concept or the way the self is being perceived to be threatened. Unfortunately, this paper does not allow for a more elaborate discussion of the self and how its role during conflict personalization could be determined empirically. However, we do suggest looking into existing work on identity threat ( Banaji and Prentice, 1994 ; Ellemers et al. , 2002 ) and face threat ( Carson and Cupach, 2000 ; White et al. , 2004 ). Even though these terms were not mentioned specifically in the papers in our literature review, we do think they are relevant, and it would be helpful to consider research on these constructs when developing measures for conflict personalization.

Here, it is important to clarify that the separation of negative affective reaction and cognitive reaction is justifiable for conceptual and scientific purposes, but that they often overlap in social life ( Lazarus, 1999 ). For most people, feelings and cognitions are not entirely distinct during interpersonal conflict. Appraisal theories could offer a basis for understanding the linkage between negative affective reaction and cognitive reaction during conflict personalization. Most appraisal theories are based on the assumption that “emotional responses are elicited as the organism evaluates the relevance of environmental changes for its well-being” ( Brosch, 2013 , p. 370). For conflict personalization, the emotional response would be the negative affective element, and the evaluation of the relevance would be the cognitive element.

Such new measurement instrument enables the empirical study of the extent to which workplace conflict has positive or negative consequences. This is a crucial but unanswered question within the field of workplace conflict; findings vary and moderators are expected to play a substantial part ( De Dreu, 2008 ; De Dreu and Weingart, 2003 ; De Wit et al. , 2012 ). As a start, a model could be put to the test with conflict issue as independent variable (i.e. task or relationship as measured with the “clean” measure, which excludes references to emotion; Jehn et al. , 2008 ), conflict personalization as the moderator, and performance and satisfaction as the dependent variables ( De Dreu and Weingart, 2003 , p. 743 for commonly used measures of performance and satisfaction). Based on empirical research ( De Dreu and Weingart, 2003 ; De Wit et al. , 2012 ), we then firstly would expect that low levels of conflict personalization will increase the likelihood of potential positive outcomes of task conflict on performance and satisfaction, while higher levels of conflict personalization will negate potential positive outcomes and increase the negative effects of task conflict. Secondly, concerning relationship conflict, we would expect that lower level of conflict personalization will at least neutralize the negative effects on performance and satisfaction, while higher levels conflict personalization will increase negative effects of relationship conflict. Furthermore, we could explore the possibility of positive effects of non-personalized relationship conflict. People having a less threatening and/or endangering experience of the conflict would be expected to be more able to focus on the issue instead of the self. This in turn could, for instance, positively influence performance ( Aloia and Worley, 2019 ; Carnevale and Probst, 1998 ; Fisher and Ury, 1999 ; Hample and Dallinger, 1995 ).

In addition, should studies indeed show that conflict personalization is a predictor of workplace conflict outcomes, we propose to study under what conditions people personalize their workplace conflicts and what conditions prevent them from doing so. Subsequently, those results can be translated into effective interventions that are not aimed at preventing workplace conflict as such but instead at decreasing the personalization of the conflicts that inevitably occur. For instance, conflict expression directness and oppositional intensity ( Weingart et al. , 2015 ) affect perceptions and emotions and thereby could increase conflict personalization. Furthermore, it would be interesting to study the association between other aspects of conflict communication and conflict personalization. Additionally, perspective-taking ability (see for a review, Ku et al. , 2015 ) could be associated with conflict personalization. Arguably, people who can recognize the perspective of the other conflict party would be less inclined to perceive a threat or danger to the self as they – at least partly – better comprehend the motives of their counterpart. As a result, we would expect them to personalize the conflict to a lower extent. Research could examine whether individual differences in perspective-taking abilities and/or situational factors that enhance perspective-taking affect conflict personalization.

With respect to organizational conditions, we suggest studying the effect of psychological safety ( Edmondson, 1999 ). It has been theorized that people do not take conflicts personally in highly psychologically safe groups because of a sense of openness ( Bradley et al. , 2012 ). High levels of psychological safety could make people feel less at risk for rejection or embarrassment, and thus their perception of a threat or danger to their self should decrease, and they should be less likely to personalize conflicts. Likewise, the association between trust ( Simons and Peterson, 2000 ) and conflict personalization is a potential avenue for further research. Possibly, the role of trust could take two forms: it could act as a buffer and decrease the likelihood of conflict personalization (due to the assumption of benevolence and honesty), but it is also conceivable that in a group characterized by high levels of trust, conflict is perceived as a betrayal of that trust, thereby increasing the likelihood of conflict personalization.

The main practical implication of our study is that it creates the possibility of creating a measurement instrument based on the integrative definition of conflict personalization. Thereby, it becomes possible to determine if conflict personalization during workplace conflicts has consequences for performance and satisfaction and under which conditions conflict personalization is more or less likely to occur. This is essential to develop effective research-based interventions.

Understanding when and why workplace conflict is beneficial and/or injurious is both relevant and difficult for scholars and practitioners. We argued that studying workplace conflict in terms of conflict personalization can contribute to our understanding, as it allows scholars to examine the personal experience of conflicting parties distinctly from the conflict issue and place workplace conflict in a two-dimensional framework. However, the field of conflict personalization was characterized by conceptual vagueness, which hampers theory development, creates operationalization and analysis problems and limits scholarly capacity to develop effective interventions. Our systematic review of the literature and subsequent thematic analysis identified four building blocks of conflict personalization: negative affective reaction, perception of threat/danger, cognitive reaction and the self. Subsequently, using these building blocks, we constructed the following definition of conflict personalization: Conflict personalization is the negative affective as well as cognitive reaction to the self being threatened and/or in danger as a result of a social interaction about perceived incompatibilities.

In addition to contributing to the scholarly field of workplace conflict, we hope our work will eventually help support organizations through effective intervention development. Organizations could potentially benefit from their workplace conflicts if they are able to prevent injurious outcomes like a decrease in performance or satisfaction. By understanding the role of conflict personalization better, we can work towards research-based interventions that help people to handle their workplace conflict productively and limit the negative consequences to a minimum.

Frequency of occurrence of themes in publication set and examples for context

Source: Authors’ own work

Other conflict types have been discussed and examined, such as process conflict ( Jehn et al. , 1999 ), which refers to conflict about disagreements about how to do the task or how to delegate resources, and status conflict ( Bendersky and Hays, 2012 ), which refers to conflict about people’s relative status positions in their group’s social hierarchy, but the majority of workplace scholars distinguish between conflict about tasks and conflict about non-tasks ( De Wit et al. , 2012 ).

Despite the availability of a revised, emotion-free definition and corresponding clean operationalization of relationship conflict since 2008 (“Relationship conflicts are disagreements and incompatibilities among group members regarding personal issues that are not task-related”, Jehn et al. , 2008 , p. 467), the original scales ( Jehn, 1995 ) are still the most commonly used (e.g. Desivilya et al. , 2010 ; Kozusznik et al. , 2020 ; Ullah, 2022 ). We strongly recommend the use of the adapted definition and scales.

Supplementary material

The supplementary material for this article can be found online.

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Acknowledgements

The authors would like to thank two anonymous reviewers for their constructive comments and suggestions for improvement. They would also like to thank Dale Hample for providing helpful answers to questions that came up during the process of writing this paper.

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Literature Review on Conflict Management: A critical study

• Dr. Ani Smriti , Mr. Rajesh Kumar
• Published 2021
• Sociology, Business

54 References

Interpersonal conflict and its management in information system development, impact of individualism and collectivism on managing conflicts at work: evidence from public sector banks in sri lanka, culture and conflict management: a theoretical framework, conflict and conflict management, do conflict management styles affect group decision making evidence from a longitudinal field study, maximizing the benefits of task conflict: the role of conflict management, the importance of conflict in work team effectiveness, patterns of organizational conflict., toward a theory of managing organizational conflict, the virtue and vice of workplace conflict: food for (pessimistic) thought, related papers.

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A literature review of conflict communication causes, costs, benefits and interventions in nursing

Affiliation.

• 1 Department of Corporate Communication, The Pennsylvania State University, Abington, PA 19001, USA. [email protected]
• PMID: 20465742
• DOI: 10.1111/j.1365-2834.2010.01061.x

Aim: This paper reviews the literature on conflict communication in nursing in order to prioritize research, theory and interventions that will support nurse managers and staff nurses.

Background: Conflict is pervasive in nursing and has many costs, including burnout, higher absenteeism and higher turnover. Increased and more effective use of conflict management seems important in sustaining and developing the field.

Methods: The literature study focused on the intersection of nursing, communication and conflict. The review primarily drew from the nursing and communication disciplines.

Results: While much is known about the sources and costs of conflict in nursing, more can be done to research the benefits of conflict and intervene effectively.

Conclusions: Conflict is a routine feature of nursing. Nonetheless, sources can be managed, costs decreased and benefits increased with indirect and direct interventions.

Implications for nursing management: Nurse managers can support themselves and others in working through conflict by normalizing conflict, employing proven proactive and reactive interventions and by helping to build integrated conflict management systems.

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1 – Introduction: the dual role of the foreign aid community in civil conflicts

1 The foreign aid community plays a dual role in armed conflict.  [1] On the one hand, aid workers often become victims of conflict, and war exposure represents a major risk for foreign aid delivery. On the other hand, however, the international aid community can also directly affect the likelihood of shortening or prolonging existing conflicts. The current contribution focuses explicitly on the various angles of the nexus between foreign aid implementation and armed conflict. It will provide an easily accessible, non-technical review of the recent literature on civil conflict and highlight the aspects that are particularly relevant for aid practitioners.

2 Given the volume of the literature on conflict, this essay is necessarily selective and is unable to reflect all of the great contributions to the literature—many of which will not be covered. The focus of the literature review will lie on findings that are of direct practical use for the international foreign aid community. In particular, after this brief introduction, Section 2 will provide an overview of the scientific findings on the consequences and causes of conflict, with a particular emphasis on environmental issues and climate change. Section 3 will discuss, from a practical point of view, how the foreign aid community can best predict and hence manage the risks related to operating in a war zone, and Section 4 will focus on what the international community can do to minimize the risk of conflict and to shorten existing wars. Last, Section 5 will offer some conclusive remarks.  [2]

2 – Overview of the costs, causes, and evolution of conflict

2.1 – the consequences and costs of conflict.

3 The costs and consequences of conflict are manifold and multidimensional. To start with the burden of fighting, we can distinguish three types of costs: i) fatalities and physical and psychological harm, ii) economic costs, and iii) social costs.

2.1.1 – War kills and injures

4 Fearon and Laitin (2003)—one of the most-cited sources on conflict fatalities—estimate that, between 1945 and 1999, about 3.3 million fatalities were mourned in twenty-five interstate wars and 16.2 million people lost their lives in 127 civil wars. These figures only account for deaths directly related to battle, but of course, the poor economic and sanitary conditions that accompany conflict have their own additional indirect death toll. Thus, when we take these indirect effects into account, casualties more than double, particularly though the spread of diseases (Ghobarah et al., 2003).

5 Moreover, the above figures only account for two-sided fighting (e.g. the army against militarized rebels), but do not relate to killings that occur in instances of one-sided violence, for example, of an army turning against unarmed citizens. Indeed, the death toll of one-sided violence is large by any standards: since 1946, in around fifty episodes of mass killings, between 12 and 25 million civilians have perished (Political Instability Task Force, 2010). Bae and Ott (2008) estimate that the total number of conflict-related deaths in the twentieth century amounts to 109.7 million people—4.35 % of the world’s population.

6 Physical and psychological injuries constitute a further source of human conflict costs. A number of studies find that conflict exposure deteriorates both physical and mental health, and that involvement in armed conflict can have a multitude of psychological consequences, ranging from post-traumatic stress disorders to suicidal ideation (see e.g. Barenbaum et al., 2004; Tanielian and Jaycox, 2008; Cesur et al., 2013; Grossman, 2014).

2.1.2 – The monetary costs of conflict

7 In popular media, war is sometimes portrayed as good business. While it may prove beneficial for some firms (see Guidolin and La Ferrara, 2007), for society overall, conflict is wasteful and amounts to a net loss. In particular, Collier (2007) estimates that civil wars shrink average growth by 2.3 % per year, with the average seven-year civil war causing GDP to depreciate by about 15 % and costing on average around 64 billion USD, when direct and indirect costs are taken into account, as well as spillovers to neighboring states. Even low-intensity conflicts can weigh heavily on the economic balance, as shown by the impact of ETA fighting in the Basque Country, which has been by studied by Abadie and Gardeazabal (2003). By comparing the Basque Country region between 1955 and 1995 to a “synthetic control group”—that is, a weighted average of comparable Spanish regions—their study concludes that Basque GDP would be 10 % higher today in the absence of ETA’s armed fighting. In a similar vein, Besley and Mueller (2012) find that during “the Troubles” in Northern Ireland, compared to peaceful areas, houses in the most affected areas sold for between 2 and 17% less, depending on the level of violence. Further, Besley et al. (2015) estimate that Somali pirates—for an appropriated looting revenue of around 120 million USD—create a welfare loss exceeding 630 million USD. A fortiori, high-intensity wars carry a larger price tag: Stiglitz and Bilmes (2008) estimate the Iraq War to have cost three trillion USD. And when it comes to long-term economic consequences, in 2002, several decades after the end of the Vietnam War, Miguel and Roland (2011) can detect no remaining negative impact on poverty rates, nor on any other economic indicators.

8 Furthermore, there are substantial trade costs associated with conflict (Glick and Taylor, 2010). Conflict is predicted to fuel the large-scale extraction of non-renewable natural resources (Van der Ploeg and Rohner, 2012), and has been found by several studies to weaken school attendance and human capital accumulation (Shemyakina, 2011; Leon, 2012; Verwimp and Van Bavel, 2013; Swee, 2015), another harmful side effect with a further long-term economic cost.

2.1.3 – The social scars of fighting

9 While the aforementioned negative effects of wars in terms of fatalities, health, and prosperity are overall quite uncontroversial, there is less consensus when it comes to the societal impact of war. A series of papers have found that war destroys trust, weakens local governance, fosters ethnic identity, and favors crime propensity later in life (Cassar et al., 2013; Rohner et al., 2013a; Besley and Reynal-Querol, 2014; Dell and Querubin, 2017; Couttenier et al., 2016). In contrast, several contributions have found conflict to be associated with higher political participation, more local collective action, and stronger intra-group trust (see Bellows and Miguel, 2009; Blattman, 2009; Gilligan et al., 2014; Bauer et al., 2016).

10 Despite the ambiguous social impact of war, its clear-cut effects in terms of fatalities, health, economic growth, and human capital accumulation testify that reducing the likelihood of new wars breaking out, and ending current ones, should be a major policy priority. Before delving into the normative question of the policies that ought to be implemented, we will take a moment to reflect on the main drivers of conflict.

2.2 – The causes of conflict

2.2.1 – ethnic cleavages and conflict.

11 One factor highlighted in the literature is that ethnic polarization is associated with a higher risk of ethnic conflict and mass killings (see for example Montalvo and Reynal-Querol, 2005; Esteban et al., 2012, 2015; Amodio and Chiovelli, 2017; Bazzi and Gudgeon, 2018). The recent paper by Moscona et al. (2018) discusses the influence of the structure of social groups, in particular segmentary lineage societies, on increasing the risk of conflict onset and duration, while Michalopoulos and Papaioannou (2016) find that ethnic groups with partitioned ethnic homelands experience more frequent and prolonged episodes of political violence.

12 While ethnic diversity measures are calculated on the basis of group size (and potentially preferences), research has found that inter-group economic differences and geographical features should also be taken into account. For example, Østby (2008) and Cederman et al. (2011) have associated horizontal inequality between ethnic groups with an increased risk of armed conflict, and segregation and geographical distances between groups also have a considerable impact on the levels of violence (Corvalan and Vargas, 2015; Klašnja and Novta, 2016; Mueller et al., 2017). Unsurprisingly, institutions and policies also play a key role, and as discussed below, the link between ethnic diversity and conflict is not hard and fast, as sound policies can significantly alleviate the risks of ethnic turmoil.

2.2.2 – Natural resources and conflict

13 Another major conflict driver identified in the literature is the abundance of natural resources. Oil and gas (Ross, 2006; Dube and Vargas, 2013; Lei and Michaels, 2014; Cotet and Tsui, 2013), minerals and gemstones (Ross, 2006; Lujala, 2009; Berman et al., 2017; Sanchez de la Sierra, 2019), and illegal drugs (Angrist and Kugler, 2008; Dell, 2015; Mejia and Restrepo, 2015), among other resources, have all been linked to an increased risk of armed conflict.  [3]

14 Interestingly, the volume of natural resource production is not the only contributing factor: its labor intensiveness (Dube and Vargas, 2013), as well as its geographical location and distribution (Caselli et al, 2015; Morelli and Rohner, 2015) must also be taken into account. These articles have found that more capital-intensive resources and greater inter-group asymmetries in resource assets can be powerful incentives for war. Again, as regards ethnic diversity, we shall below discuss how policies can help to turn this apparent resource curse into a blessing.

2.2.3 – The role of poverty and economic and meteorological/climate shocks

15 Other relevant explanatory factors for conflict include poverty and averse economic shocks, and a considerable number of studies have found a strong negative correlation between economic output and conflict (see e.g. Fearon and Laitin, 2003; Collier and Hoeffler, 2004; Collier et al., 2009). As one would expect, poverty is a powerful breeding ground for fighting, as it both spreads discontent and lowers the opportunity cost related to giving up a productive activity in order to join a rebel movement. Of course, this correlation is by no means conclusive, as a variety of factors may jointly affect both poverty and conflict (for example, social norms or politics), and as there is also an obvious reverse causation, as conflict can be damaging to economic activity, as discussed above.

16 In order to circumvent this methodological challenge posed by the endogeneity of income, a focus in this line of research has lain on identifying the causal impact of exogenous meteorological variation. This literature has been pioneered by Miguel et al. (2004), finding that negative rainfall shocks driving down economic growth may be a powerful trigger for armed violence. Since then, a number of papers have found that averse economic and meteorological shocks—both exceptional scarcity of rain or excessively high temperatures—may fuel fighting (see e.g. Hidalgo et al, 2010; Jia, 2014; König et al., 2017; Harari and La Ferrara, 2018; Vanden Eynde, 2018). Iyigun et al. (2017) have also found that a rise in agricultural productivity, such as the introduction of potatoes, reduces the scope for conflict.

17 A major determinant of the frequency of averse rainfall shocks, such as droughts, is obviously the global climate, making these studies on the meteorological determinants of war particularly timely and relevant. Hsiang et al. (2013) perform a meta-analysis of sixty scientific studies linking meteorological/climatic shocks to conflict.  [4] Based on the average coefficients computed by these studies, Hsiang et al. (2013) extrapolate the expected impact of climate change. In particular, they argue that “for each one standard deviation (1s) change in climate toward warmer temperatures or more extreme rainfall, median estimates indicate that the frequency of interpersonal violence rises 4% and the frequency of intergroup conflict rises 14%. Because locations throughout the inhabited world are expected to warm 2s to 4s by 2050, amplified rates of human conflict could represent a large and critical impact of anthropogenic climate change” (Hsiang et al., 2013).

3 – How to cope with the conflict risk in daily operations: the role of prediction

18 Coping with conflict is difficult, and of course, those who suffer the most are the local population. Still, the international community is also to some extent affected by fighting and it is important to question how foreign aid workers can continue to deliver help and services in combat zones.

19 Science can attenuate risks and help humanitarian aid to reach the civilian population, even in dangerous conditions, by obtaining reliable predictions of combat locations and intensity. There are some (structural) estimations of theoretical models that make it possible to explain which groups fight more in reaction to shocks, where in a given country conflict may flare up, and how it might spread (Schutte and Weidmann, 2011; O’Loughlin and Witmer, 2012; Novta, 2016; König et al., 2017; Mueller et al., 2017). Trebbi and Weese (2019) have also developed methodologies for detecting unobserved coalitions of militants in conflict areas. Still, the models in the papers mentioned above typically remain quite difficult to apply “off the shelf”, for a particular context of interest, such as for a given NGO.

20 Hence, what would be particularly useful for the policymaking community might be actual out-of-sample forecasting studies of where fighting might occur in the future, presented in an easily-accessible format. The recent literature in political science and economics has made significant progress on this and the field is rapidly growing; it is now the subject of several dozens of scientific articles. While discussing all contributions in detail is beyond the scope of the current paper, the recent and well-researched literature reviews by Cederman and Weidmann (2017), Chadefaux (2017), and Hegre et al. (2017) cover most of the major works on this. Here however, I will merely briefly outline some key issues and approaches.

21 The classical approach for predicting conflict is to start from regression estimates. Lagged explanatory variables of conflict are used to explain conflict onsets, and the estimated coefficients are then applied to current data to forecast out-of-sample future conflict occurrences. The work by Hegre et al. (2013) is an example of such a macro-study. It uses a global sample and extrapolates future predictions from country-level macro indicators such as population size and other demographical indicators, health indicators, education levels, natural resource abundance, and ethnic diversity. The work predicts a general decline in conflict until 2050, particularly marked in Western Asia and North Africa. Similar country and year-level data is used for predictions by Celiku and Kraay (2017), for example.

22 Such predictions can also be performed for predicting the breakout and location of fighting for different regions within a given country. Using a comparable approach, but using micro-data for one country, Weidmann and Ward (2010) take into account in their specification both temporal and spatial explanatory factors and perform predictions on data from the Bosnian conflict. Similar micro-data on geo-referenced conflict events is, for example, used in the prediction work done by Schutte (2017) and Chiba and Gleditsch (2017).

23 A somewhat different approach makes use of artificial intelligence and machine learning to exploit the new opportunities presented by “big data” (see the survey of Schrodt et al., 2013). An example of such a study is Mueller and Rauh (2018), who use machine learning to assess vast amounts of newspaper text in order to predict conflict outbreaks (for another article using newspaper text analysis, see also Chadefaux, 2014).

24 While this literature has been booming in recent years, a freely available, easy-to-use software producing risk charts for specific regions is only now being developed. In particular, a pilot version of a project called Violence Early-Warning System (ViEWS) is now online: https://www.pcr.uu.se/research/views/ . This program, led by Håvard Hegre and located at Uppsala University, presents among others “heatmaps” of conflict risk at a very localized level for the month ahead, freely available on their website. The underlying methodology is described in Hegre et al. (2018).

4 – Policies for peace: what the international community can do

25 The international community is—of course—not only a potential victim in conflict, but also an important actor that may be able to influence the course of war. Some policies are directly in the hands of the international community (for example, stricter regulation on transparency and traceability in the mining industry), while others are under the control of national states. However, even in the latter case, the international community may be able to influence or help with the financing of polices that they deem promising.

4.1 – Words of caution: Do no harm

26 Given the complexity of economies and societies generally, the credo “do no harm” should be applied when it comes to policies surrounding conflict. As the proverb goes, “the road to hell is paved with good intentions,” and ill-planned policy interventions may well backfire. Obvious dangers include the issue that the arrival of the international community in a given region may lead to the inflation of prices, thus reducing real wages and increasing the opportunity cost of leaving work to join an armed conflict. Similarly, in contexts with weaker institutions, some cash inflows might be sidetracked and end up fueling rebel financing. While it is important to keep such risks and caveats in mind, to date there are but few empirical studies that either confirm or rebut such fears.

27 Amongst them is the study done by Nunn and Qian (2014), which concludes that a rise in U.S. food aid leads to higher incidence and duration of civil conflicts (see also Wood and Sullivan, 2015, which had similar results). Similarly, Crost et al. (2014) reveal that a development project in the Philippines increases the likelihood of conflict, which they attribute to insurgents trying to sabotage the program (see also a related study by Weintraub, 2016, for Colombia). Bazzi and Gudgeon (2018) have studied the impact of redistricting in Indonesia in the last two decades, another example of a well-intended policy that partially backfired. While the aim of increasing the number of districts was partly to have a more “uniform population,” in a significant number of districts, this only created new cleavages and increased ethnic polarization, triggering a surge in violence.

28 While the gloomy conclusions of these influential articles should act as a word of caution, they of course do not imply that all programs must necessarily be vain and counterproductive. In fact, other programs have been found to reduce conflict, such as a conditional cash transfer (CCT) program in the Philippines (Crost et al., 2016) or the INPRES school construction program in Indonesia (Rohner and Saia, 2019), which is also discussed below.

29 Care in designing programs is thus more important than ever. If possible, large-scale, long-term programs should be implemented first as smaller-scale pilot studies, allowing a randomized control trial (RCT) evaluation before being stepped-up. A caveat is of course that the general trade-offs are different for emergency humanitarian relief versus long-term foreign aid, with, in the latter case, lengthy, careful program design and evaluation being easier than in the former.

4.2 – Power-sharing and democratic institutions

30 When demarcating the main triggers of ethnic conflict above, we started by highlighting ethnic polarization and horizontal inequality. One specific policy that has been found in the literature to reduce the risk of conflict between ethnic or religious groups has been that of power-sharing. The effect of power-sharing between ethnic groups has been demonstrated both with aggregate data on the global scale (see e.g. Hartzell and Hoddie, 2003; Cederman et al, 2010; Francois et al., 2015), and with micro-data for Northern Ireland (Mueller and Rohner, 2018).

31 More broadly, beyond power-sharing, there is an indication that democracy may at least, under some conditions—particularly in cohesive, rich democracies with electoral accountability—reduce the risk of conflict (Hegre et al., 2001; Collier and Rohner, 2008; Besley and Persson, 2011; Conconi et al., 2014; Laurent-Lucchetti et al., 2018).

32 While it would of course be dangerous to naively advocate power- sharing in any situation, without first carefully studying a country’s context and specific characteristics, the substantial suggestive evidence in favor of power-sharing should at least encourage policy-makers to consider this avenue.

4.3 – Transparency and traceability of minerals

33 The second major driver of conflict that we identified above was natural resource abundance. One specific policy that has been considered to attenuate resource-related conflict concerns increased transparency for the origins and traceability of minerals, which should reduce incentives for the illegal mining and appropriation of minerals. This policy dimension is important for the international community, which is a key player in the design and implementation of such initiatives. Recently, Berman et al. (2017) have indeed found that mineral transparency reduces the conflict potential related to resource price spikes. Their Africa-wide results on general traceability contrast with the more specific findings for the DRC regarding the harmful impact of the Dodd-Frank Act (Stoop et al., 2018). These divergent results imply that the devil may well again lie in the detail of the implementation, and more research on this policy dimension is to be encouraged.

34 Another aspect of policymaking that specifically relates to natural resource exploitation is the behavior of mining firms and its regulation. Berman et al. (2017) have also found that mining extraction by companies with higher corporate social responsibility is less liable to create conflict. This again provides suggestive evidence that more stringent international norms and standards for mining exploitation could merit consideration.

4.4 – Education

35 Recent research results highlight policies that boost education as potentially useful in curbing fighting, particularly in resource-rich economies (see De la Brière et al., 2017), but also more generally as a way to address the third root cause of conflict discussed above: poverty and bad economic shocks. In particular, there is evidence from both cross-country macro-data (Collier and Hoeffler, 2004; Thyne, 2006) and from micro-data for Indonesia (Rohner and Saia, 2019) that education can play a key role in suppressing conflict. In particular, Rohner and Saia find that school construction under the Indonesian INPRES program in the 1970s contained the likelihood of conflicts, fostered inter-religious tolerance and local community involvement, and led to a relative shift from violent to non-violent means of expression.

36 The above findings are consistent with the underlying logic that education may not only increase the opportunity cost of fighting, but also that human capital is less appropriable than physical capital, so transforming cash into human capital results in fewer resources available for grab (Rohner, 2018b). Again, although a one-size-fits-all approach is out of the question and education may have different effects in different places, it appears to be a promising policy dimension for policymakers to consider. While of course, state schools are typically run by local and national governments, international actors may be helpful, such as when it comes to funding schooling expansion.

4.5 – Providing access to employment

37 Another crucial poverty-related policy dimension is labor-market access, as being excluded from work may reduce the opportunity cost related to engaging in appropriative activities. While empirical evidence is limited, a few studies have indeed found that employment programs have led to a reduction of conflict in India (Dasgupta et al., 2017) and Liberia (Blattman and Annan, 2016). The scarcity of evidence warrants caution, however, work access programs seem a promising avenue to consider.

4.6 – Building resilience against the perpetuation of instability: The role of trust and state capacity

38 In this concise and hence necessarily selective literature review, I have stressed the role of three major root causes of conflict: ethnic cleavages, natural resource abundance, and poverty/bad economic shocks. While these factors may play a role both in the onset of fighting and in its duration, there are further factors that tend to prolong conflict. In particular, there are vicious cycles due to the fact that wars may destroy inter-ethnic trust and erode state capacity, and lower trust and weak security may plant the seeds for further turmoil (see e.g. Rohner et al., 2013b). Building trust and state capacity can thus play the role in limiting the potential for conflict escalation and persistence.

39 In terms of building trust, Cilliers et al. (2016) have studied the impact of “trust and reconciliation forums” in Sierra Leone. They have found that while social bonds are indeed reinforced, such forums also have psychological costs. In terms of alternative interventions that focus on psychological effects, another set of measures for fighting crime and violence include cognitive behavioral therapy (CBT). Blattman et al. (2017) have found that the combination of CBT and cash transfers has been able to substantially curb the potential for violence in criminally engaged men in Liberia.

40 Similarly, it is important to reestablish state capacity (Besley and Persson, 2011). Berman et al. (2011, 2013) show that, for Iraq, improved service provision is key when it comes to attenuating insurgence violence, especially when the projects are of modest size, when they are backed up by considerable troop strength, and when they benefit from professional development expertise. Again, the devil lies in the detail and words of caution are in order. As concluded by Acemoglu et al. (2017), providing high-powered incentives for members of the Colombian army in the fight against guerrillas has backfired, resulting in more civilian casualties and a worsening of the security situation. In the same vein, Dube and Naidu’s study (2015) of the effect of US military aid on conflict in Columbia finds that such military assistance may have—if anything—strengthened armed non-state actors and undermined domestic institutions.

5 – Conclusion

41 Conflict affects the international community in two major ways: as potential victims and as potential actors with the capacity to make a difference. As far as the risks and perils of fighting for daily operations are concerned, the main focus of this essay has been on the growing supply of easy-to-use, freely available prediction tools. Today, ViEWS is amongst the prime options.

42 When it comes to the second role of the international community—as stakeholders with the potential to help enact positive change—the costs and complexity of conflict need to be taken into account. In particular, while the large burden of loss for society makes it a priority to tackle the drivers of political violence, its complexity renders this task challenging. It would be dangerous to single out one particular root cause for civil violence or to engage in large-scale interventions without proper and detailed knowledge of the context and scientific evidence from a pilot study.

43 This essay has focused on three main drivers of conflict, namely ethnic cleavages, natural resource abundance and poverty/averse economic shocks, and has stressed that these factors influence both the breakout of hostilities as well as their potential persistence over the long term. The recurrence and persistence of political instability are also fostered by vicious cycles inherently linked to the demise of trust and state capacity.

44 To address both the root causes of war and its escalating factors, this literature review has emphasized the potentially promising role of power-sharing, the transparency/traceability of natural resources, education, employment programs, and a series of measures designed to bring about reconciliation and reconstruct state capacity. While, again, caution must be deployed at every step of implementation, programs and initiatives containing elements of the policy dimensions discussed are likely to have positive results. In order to design programs on the basis of scientific evidence, it would prove valuable in most cases to first put in place a pilot study, such as a randomized control trial (RCT), enabling a solid scientific evaluation, prior to potentially implementing the program in the field. In this way, science and practice can work together to tackle conflict—one of the most important issues of our time, and one of the hardest to solve.

Cite this article

• ROHNER Dominic ,
• Rohner Dominic ,
• Rohner D. ,

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Conflict management.

Yasmyne Ronquillo ; Vickie L. Ellis ; Tammy J. Toney-Butler .

Affiliations

Last Update: July 3, 2023 .

• Introduction

Conflict is the disagreement or difference of opinions between or among individuals that can be potentially harmful to any organization. In the workplace setting, it often involves personal agendas, insights, or goals versus the agendas, insights, or goals of the group or team. Conflict management seeks to resolve the disagreement or conflict with positive outcomes that satisfy all individuals involved or is beneficial to the group. However, the perception of conflict is often negative.

Conflict can, in fact, be positive if it is managed properly. Conflict can promote team-building skills, critical thinking, new ideas, and alternative resolutions. Conflict management is a crucial competency that leaders must possess, for the success of the team, group, unit, or employees they lead. [1] [2] [3] [4]

Providing conflict management skills could help raise the emotional intelligence of future managers. Excellent communication skills allow the manager to resolve interpersonal situations and conflicts. Mentoring new leaders is vital in bridging generational gaps and shaping the culture of the organization. Mentoring can assist a new leader in navigating the organizational hierarchy and developing a style of leadership that fits well within the charted course. [5] [6] [7]

Leadership style has a role to play in conflict resolution and overall team dynamics. 

Leadership Styles [8] [9] [10]

To prevent or limit conflict, leadership should seek the proper and impartial implementation of a professional code of conduct, ground rules, and discipline. [11]  Leadership is a process by which one person or a group sets the purpose or direction for others and helps them achieve goals. Leadership styles in healthcare were found to be strongly correlated with quality care and patient outcomes, such as 30-day mortality, safety, injuries, patient satisfaction, and pain. Leadership styles that proved more effective were those that emphasized a collaborative, multifaceted, and dynamic process. [12]

Servant Leader and Lean Leader

A servant-leader is where a person aspires to lead by servitude and ensures the needs of others are a priority. Servant leaders focus on the needs and growth of others, putting their well-being first, rather than their self-interests. This leadership style reflects a sharing of power, enabling others to perform at a higher level for personal growth. Servant leadership may provide the means to develop Lean leaders in the organization. The lean management style focuses on improving processes and eliminating waste. Lean and servant leadership could be combined to achieve high-quality and cost-effective patient-centered care. [13]

Transformational Leader

Transformational leaders assist an individual in the process of transformation where their own beliefs and values support or align with the organizational values. A transformational leader fosters an environment of trust, relationship building to meet common goals, and sharing of innovative ideas or long-term vision for the organization.

Transformative leaders can develop a trusting, relationship with their followers or team members, thus influencing their actions. The effect is a trickle-down outcome of conflict resolution in an environment built on mutual trust and the ability to mold an individual's response to a conflict or stressor for the greater good of the organization and population served. An ability to manage conflict effectively is a quality of a transformative leader. This leadership style has been demonstrated as a positive contributor to safety climate. [14]

Laissez-Faire Leader

Laissez-Faire leaders leave the decision-making to their followers or team members, lacking real authority within their organization, but responsible for group decisions and actions. The leader trusts the individual members of the team to problem solve, create new projects, make and meet goals, and self-monitor. This leadership style requires no real feedback, oversight, direct leadership, discipline, or praise. Thus, productivity may be low amongst some members of the group and lead to a source of conflict. This style was shown to negatively contribute to unit socialization and a culture of blame. [14]  

Authoritarian Leader

Authoritarian leaders lead by dictating and controlling the actions and decision-making capacity of the group. This leadership style reflects choices made based on their ideas, judgments, and personal beliefs, not those of their employees. Authoritarian leaders lead by enforcement and welcome little input from their team members or followers. 

Expecting a job to be done, focused on tasks rather than individuals performing those tasks, and the inability to accept input and give positive feedback yields an environment lacking in trust. Team members are not trusted, nor empowered to resolve conflicts on their own. Thus, the team dynamic may suffer long-term. Turnover in staff directly related to the inability to manage disputes and promote an environment that enriches positive growth and resolves conflicts. Nevertheless, the autocratic style is considered ideal in emergencies when the leader makes all decisions without taking into account the opinion of the staff. [12]

Transactional Leader

A transactional leader primarily focused on workflow. This leadership style may focus on incentives for "getting the job done" in a timely, efficient manner. Rewards for completing work on time or ahead of schedule, or penalties (disciplinary action) if the job delayed are components of this leadership style. These leaders may fail to plan for the future of the organization, focused only on the demands of the present. This leadership style may fail to promote and implement creative and innovative ideas necessary in a rapidly evolving health care industry.

Visionary Leader

A visionary leader has a vision or long-term goal. These leaders possess insight, imagination, and passion related to an innovative goal or idea. They are always looking out for the best interest of the team, promoting the sharing of ideas, creative goals, and a sense of empowerment to go beyond what is expected to create something unexpected.

A visionary leader fosters a healthy relationship with their team. Promoting entrepreneurial ideas and visions for the future, thus fostering a strong team dynamic capable of managing conflicts through open communication in a positive, nonadversarial manner.

• Issues of Concern

Conflict Management Styles (Thomas-Kilman Conflict Modes)

Conflict management styles take many forms and may reflect a particular style of leadership.

In this style of conflict management, some or all people involved in the conflict simply avoid the situation or ignore its existence. For the individuals involved, this is a losing situation in the long run. The conflict is unresolved. It continues to fester and build, creating more conflict. However, this style may be useful temporarily to de-escalate a very tense, non-emergency situation. 

Accommodative

In this style of conflict management, one party wins and one party loses. One opinion is accepted, and the other opinion is lost. The resolution will benefit one instead of all involved. For the person who manages the conflict, this becomes a sore spot and causes resentment. Although it may resolve the conflict, it may not satisfy all involved individuals. 

Competitive

In this style of conflict management, one party will win, and one party will lose. It will resolve the situation, but will not promote a unified or team approach to solving problems.

In this style of conflict management, neither party will be fully satisfied. The result will harbor resentment between those involved. In the resolution, each party sacrifices a portion of his or her solution. A significant part of the resolution can be left out, and the best outcome may not prevail.

Collaborative

In this style of conflict management, all parties involved are brought together for a resolution. Active listening, respectful communication, and an open mind are incorporated into the solution process for the best outcome. All parties involved have a say, and all parties involved reach a solution. This solution is accepted as the best outcome for all involved.

Steps To Conflict Management

• Before communication begins, set rules for respectful communication.
• Ask all involved to set aside preconceived opinions about each other.
• Ask all parties to engage in active listening without interruption.
• Ask all parties to write down the problem. Then restate the problem out loud. This provides understanding and agreement about the problem causing the conflict.
• Ask each party to come up with a solution. 
• Discuss each solution and the positive and negative aspects of each proposed solution.
• Clinical Significance

Resolution of conflicting views is of paramount importance in assuring that patients receive the best care possible. As such, it is important for healthcare providers to work together to achieve conflict resolution.

• Enhancing Healthcare Team Outcomes

Respectful communication among all health care staff is the anchor to preventing conflicts. An interprofessional team must never lose sight of the collective overarching goal of excellent patient care. When conflicts arise, team cohesion is enhanced by a collaborative and timely resolution of conflicts.

• Review Questions
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• Comment on this article.

Disclosure: Yasmyne Ronquillo declares no relevant financial relationships with ineligible companies.

Disclosure: Vickie Ellis declares no relevant financial relationships with ineligible companies.

Disclosure: Tammy Toney-Butler declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Ronquillo Y, Ellis VL, Toney-Butler TJ. Conflict Management. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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The Relationship between Conflict and Social Change in the Perspective of Expert Theory: A Literature Review

International Journal of Arts and Humanities Studies

Conflict and social change are a couple that influences each other. Conflict inevitably drives social change. Social changes also inevitably lead to conflict. These conditions can manifest in large or small sizes. Every society that exists on this earth in their life will certainly experience what is called changes. The existence of these changes will be known if we compare by examining society at a particular time which we then compare with the state of society in the past. Changes that occur in society are a continuous process. This situation means that every society will, in fact, experience changes. This study aims to collect argumentative views on the relationship between conflict and social change. The conclusions of this study have a significant impact in providing illustrations and projections of what social situations occur before and after conflicts or social changes occur. This research is a discourse relation analysis research. This type of research analyzes the relation...

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Sosyal Bilimler Enstitüsü

kamuran yavuz

Sadruddin Ahmad

Political Psychology

Michael D English

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• Published: 08 April 2024

The impact of conflict on infectious disease: a systematic literature review

• Valia Marou 1 ,
• Constantine I. Vardavas 1 , 2 ,
• Katerina Aslanoglou 1 ,
• Katerina Nikitara 1 ,
• Zinovia Plyta 1 ,
• Jo Leonardi-Bee 3 ,
• Kirsty Atkins 3 ,
• Orla Condell 4 ,
• Favelle Lamb 4 &
• Jonathan E. Suk 4  

Conflict and Health volume  18 , Article number:  27 ( 2024 ) Cite this article

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Conflict situations, armed or not, have been associated with emergence and transmission of infectious diseases. This review aims to identify the pathways through which infectious diseases emerge within conflict situations and to outline appropriate infectious disease preparedness and response strategies.

A systematic review was performed representing published evidence from January 2000 to October 2023. Ovid Medline and Embase were utilised to obtain literature on infectious diseases in any conflict settings. The systematic review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis). No geographical restrictions were imposed.

Our review identified 51 studies covering AIDS, Hepatitis B, Tuberculosis, Cholera, Coronavirus 2, Ebola, Poliomyelitis, Malaria, Leishmaniasis, Measles, Diphtheria, Dengue and Acute Bacterial Meningitis within conflict settings in Europe, Middle East, Asia, and Africa since October 2023. Key factors contributing to disease emergence and transmission in conflict situations included population displacement, destruction of vital infrastructure, reduction in functioning healthcare systems and healthcare personnel, disruption of disease control programmes (including reduced surveillance, diagnostic delays, and interrupted vaccinations), reduced access by healthcare providers to populations within areas of active conflict, increased population vulnerability due to limited access to healthcare services, and disruptions in the supply chain of safe water, food, and medication. To mitigate these infectious disease risks reported preparedness and response strategies included both disease-specific intervention strategies as well as broader concepts such as the education of conflict-affected populations through infectious disease awareness programmes, investing in and enabling health care in locations with displaced populations, intensifying immunisation campaigns, and ensuring political commitment and intersectoral collaborations between governments and international organisations.

Conflict plays a direct and indirect role in the transmission and propagation of infectious diseases. The findings from this review can assist decision-makers in the development of evidence-based preparedness and response strategies for the timely and effective containment of infectious disease outbreaks in conflict zones and amongst conflict-driven displaced populations.

European Centre for Disease Prevention and Control under specific contract No. 22 ECD.13,154 within Framework contract ECDC/2019/001 Lot 1B.

Introduction

Military conflicts characterised by war have had a significant impact on healthcare infrastructure and systems [ 1 , 2 ]. Affected populations may be subjected to periodic outbreaks of violence (lasting weeks to months), ongoing or recurring insecurity in a protracted conflict (lasting years to decades), or long-term ramifications of previous (usually prolonged) war [ 1 ].

In addition, populations in conflict situations present increased incidence of infectious diseases as a result of a multitude of risk factors that precipitate disease emergence and transmission [ 2 ]. These conflict-related factors include the disruption of vital and health infrastructures and large-scale, forced population movements that further challenge resources in affected countries and aid disease emergence and transmission [ 1 , 3 ]. Infectious disease outbreaks in conflict settings present a unique challenge to public health and emergency response. Detection and control of many emerging infectious diseases in conflict situations require a functional healthcare system with a sufficient number of trained healthcare workers and adequate supplies of medications, vaccines, and equipment [ 1 , 4 ]. Thus, delays in the detection, response, and containment of an infectious disease outbreak in countries affected by conflict prolong the suffering of the population of the country and elevate the risk of the transmission of infectious diseases to surrounding countries and to countries globally [ 4 ].

The Conflict in Ukraine, which started in early 2022 during the COVID-19 pandemic, reminded the world of the risks associated with infectious disease outbreaks among displaced populations and emphasised the significance of having an emergency preparedness plan and response system in place to address infectious disease outbreaks in conflict regions [ 5 ]. Considering the former, this systematic literature review examines the pathways through which infectious diseases emerge in conflict situations and assesses preparedness and response strategies with the aim of informing the work of public health agencies and countries affected by protracted conflicts.

The systematic review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) presented in Supplementary Table 1 [ 6 ]. The protocol of this systematic review was pre-reviewed by the European Centre for Disease Prevention and Control. The protocol was not pre-registered in any database for systematic reviews.

Outcomes and inclusion/exclusion criteria

Studies of all study designs, including field reports and perspective articles, with no geographical limitation were considered eligible provided they evaluated infectious diseases in conflict-affected countries and were published in English between January 2000 and October 2023 (Supplementary Table 2 ).

Study selection

Relevant studies were identified within Ovid Medline and Embase. Subject heading terms and free text words were used to develop a comprehensive search strategy which is presented in Supplementary Table 3 . Studies that met the search criteria were evaluated for their validity and reliability. Systematic and non-systematic literature reviews were excluded, but their references were screened. Initially, a pilot round of title/abstract screening was conducted, where a random sample of 100 titles was screened for eligibility independently by two reviewers (ZP, KA) to enable consistency in screening and to identify areas for amendments in the inclusion criteria. A high measure of inter-rater agreement was achieved (percentage agreement > 90%), hence the remaining titles were distributed to be screened independently by two reviewers. For the full-text screening, all full texts were screened for eligibility independently by two reviewers (KN, KA). Any disagreements were discussed with a third reviewer (CV). Documents that passed the inclusion criteria on the full-text screening were included in the review.

Data extraction, synthesis, and presentation

Data were extracted independently by two reviewers (VM, CV) using a predesigned data extraction sheet. Any discrepancies were discussed and agreed upon. The extracted data were organised in a tabular format and included: study characteristics (first author’s name, year of publication), geographical context (country/area), setting, population characteristics, sample size, methodology/study type, and numerical/ descriptive findings regarding type of infectious disease, “conflict-to-infectious disease pathways”, and measures implemented and/or suggested to mitigate outbreaks. A qualitative analysis of the included literature was performed. To evaluate the data and describe each study, a narrative synthesis approach organised by infectious disease category was utilised.

Assessment of study quality

The methodological quality of the included studies was evaluated independently by two reviewers (VM, KA) using the appropriate Joanna Briggs Institute (JBI) standardised critical appraisal tools [ 7 ]. Any points of uncertainty were addressed through discussion and consensus with a third reviewer (CV). The results of the quality appraisal are presented in Supplementary Table 4 .

A total number of 8,042 studies were identified according to the specified selection criteria in Ovid MEDLINE and Embase. After removing duplicates, 7,408 were screened by title and abstract, out of which 355 studies were assessed for full-text eligibility. Through the assessment of the full texts, 304 studies were excluded due to limited data, language and timeframe restrictions, irrelevant outcomes, settings, and study types (reviews, conference abstracts). Consequently, 51 studies were eligible to be included in this current systematic review as depicted in the PRISMA flowchart in Fig.  1 .

Flowchart of study selection for the current review

HIV and HBV

Our systematic review identified five studies reported in Table  1 , on Human Immunodeficiency Virus (HIV)/ Hepatitis B virus (HBV) in association with conflict published within the timeframe January 2000– October 2023 [ 9 , 10 , 11 , 12 , 13 ]. A higher incidence rate of HIV was reported in the conflict-torn regions of Cote d’Ivoire [ 9 ], Libya [ 10 ], Ukraine [ 11 ], and Uganda [ 12 ], as the result of population displacement [ 9 , 10 , 11 ], continuous interruption of healthcare services [ 10 ], overall decrease in healthcare personnel (especially in medical doctors), and reduction in functioning health facilities [ 9 ]. Additional effects of the armed conflict escalating HIV prevalence in Cote d’Ivoire had been the plundered healthcare delivery structures and the disappearance of laboratory equipment and surveillance data [ 9 ]. Conflict-affected participants who had experienced abduction and multiple traumas during the war were reported to be at a greater risk of HIV infection [ 12 ]. It has been noted that human resource and financial constraints, lack of equipment, diagnostic kits for sexually transmitted infections, essential drugs, reduction in the number of condoms sold and the lack of awareness campaigns were major factors impeding the implementation of effective HIV/ Acquired Immunodeficiency Syndrome prevention activities in war-torn areas [ 9 ]. In Pakistan, the prolonged armed conflict was reported to have caused an increase in poverty, medical deprivation, uncertainty, and a breakdown of social structures that facilitated the transmission of HBV [ 13 ]. High prevalence of HBV was observed in areas with high frequency of military activities [ 13 ]. Finally, the low socioeconomic status and the lack of basic health facilities were risk factors associated with HBV infection [ 13 ].

With the exception of the Non-Governmental Organisations’ (NGOs) active involvement in the prevention of and care for people with HIV in Cote d’Ivoire [ 9 ], there was no reported implementation of infection prevention protocols in the included literature. However, preventive measures were suggested and included vaccination [ 13 ], awareness campaigns [ 9 , 13 ] with emphasis on age group 15–24 year olds [ 9 ], and rehabilitation of health facilities to provide people living with HIV/AIDS antiretroviral treatment and STIs in the long term [ 9 ]. Furthermore, proactive HIV testing was suggested for internally displaced people (IDPs) and people who frequently travel to war-affected areas to be included in effective preventative measures [ 11 ]. Also, harm reduction services were suggested as significant preventative measures for HIV outbreaks among people who inject drugs. Finally, the importance of enabling sustainable prevention services and treatment provision in locations where services have been physically disrupted because of the armed conflict was also stressed [ 11 ].

The current systematic review identified eleven studies, outlined in Table  2 , on cholera and conflict published between January 2000 and October 2023 [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. In the conflict-affected regions of Monrovia, Liberia [ 17 ], cholera transmission was caused most likely by a severe shortage of clean water (as the piped water distribution system was deemed inactive), inadequate sanitation, and overcrowding. The above pathways were compounded by weather conditions as regional flooding washed contaminated water into shallow unprotected wells [ 17 ]. Due to the conflict in Yemen a massive internal population displacement occurred [ 18 , 19 , 24 ] and the population had to face insufficient shelter [ 16 ], limited access to safe drinking water, shortages of food [ 14 , 16 , 18 ], poor sanitation, destruction of healthcare facilities [ 14 , 16 , 19 , 24 ], disruption in sewage management and wastewater treatment facilities, and a lack of electricity to power water pumps [ 16 , 18 ]. Compounding environmental factors (rainfall, flooding, and water contamination) were noted in Yemen as well [ 14 ]. In Iraq, the armed civil war dispersed a large number of IDPs which, combined with the influx of Syrian refugees into the country (a result of the Syrian civil war), ultimately led to overcrowded shelter arrangements and limited access to drinking water, safe food, and basic healthcare services [ 15 ]. These factors greatly contributed to the cholera transmission in the region [ 15 ].

The war in Syria collapsed infrastructure including healthcare infrastructure, leaving healthcare understaffed and with limited resources [ 23 ]. This extended to water and sanitation infrastructure forcing the population to rely on unsafe water sources and unmonitored water resources (such as private vendor trucks) and resulted in the rapid spread of cholera [ 22 ]. Non-operational sewerage systems acerbated by the lack of access to proper water, sanitation, and hygiene (WASH) due to either physical destruction of established water systems or migration into insufficient and crowded camps further exposed residents to waterborne diseases, while the lack of laboratory testing facilities, healthcare personnel and surveillance further facilitate cholera outbreaks [ 21 ], aspects which were additionally impacted by the 2023 earthquake [ 25 ].

In South Sudan, the large-scale population displacement and movement (both within the country and from neighbouring countries) due to civil war partially explained the differences in the temporal and geographical cholera transmission patterns, together with the synergistic effects of precipitation and climatic determinants that aided bacterial transmission and spread [ 20 ].

Overall, response to cholera outbreaks were based on the cooperation of NGOs and governmental healthcare providers [ 17 − 18 , 20 ] who organised access to safe water through water trucking [ 21 , 24 ], water-sanitation-hygiene (WASH) interventions [ 15 , 18 , 20 , 22 , 24 ], health-hygiene education [ 16 , 17 , 18 , 20 , 24 ], chlorination of public water sources [ 17 , 20 ] case management [ 20 ], surveillance through phylogenetic analyses [ 20 ], and the provision of oral cholera vaccine (OCV) [ 20 , 24 ]. Additional suggestions for optimal cholera control included awareness campaigns [ 18 ], distribution of public awareness material on proper personal hygiene, food, and water safety [ 19 ], improved preparedness of the public health authorities for surveillance (including public health laboratories at central and regional levels and community surveillance systems) and response systems [ 19 , 21 , 23 ], preparedness of case definitions [ 19 ], rapid testing kits [ 19 ], arrangements for leadership and coordination [ 19 , 23 ], and case management procedures [ 19 ]. Finally, the authors recommended economic development [ 23 ], the creation and deployment of stockpiles of medical supplies [ 19 ], the OCV global stockpile [ 16 ], the development of predictive tools to identify humanitarian emergencies [ 16 ], and utilisation of improved methods for measuring population movement within and between countries during complex emergencies [ 20 ].

The current review identified six studies published between January 2000 and October 2023 related to COVID-19 in conflict settings [ 26 , 27 , 28 , 29 , 30 , 31 ], presented in Table  3 . COVID-19 outbreaks occurred in the conflict-affected regions of Libya [ 26 , 28 ], Ukraine [ 27 , 30 , 31 ], and Cameroon [ 29 ]. The armed civil war in Libya hindered access to populations and thus masked the actual status of the pandemic, particularly in cities devastated by the ongoing conflict where no cases of COVID-19 were reported since no health authority could work there [ 26 ]. In addition, it caused deterioration of the healthcare infrastructure, inadequate human and financial support, inadequate health facilities with limited bed capacity, lack of readiness for health emergency services, and population mobility due to displacement, all of which were reported as high risk Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission factors in Libya [ 28 ]. While lockdown measures and isolation procedures within main cities were implemented, the sharing of resources towards the conflict led to inadequate surveillance and response systems [ 26 ]. In Ukraine, the Russian invasion destroyed the healthcare infrastructure causing severe constraints such as power outages and oxygen shortages [ 31 ], damaged primary healthcare facilities [ 31 ], and led to mass migrations with people seeking refuge in confined subway systems or relocating to more secure locations [ 31 ], factors reported to have impacted SARS-CoV-2 transmission. Furthermore, the war was reported to have adversely affected Ukraine’s response to the COVID-19 pandemic through the allocation of resources to warfighting efforts [ 30 ], the reduction in medical personnel [ 27 ], reduction in hospital beds due to the need for emergency care to war wounded [ 27 ], limited testing [ 27 ], limited recording of cases in active conflict areas [ 27 ], no medicine delivery due to active hostilities [ 27 ], no application of social distancing due to high population density during the evacuation (in trains, stations, shelters) [ 27 ], limited application of personal protective measures in shelters [ 27 ], and poorly equipped health-care system in occupied territories [ 30 ]. The halting of vaccination plans in active conflict areas and the slow vaccination rollout within the other areas of Ukraine were attributed partially to the burden on medical institutions caused by the number of IDPs and the fleeing of medical staff to neighbouring countries [ 27 ]. The armed conflict in the Northwest region of Cameroon created destructive conditions that exacerbated the COVID-19 pandemic, including the internal population displacement, the destruction of health facilities, the killing of healthcare workers, the disruption of the regional healthcare system, and difficulties in delivering vaccines in security-compromised areas [ 29 ].

The reported emergency control measures included social distancing, face masks, hand washing, isolation, limited movement and travelling, acquisition of diagnostic test kits for COVID-19 detection at checkpoints across state borders, self-isolation of troops, and the deployment of mobile hospitals and military medical centres for COVID-19 prevention and treatment [ 30 ]. In addition, immediate financing was provided to the Institute of Molecular Biology and Genetics of the National Academy of Sciences of Ukraine for the production of self-tests [ 30 ].

Suggestions for mitigating SARS-CoV-2 transmission included enforcing national policies with internationally accepted guidelines and tools adapted to conflict situations [ 26 ] and rebuilding healthcare systems [ 31 ]. It was further suggested that NGOs, doctors and front-line workers should extend their support by supplying vaccines and medicine and that standard medical facilities should be prepared with medications, equipment, medical military personnel, and a combat support hospital with intensive care capacity [ 31 ]. Other suggested preparedness strategies included training of health facility staff [ 26 , 28 ], disease awareness programmes for civilians [ 26 , 28 , 31 ] and for military personnel [ 31 ], establishment of isolation spaces [ 28 ], and the scale-up of COVID-19 vaccination [ 29 ]. It was additionally suggested that surveillance and testing policies should not be restricted to severely hospitalized patients but should include milder cases and asymptomatic infections and that access to accurate rapid tests should be broad [ 30 ]. The allocation of resources, beds, and medical staff was recommended to be on strict prioritization [ 30 ]. Finally, information sharing of data and interoperability with international partners was stressed [ 30 ].

Tuberculosis

With this systematic review, five studies were identified that reported on tuberculosis (TB) in conflict settings between January 2000 and October 2023 [ 32 , 33 , 34 , 35 , 36 ] (Table  4 ). Increased TB incidence was reported in Ethiopia [ 32 ], South Sudan [ 34 ], and Nigeria [ 33 ], following armed conflict, and recently appeared in Ukraine, Russia and neighbouring countries due to the displacement of citizens [ 35 , 36 ].

Delay in the diagnosis of TB patients and self-treatment prior to diagnosis have been associated with increased transmission and morbidity [ 32 ]. The armed conflicts in Ethiopia disrupted the healthcare system and economic resources were diverted to priorities other than health needs, this meant that patients were unable to seek prompt TB care resulting in diagnostic delay and hampered TB control efforts [ 32 ]. In South Sudan, key challenges resulting from civil unrest that contributed to TB transmission included the limited number of healthcare providers, the interruption of treatments because travel was impossible, and the relocation of people [ 34 ]. During the war in Ukraine and Russia, internal displacement of citizens resulted in the dispersal of drug-resistant Mycobacterium tuberculosis to affected and neighbouring countries. The heightened risk of interrupted treatment during war contributes to an increased likelihood of drug resistance and treatment failure [ 35 ]. In addition, the war resulted in a large population movement fleeing Ukraine to reach France among which TB cases and consequently the spread of the TB [ 36 ] Finally, Adamawa State experienced several years of violence with severe disruption of public health activities including TB services and a massive population displacement [ 33 ]. The study shows that years and places of higher conflict were associated with lower TB notifications [ 33 ]. The decrease reflects the displacement of the populations to other locations that were considered safer, the limited or no access to TB health services due to displacement, the general disruption of TB services along with the reduced number of healthcare staff [ 33 ].

Suggested measures for TB control in conflict zones were the expansion of user-friendly directly observed short-course treatment (DOTS), the establishment of early TB detection training programmes for community health workers [ 32 ], and population-target risk communication activities [ 33 ]. Importantly, international organisations providing health services should be given unconditional access to conflict zones [ 32 ] while the global health community should be ready to step up efforts to detect and treat drug-resistant and drug-susceptible TB, as well as to strengthen screening initiatives for TB prevention and treatment in migrants and close contacts [ 35 ]. Finally, it was noted that a pre-established well-organised network of TB centres such as the CLAT network is effective in the case of sudden mass migration from a high TB incidence country [ 36 ].

Ebola virus disease

The current systematic review identified five studies on Ebola virus disease and conflict published between January 2000 and October 2023 [ 37 , 38 , 39 , 40 ] (Table  5 ). The Ebola epidemic in the Democratic Republic of Congo (DRC) [ 37 , 38 , 39 ,− 40 ] occurred in the midst of an active armed conflict, geopolitical volatility and with a million displaced people [ 31 ]. The conflict in the region was associated with inhibited case detection [ 39 , 40 ], delayed reporting of the outbreak [ 37 , 40 ], delayed time to isolation [ 40 ], deteriorating security [ 39 ], dampened vaccine deployment [ 40 ], and limited follow-up [ 40 ] especially with people in the zone of violence [ 37 ] all of which led to an increase in transmission that was attributable primarily to the organised attacks by armed groups targeting healthcare providers and Ebola treatment centres [ 39 , 40 ] and the population’s increasing distrust of the response effort [ 38 , 39 , 40 ] that impedes information-sharing and cooperation.

In response, the DRC Ministry of Health collaborated with health workers from NGOs and UN agencies and, alongside with the linguistic and cultural awareness of local personnel, implemented contact tracing [ 38 ], medical isolation [ 38 ], exploratory therapies [ 38 ], ring vaccination [ 37 , 38 ,− 39 ], entry and exit screenings at key points [ 39 ], real-time epidemiologic surveillance of contacts [ 39 ], provision of safe and dignified burials [ 39 ], and medical treatment [ 39 ]. Additional measures that aided the outbreak’s containment were the rapid decontamination of facilities with identified cases and the distribution of infection prevention and control equipment to healthcare facilities and strategic areas (schools, public offices, and transition points) [ 39 ].

Suggested preparation strategies included engaging the community to build trust among residents [ 38 , 39 , 40 ], ensuring the safety of frontline workers that provide treatment, conducting contact tracing, and distributing vaccines [ 38 , 39 , 40 ]. In addition, the significance of increased security and expanded capabilities in laboratories, surveillance, data analysis, and clinical response were emphasised [ 38 ]. Finally, the necessity of a transparent framework for responding to epidemics in conflict zones was acknowledged, which should be supported by national action plans to safeguard public health action in conflict zones [ 38 ].

Poliomyelitis

The current review identified five studies published between January 2000 and October 2023 on poliomyelitis and conflict [ 41 , 42 , 43 , 44 , 45 ] presented in Table  6 . According to a study that collected data from countries affected by conflict and experiencing polio outbreaks between 2011 and 2014, polio was more common in countries with political conflict and instability [ 42 ]. People faced a lack of access to clean water, as well as deteriorating sanitation and living conditions as a result of conflict and political instability, which aided polio transmission significantly [ 42 ]. Furthermore, polio incidence was found to be spatially associated with violence [as represented by the location of Improvised Explosive Devices (IEDs)] in Afghanistan [ 44 ]. The high-risk districts had a statistically significant greater mean number of IEDs compared to non-polio high-risk districts [ 44 ]. According to the authors, violence in the region leads to reduced rates of polio vaccination and disruption in vaccine coverage, which in turn is responsible for increased polio incidence [ 44 ]. It was reported that vaccination campaign workers and public health workers had been directly targeted by armed groups, with abductions and murders. The Afghani government and international agencies had been forced to suspend operations or delay subnational immunisation days in some regions. The response was challenged from the combined impact of a government transition, a depressed economy, droughts, floods, food insecurity, displacement, and severe gaps in delivery of health services [ 45 ].

In Syria, poliomyelitis reappeared in mid-2013 during the civil war [ 43 ]. Reported conflict-to-disease related factors included the collapse of the healthcare system and infrastructure, decline in the economy, and shortages of food, water, and inadequate sanitation [ 43 ]. The emigration of healthcare personnel from both government and nongovernment territory due to conflict further affected the country’s healthcare system [ 43 ]. Moreover, a severe lack of basic medications and preventative services had ensued, including a sharp decline in the overall vaccination coverage to only 50% in 2015 [ 43 ]. Finally, in Iraq children who had been exposed to war were over 20% points less likely to receive neonatal polio immunisation compared to children who had not been exposed [ 41 ]. According to the authors, the decline is part of a broader war-induced deterioration of routine maternal and new-born health services [ 41 ].

In response, the World Health Organization (WHO) mandated polio immunisation for all travellers to and from Pakistan, Syria, and Cameroon and suggested travel vaccinations for Afghanistan, Nigeria, and other nations as a preventive measure [ 42 ]. Additionally, the Global Polio Eradication Initiative (GPEI), which coordinated the actions of the Afghan government, UNICEF, and NGOs, represented a significant polio mitigation effort through which vaccination sites, vaccinators, and supplemental immunisation activities were organised, and “mop-ups” (i.e. revaccination of children close to a polio outbreak) were carried out [ 44 ]. Moreover, in 2020 the GPEI authorised the use of trivalent OPV (tOPV) for outbreak response, with supplementary immunization activities carried out throughout 2021 and 2022 outbreak response [ 45 ]. In 2022 the program reached 3.5–4.5 million children that were previously unreachable because the insurgency prevented access [ 45 ]. The development of Acute Flaccid Paralysis took place and also environmental surveillance with the systematic sampling and virologic testing of sewage sites [ 45 ]. Finally, genomic sequence analyses were preformed to assess cross border transmission between Afghanistan and Pakistan [ 45 ]. Regarding Syria, Syrian and regional NGOs, in an effort to control the outbreak, established vaccination facilities, trained local personnel, and delivered vaccines to children in areas inaccessible to WHO [ 43 ].

The control of polio and other infections in impoverished, conflict-ridden areas was suggested that may be improved by providing displaced families and those in high-risk areas with urgent care in the form of clean water, increased nutritional measures, improved sanitation, and easy access to health care and vaccinations [ 42 ]. Additionally, Geographic Information System (GIS) maps presenting the recent virus origin and the current virus movement may help to identify areas with high rates of polio and to predict the possibility of movement of the virus to neighbouring countries, thus guiding preventative measures [ 42 ]. Furthermore, the lack of polio-licenced laboratories or the lack of access to laboratories in conflict zones was noted, necessitating international surveillance to be strengthened [ 43 ]. Finally, financial and logistical international support for vaccine and immunisation of the population in conflict-torn countries is needed [ 43 ]. The authors emphasised that during conflicts, WHO, UNICEF, and UN agencies involved in global health should be supported, funded and allowed to function independently of governments to provide necessary medical and humanitarian relief for civilians [ 43 ]. Also, in order to ensure uninterrupted immunisation coverage and thus successful eradication of polio in conflict zones, direct negotiations with anti-government organisations should be conducted [ 44 ].

The current review identified two articles on malaria prevalence in conflict-affected areas of Timor-Leste and Sub-Saharan Africa that were published between January 2000 and October 2023 [ 46 , 47 ], presented in Table  7 . During the 2006 Timor crisis, gang fights and street violence ensued, over 3,000 homes burned down mostly in the capital city, Dili and 15% of the country’s population was displaced [ 46 ]. The IDPs sought refuge in camps, churches, convents and schools, with some displaced from Dili, to districts [ 46 ]. In Dili, more than 60 camps were established to provide temporary shelter for displaced people [ 46 ]. Breakdown of health services and of malaria control programmes, movement of people from low to high transmission areas, and environmental deterioration encouraging vector breeding, such as rainy seasons are factors that contribute to the increase of morbidity and mortality due to malaria [ 46 ]. The authors argue that the timing of the crisis which occurred at the end of the rainy season along with the early malaria interventions which covered treatment, massive insecticide-treated nets [ 48 ] distribution with emphasis to pregnant women and children under five, vector control, surveillance and health promotion for IDPs possibly prevented major Malaria outbreaks in the area [ 46 ]. It was recommended that future malaria intervention responses be planned beyond the IDP camps and adequate resources and expertise be made available to ensure a whole-city approach [ 46 ].

The second study examined the link between conflicts and variations in the Plasmodium falciparum parasite in Sub-Saharan African countries from 1997 to 2010, during which a significant number of armed conflicts occurred [ 47 ]. The duration of conflicts, the distance from conflicts, the number of conflicts, and the level of violence associated with the conflicts were found to be major factors that explained the prevalence of malaria [ 47 ]. More specifically, locations affected by a larger number of longer and closer conflicts with significant amounts of violence and deaths were more likely to see an increase in P. falciparum prevalence [ 47 ]. Moreover, decreased post-conflict P. falciparum parasite rate was associated with conflicts without violence against civilians, without violent transfer of territory or battles with change of territory, and without riots/protests [ 47 ]. The maintenance of intervention coverage and provision of healthcare in conflict situations to protect vulnerable populations was suggested [ 47 ].

Leishmaniasis

This systematic review identified two studies on leishmaniasis displayed in Table  7 [ 49 , 50 ]. Leishmaniasis outbreaks occurred in the conflict-affected regions of Lebanon [ 49 ] and Syria [ 50 ]. The outbreak in Lebanon was reported to be a result of the Syrian crisis and the consequent influx of Syrian refugees [ 49 ]. The massive and rapid increase in the arrival of Syrian refugees, and their large-scale movement to different regions of Lebanon, without allocation to designated camps, along with the limited access to treatment and the absence of well-trained personnel exacerbated the spread of the parasite [ 49 ]. The Lebanese Ministry of Public Health (LMOPH) to contain the spread of infection implemented the following measures: sprayed pesticides to kill the vector, provided free treatment and diagnosis for emerging cases, distributed free medications to the different primary care centres, and monitored the disease activity [ 49 ]. Additionally, medical and healthcare professionals received training on disease symptoms, and the Lebanese people and Syrian refugees received education on disease symptoms and medical treatment [ 49 ]. Furthermore, the government established new Leishmania detection and treatment units in all Lebanese hospitals, mainly in rural areas and near refugee camps [ 49 ]. The authors note that the measures taken by the LMOPH are key to any health emergency response, but require the cooperation of other concerned parties to ensure success [ 49 ]. The importance of coordinating efforts among various governmental departments, international agencies, local authorities, medical associations, and NGOs for containing similar outbreaks in Lebanon, or any other country in the region is emphasised [ 49 ].

In Syria, the conflict displaced more than 6.5 million people causing a major refugee crisis, severely damaged 60% of Syrian hospitals, and greatly reduced the pharmaceutical production capacity of the country [ 50 ]. The destruction of healthcare infrastructure, the over-crowding of what was considered “safer Syrian cities” (such as Latakia) and their healthcare facilities, and the displacement of a large population from leishmaniasis-endemic areas enabled the transmission of the Leishmania parasite [ 50 ]. To control transmission, healthcare authorities initiated a campaign that consisted of vector control, early detection and treatment, and public education. Improving the living circumstances in sites with high population densities, enforcing better health-care services, and activating surveillance, early diagnosis, vector control, and public education is suggested as an integral part of any plan to successfully control and eliminate leishmaniasis [ 50 ].

Two studies were identified on measles and conflict between January 2000 and October 2023 [ 51 , 52 ](Table  7 ). Higher incidence rates of measles were reported in conflict-affected Darfur, Sudan [ 51 ] and in Borno state, Nigeria [ 52 ]. In 2003, Darfur experienced civil conflict that resulted in the internal displacement of approximately one million residents and an estimated 170,000 persons fleeing to neighbouring Chad [ 51 ]. The conflict left a vulnerable population with limited access to food, health care, and other basic necessities, which adversely affected measles vaccination coverage [ 51 ]. During March-April 2004 a measles outbreak among IPDs was reported in Darfur [ 51 ]. In response, the Federal Ministry of Health in collaboration with the UNs and NGOs conducted vaccination campaigns targeting children aged 9 months – 5 years to limit the transmission. Moreover, clinics were established in IDP camps to vaccinate current and incoming residents [ 51 ]. Despite these measures, measles virus transmission continued to occur both within the camps and in neighbouring communities [ 51 ]. Vaccination was organised using a combination of fixed posts and outreach immunisation teams, the use of checklists to monitor vaccination sessions, social mobilisation activities, and surveillance for adverse events after vaccination. In addition, rapid convenience surveys were used to monitor coverage in hard-to-reach areas [ 51 ]. Tally sheets were used to monitor campaign coverage, and data were sent to the federal level for compilation and analysis [ 51 ].

In Borno state, Measles vaccination campaigns were organised based on accessibility mapping of each area [ 52 ]. They organised both fixed locations of the healthcare team at health facilities and temporary locations at strategic areas of the communities (schools, markets, and places of worship) [ 52 ]. In addition, the Reaching Every Settlement (RES) strategy was implemented in some partially accessible areas and involved vaccination teams with security cover by the Military or armed local vigilante referred to as the Civilian Joint Taskforce [ 52 ]. For nomadic populations, combined Human and Animal Vaccination teams were organised [ 52 ]. Finally, the strategy of reaching Inaccessible Children was adopted to reach eligible children in security-compromised areas by leveraging the military personnel to conduct vaccination, but the plan was suspended by the military [ 52 ]. Although the above immunisation strategies were organised, the escalation in insurgency during the timeframe and the prioritisation of the military to address security issues over delivering health commodities compromised the vaccination campaign [ 52 ]. Most of the local government areas (LGAs) were not fully accessible and children remained trapped with no access to immunisation services [ 52 ]. Another reported factor related to the introduction and transmission of measles was the mass movement of people between IDP camps and host communities [ 52 ]. The authors recommended a continuous, stronger engagement with the military, re-establishment of holding camps, vaccination posts at all entry points into IDP camps and host communities to ensure screening and vaccination of new entrants [ 52 ].

Our systematic review identified one study reporting on the dengue outbreak in Taiz, Yemen in 2016 during the civil war [ 53 ](Table  7 ). According to the authors, the prevalence of dengue in Taiz increased markedly because of the ongoing civil war which damaged the public health infrastructure of the country [ 53 ]. More than 2.2 million people were displaced and moved into overcrowded shelters forced to live in unsanitary conditions with limited access to medical care [ 53 ]. The war led to the creation of numerous potential mosquito-breeding sites such as open water storage containers, areas with inadequate drainage, discarded plastic containers in which water accumulates, and puddles of water and resulted in propagation and transmission of the mosquito-borne dengue virus that was difficult to control [ 53 ]. No prevention or preparedness strategies were noted within this report.

Our review identified one study that investigated a diphtheria outbreak in Bangladesh among Myanmar nationals displaced due to political conflict [ 54 ]. As noted in Table  7 , from August to December 2017, a massive influx of approximately 630,000 forcibly displaced Myanmar nationals created makeshift settlements in and around established refugee camps in Bangladesh where the first suspected diphtheria case was reported which resulted in over 800 suspected cases reported in the area by mid-December. No prevention or preparedness strategies were noted within this report [ 54 ].

Acute bacterial meningitis (ABM)

Our review identified one study that assessed ABM outbreaks in Yemen before and during the civil war [ 55 ]. The study noted that the civil war reduced vaccination coverage and increased the prevalence of suspected cases, with areas which were more affected by civil war found to have the highest suspected prevalence and lowest vaccination coverage [ 55 ]. Overall, the ongoing war and the land–sea–air embargo imposed on Yemen eventually caused the vaccination coverage rate to decline [ 55 ].

Studies assessing the impact of conflict on multiple infectious diseases

The current review identified and analysed six studies on multiple infectious diseases published between January 2000 and October 2023 [ 56 , 57 , 58 , 59 , 60 , 61 ] (Table  8 ). Higher incidence rates of several infectious diseases were reported in Iraq [ 56 ], in the Southwest region of Cameroon [ 57 ], in Syria and neighbouring countries [ 61 ], in Jordan [ 59 ], in Ukraine [ 58 ], and in DRC [ 60 ]. During the peak years of the war in Iraq, particularly during the US military surge (2007–2009), the incidence of infectious diseases increased significantly [ 56 ]. Iraq experienced four vaccine-preventable disease outbreaks: measles in 2009, mumps in 2004 and 2016, and rubella in 2004. These outbreaks were reported to have been attributed to deterioration of the infrastructure during the conflict, lower vaccine coverage and higher vaccine failure due to inappropriate vaccine handling, failure to maintain the cold chain, and improper administrative procedures [ 56 ]. The Cholera outbreak in 2008 was reported to have been facilitated by the war-related deterioration of water quality and sanitation. The rise in the incidence of Hepatitis A was attributed to conflict zone-related circumstances, namely poor primary hygiene practices, interrupted water supplies, and population displacement [ 56 ]. In response, the Ministry of Health reoriented public health sector towards primary care, restored disease surveillance systems and screening programmes, and initiated individual smart cards with health records and messages for required immunisations and clinic visits [ 56 ]. The importance of vaccination along with immediate water treatment and case management for the successful control of cholera outbreaks was also mentioned [ 56 ].

In the Southwest region of Cameroon, the reduction in healthcare utilisation due to reduced community accessibility to health facilities was a main consequence of the armed conflict [ 57 ]. The conflict led to the abandonment of healthcare facilities because of the attacks on health personnel and infrastructure. Moreover, there was disruption to drug deliveries to health facilities, roads were blocked, communication networks were destroyed, and the disease surveillance system was disrupted due to active fighting [ 57 ]. The disruption of normal life and health services due to the insurgency created an enabling environment for the spread of infectious diseases [ 57 ]. In response, vaccine rollouts were targeted towards displaced children and community health workers were engaged to provide a continuity of care. It was suggested that local, national, regional, and global authorities should work together to develop risk-mitigating interventions in settings with armed conflicts to preserve the delivery and utilisation of health services [ 57 ].

In Syria and neighbouring countries, the number of vector-borne disease outbreaks reported among human and animal populations increased significantly following the onset of conflict in Syria [ 61 ]. Conflict-related factors that led to the spread of infectious diseases were the disruption of WASH infrastructure and standard health services, migration, and overcrowded healthcare systems not equipped to handle a surge of forcibly displaced people [ 61 ].

In Jordan, the Syrian conflict led to the influx of Syrian refugees that placed further pressure on the country’s over-stretched resources [ 59 ]. People arriving as a result of conflict-driven displacement had no or low access to healthcare and thus were at a greater risk of exposure to diseases [ 59 ]. Additionally, conflict-driven displacement was reported to have an immediate effect on child health due to disrupting access, and limited availability and affordability of healthcare services [ 59 ]. In response, sanitation programmes and sewage networks were organised in refugee camps [ 59 ]. Coordinated and effective measures to provide the health care services among the displaced populations and collaborated efforts with global partners in managing health care emergencies were suggested [ 59 ].

In Ukraine, the Russian aggression resulted in the destruction of healthcare facilities [ 58 ]. In areas with active hostilities, critical supplies, including oxygen, insulin, and medicines were in short supply, their delivery was disrupted, and people were displaced into overcrowded shelters with limited or no access to water and sanitation facilities [ 58 ]. As a result, a reported increase in cases of HIV/AIDS, TB, and COVID-19 was observed [ 58 ]. The authors suggested that Ukraine’s infrastructure and essential systems should be rebuilt to ensure appropriate recovery for the country and its people and surveillance and support should be strengthened [ 58 ].

In DRC, the conflict rendered certain health zones inaccessible, increased population/contact mobility, reduced aid for basic services, and impacted response activities [ 60 ]. The aforementioned factors, in addition to the pre-existing community mistrust and high population density, led to increased EVD transmission [ 60 ]. The authors proposed that the strategies and response measures implemented for Ebola be used for the mitigation of COVID-19 in DRC including the transfer of protocols and systems (Table  8 ) [ 60 ].

Conflict within or between countries adversely affects population health. The studies reported here demonstrate that in conflict circumstances, affected populations are at an increased risk of infectious disease outbreaks. Infectious diseases have a significant impact on the population’s health, thus understanding the link between conflict and infectious diseases is essential. With the current systematic review, we outlined the types of infectious diseases that have been emerging in conflict-affected countries, the pathways leading from conflict to infectious disease outbreaks, and noted the prevention or response strategies and protocols implemented and recommended to prevent and control infectious disease risks.

Conflict and violence have long been associated with the introduction, transmission, and propagation of infectious disease pathogens. Overall, major overarching pathways reported in the studies identified within this review included population displacement [ 9 , 10 , 11 , 15 , 24 , 18 , 20 , 27 , 28 , 29 , 34 , 33 , 46 , 50 , 51 , 56 , 57 , 58 , 55 , 62 ], disruption of vital infrastructure and of the healthcare system (including reduced surveillance, diagnostic delays, interrupted vaccinations [ 58 , 61 , 63 ], and disruption of disease control programmes) [ 9 , 26 , 27 , 28 , 31 , 42 , 43 , 50 , 53 , 56 , 57 , 58 ], and increased population vulnerability to infection [ 9 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 24 , 27 , 32 , 33 , 34 , 35 , 41 , 42 ,− 43 , 45 , 50 ]. Disease-specific pathways were also reported such as water contamination for cholera [ 17 , 14 , 21 , 22 , 23 ], poor injection safety [ 13 ], sexual exposure [ 13 ], risky practices for HIV [ 13 ], creation of potential mosquito-breeding sites for Dengue [ 53 ] etc. Further factors – such as the coincidence of rainy seasons, were also noted as compounding factors for vector-borne infectious diseases [ 46 ].

More specifically, infectious diseases are more likely to be introduced and transmitted during conflict situations as there are often large-scale population movements of IDPs [ 9 , 10 , 11 , 15 , 24 , 18 , 20 , 27 , 28 , 29 , 34 , 33 , 46 , 50 , 51 , 56 , 57 , 58 ] and large influxes of refugees to neighbouring countries [ 15 , 49 , 57 , 59 , 62 ] which challenge resources in countries and result in overcrowded settings, poor hygienic conditions, broken infrastructure, and lack of and difficulty in receiving medical treatment [ 3 ]. These factors may also have an impact on countries not directly involved in the conflict [ 3 ]. Forcibly displaced populations are affected by a wide range of infectious disease pathogens mostly due to infections acquired in the destination country, cited as related to interrupted vaccination and a breakdown in local health infrastructure and mistrust of local medical care [ 63 ]. These findings are consistent with prior studies that have demonstrated low risks of imported acute infectious diseases impacting host country epidemiology while crowding associated with temporary resettlement increases the risk of outbreaks among displaced residents [ 63 ]. More specifically, conflicts and wars led to forced large-scale population migration, large numbers of IPDs, and influx of refugees which in turn led to high population density and large numbers of people that moved into overcrowded shelter arrangements with limited access to sanitation facilities, safe water and limited or no access to medical care. Another factor related to the introduction and transmission of infectious diseases was the mass movement of people between IDP camps and host communities [ 52 ]. Additionally, internal population displacement was associated with the geographic spread of infectious diseases from the regions involved in the armed conflict to the rest of the country and to neighbouring countries (such as between Ukraine and Poland) [ 64 ] with phylodynamic evidence supporting this case [ 65 , 66 ]. High population density during evacuation plans [ 27 ] and the lack of social distancing among militaries and prisoners [ 43 , 67 ], were also reported as pathways leading to the transmission of infectious diseases.

Conflicts have been noted as a direct cause of the destruction of electricity, water, transportation, and health infrastructure as well as the disruption in functioning health systems [ 27 , 28 , 31 , 42 , 43 , 50 , 53 , 56 , 57 , 58 ]. Organised attacks on power, water, and transportation infrastructure were reported across studies. In areas with active hostilities, roads were blocked and destroyed, highways were attacked, communication networks were broken [ 57 , 58 ], power failures/loss of electrical power occurred [ 16 , 31 ], clean water sources were disrupted, and critical medical products, including vaccines, were in short supply with their deliveries to health facilities disrupted [ 27 , 29 , 57 , 58 , 60 ]. Furthermore, organised attacks on health infrastructure, including the bombing of hospitals, factories and dispensaries as well as the targeting and persecution of healthcare personnel resulted in the destruction and abandonment of healthcare facilities [ 39 , 40 , 43 , 57 ], a significant reduction in medical personnel, and ultimately the disruption of disease surveillance systems [ 9 , 26 , 56 , 57 ] and of the necessary healthcare services. Surveillance systems are often weak in conflict situations, resulting in delays in the detection and reporting of epidemics [ 37 , 40 ]. Armed conflicts also were reported to have caused treatment interruptions [ 9 , 10 , 11 , 34 , 35 , 46 ], limited patient-provider consultations [ 57 ] and limited follow-up [ 40 ], especially for people in areas with active hostilities. Other factors that aided transmission of water-borne infectious diseases were reported and these included disruptions in sewage management and wastewater treatment facilities as well as inactive pipe water distribution systems that resulted in severe shortages of clean water [ 16 , 17 , 56 ].

Additionally, certain war zones were rendered inaccessible to governmental organisations and NGOs due to active fighting or because they were controlled by anti-government organisations. In these areas, the population could not be reached, medicine could not be delivered or delivered in time, administration of vaccinations was interrupted [ 58 , 61 , 63 ], and access to treatment was limited [ 34 , 35 , 60 ]. The lack of vaccination plans in active conflict areas was also noted [ 27 ].

Finally, conflicts may fuel epidemics by increasing population vulnerabilities due to poverty, malnutrition, medical deprivation, uncertainty, and a breakdown of social structures. Shortages of food, drinking water, and medication were important conflict-to-disease-related factors in the studied literature. Conflicts make populations vulnerable and insecure with limited access to safe water, food, healthcare, and other basic necessities [ 9 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 24 , 27 , 37 , 42 , 43 , 56 , 58 ]. Moreover, migrants are often emotionally and physically stressed and thus have low immunity to disease endemics in the new area [ 35 ]. Children are the most vulnerable group as malnutrition, lack of basic necessities, and limited access to healthcare make them more susceptible to infectious diseases if neither vaccinated nor previously exposed [ 45 , 52 , 59 ]. In addition, increasing community distrust of the government and the public health response was reported in some of the affected countries [ 38 , 39 , 40 , 42 , 44 , 60 ]. Public mistrust in the governmental and international organisations that run vaccination campaigns resulted in increased rates of unvaccinated adults and children with low immunity to vaccine-preventable diseases [ 44 ], impeding the control of vaccine-preventable infectious disease outbreaks. Finally, refugees and vulnerable people due to conflicts were reported to be affected by sexual violence and abuse, increased drug use, lack of health infrastructure, education, income, and basic needs, and social structure breakdown [ 68 ].

On the antipode, prevention strategies, preparedness plans, and emergency response procedures are the key to effective epidemic control. The most important public health detection and prevention strategies reported in the studied literature included: disease awareness programmes [ 9 , 13 , 17 , 18 , 19 , 26 , 28 , 31 , 49 , 50 ] and the education of the general population [ 24 ], implementation of WASH strategies [ 15 , 18 , 20 , 24 ], organisation of vaccination sites and vaccination campaigns [ 10 , 37 , 38 , 39 , 41 , 42 , 44 , 51 , 52 ], access to healthcare and applying preventable services in conflict zones/camps, training and recruiting healthcare workers [ 26 , 30 , 32 , 33 , 43 , 49 ], developing surveillance and response protocols and ensuring cooperation/coordination between international agencies/nongovernmental organisations, national and regional authorities, and local/front-line NGOs [ 30 , 32 , 38 , 39 , 40 , 44 , 49 , 52 , 57 , 59 ].

Disease education/awareness programmes and community mobilisation/engagement campaigns were considered a necessary part of any plan to successfully prevent epidemics for the majority of the studied infectious diseases [ 9 , 10 , 18 , 26 , 28 , 31 , 49 , 50 ] Measures included education and sensitising programmes for infectious diseases targeting at-risk populations and populations in host communities [ 9 ] through culturally appropriate information on symptoms and how to seek medical advice and treatment [ 49 ]. Disease awareness programmes for civilians [ 10 , 28 , 31 ], and importantly for military personnel [ 31 ] on personal protective measures, immunisations, chemoprophylaxis and surveillance were suggested. The distribution of public awareness material on proper personal hygiene, food, and water safety [ 19 ] for other infectious diseases was also suggested. In the case of HIV infection, the emphasis was placed on educating young people aged 15 to 24 [ 9 ] with the development of educational/awareness materials in appropriate languages [ 68 ], programmes for in-school and out-of-school youth [ 68 ], peer education [ 68 ], youth centres [ 68 ], sports/drama groups [ 68 ], and programmes aimed at reducing teenage pregnancy and sexual violence [ 68 ].

Furthermore, investing and enabling health care and preventative services in locations that have been disrupted by conflict and in locations with displaced populations was stressed across the studied literature. The reconstruction and rehabilitation of health centres and hospitals [ 9 , 24 ] within conflict areas have been noted as a primary response strategy. Infection control procedures should also be instituted in healthcare centers including the development of procedures in establishing an isolation facility, ensuring safe water, sanitation and waste disposal and providing personal protective equipment for staff within hospitals [ 2 ]. The provision of therapeutic and diagnostic supplies and testing equipment [ 28 ] and preparing with medications, and equipment standard medical facilities with intensive care capacity [ 31 ] have also been noted as key response measures, including the importance and need to adapt strategies, guidelines and tools [ 26 ], such as treatment regimens [ 32 ] and the expansion of user-friendly short-course DOTS for TB [ 32 ] in conflict settings.

The recruitment of health staff and the establishment of early disease detection training programmes for healthcare professionals are also critical measures to maintaining healthcare in conflict situations and in post-conflict rehabilitation [ 27 , 28 , 32 , 33 , 43 , 49 ]. Similarly, improved preparedness of the public health authorities for surveillance (including public health laboratories at central and regional levels) and response systems [ 19 ] is also essential.

For the vaccine preventable diseases identified within the context of this review, the studies suggested the implementation of several approaches towards vaccination strategies [ 13 , 27 , 37 , 39 , 41 , 44 , 51 ], aimed to cover at-risk populations both within combat areas and amongst displaced populations with vaccination at entry and exit screenings [ 39 ]. Studies also described numerous approaches towards implementing vaccination of at-risk populations such as displaced persons, including organising vaccination campaigns at fixed posts where the team was based at the health facilities and at temporary post located at strategic areas such as transit points, bus stations and refuge sites [ 29 , 51 , 52 ], as well as the use of mobile outreach teams [ 51 ]. In addition, the creation and use of medical supplies and global vaccine stockpiles were suggested as mitigation measures that could be available for rapid deployment in emergency and outbreak situations [ 16 , 19 ]. In some cases, this is easily achievable, as with the provision of OCVs [ 15 , 20 , 24 ] while in other circumstances protocols including the maintenance of a cold chain for transport and the use of trained teams are needed [ 39 ]. In all cases, encouraging the community to participate at every level of the vaccine rollout improves public trust which is essential for the effective implementation of vaccine rollout plans [ 29 , 38 , 39 , 40 ].

The importance of collaborative efforts between international agencies and nongovernmental organisations, national and regional authorities and local/front-line NGOs was stressed in most of the studied articles [ 30 , 38 , 39 , 40 , 43 , 44 , 49 , 51 , 57 , 59 ]. During active conflicts, interoperability and biosurveillance information sharing across agencies are needed [ 30 ]. In order to maintain the delivery and utilisation of health care in areas affected by armed conflicts, it was advised that local, national, regional, and international authorities cooperate [ 57 ]. It was further recommended that international financial and logistical support should be given to front-line NGOs to reach and safely provide healthcare to isolated/hard-to-reach populations [ 43 ]. Also, international organisations providing health services should be given unconditional safe access to conflict zones. Finally, political commitment is necessary to achieve as far as possible uninterrupted and safe medical and humanitarian aid to conflict zones [ 32 , 44 ], as well as support for post-conflict recovery.

Extended wars and conflicts often make people reliant on foreign aid. This need for international aid often lasts for a long time even after peace is restored. Therefore multi-agency humanitarian assistance must promote effective, efficient, and socio-culturally suitable healthcare in a sustainable way [ 69 ]. It is of critical importance to improve the quality of life to avoid and minimise disease occurrence among both displaced and conflict-affected population’s [ 70 ]. As such, international organisations that provide health and humanitarian services should be given unconditional access to conflict zones [ 32 ] and should be allowed to function impartially within conflict [ 43 ]. The government and opposition groups must be engaged with to ease passage of aid and access to conflict-affected populations [ 71 ].

Last but not least, studies have noted the importance of a proactive identification of vulnerabilities and locations for interventions through surveillance [ 14 , 19 , 31 , 38 , 43 , 46 , 50 , 51 , 58 , 62 ]. It is essential to improve the preparedness of the public health authorities by increasing international surveillance [ 14 , 19 , 31 , 38 , 43 , 46 , 50 , 51 , 58 , 62 ] and international financial and logistical support for vaccine and immunisation of the population, especially in conflict-torn countries [ 43 ]. Improved methods for measuring population movement within and between countries during complex emergencies are needed [ 20 ], through multisource surveillance techniques [ 20 ] and through the development of predictive tools to identify vulnerabilities and settings posing a high a risk of infectious disease [ 16 ]. While advanced surveillance systems (i.e. genomics) are important, easy applicable early warning systems, such as tally sheets to monitor campaign coverage [ 51 ], are also beneficial. To this extent, tracking spatiotemporal patterns of populations and disease transmission [ 14 ], along with the early detection of outbreaks supporting the prediction of areas at increased risk for infectious disease introductions/outbreaks is essential. Surveillance and broad testing policies, not only for severe hospitalised cases but also for milder, asymptomatic cases are necessary response measures that could contribute to lower mortality [ 30 ]. Furthermore, the creation of effective and targeted public health emergency response plans based on the acquired information is also needed to enable timely and effective mitigation of future health challenges arising in conflict-affected countries and in countries hosting displaced populations.

Strengths and limitations

The systematic investigation of the literature, the thorough assessment, data extraction, quality appraisal, and synthesis of published evidence are strengths of the current review. However, it is important to acknowledge certain limitations. This review focused on peer-reviewed evidence available in the English language. Therefore, relevant information published in other languages may be missing. Additionally, our inclusion criteria did not impose geographical restrictions, necessitating cautious interpretation of the findings in light of documented variations across countries and different disease outbreaks. Furthermore, while this review elucidates several factors contributing to infectious disease outbreaks in conflict settings, it is conceivable that not all causal pathways linking conflicts and infectious diseases were identified, as monitoring and assessing all pathways within conflict zones can pose significant challenges. Hence, future research endeavours should aim to shed further light on additional disease-specific pathways that precipitate outbreaks. The identification of qualitative information from key informants and/or patients within conflict zones could enhance our understanding of the issue. Future studies should consider addressing this aspect. In addition, incorporating econometric analyses would be interesting to indicate the impact of conflict on infectious diseases in economic terms.

Conflicts play a direct and indirect role in the transmission and propagation of infectious diseases due to population displacement, overcrowded settlements with poor sanitary conditions, disruption of infrastructure, reduction in functioning healthcare system, shortages of food, limited access to clean drinking water, medications and healthcare, delays in diagnosis and disruptions in vaccine coverage. The most important prevention and preparedness strategies for an infectious disease outbreak in a conflict situation included education/awareness campaigns, reconstruction of healthcare facilities including recruitment and training of healthcare workers, strengthening surveillance and early warning systems, enabling access to healthcare in conflict zones, deployment of global vaccine and medical stockpiles, and implementation of water- sanitation- hygiene interventions. Finally, collaboration between humanitarian and health actors, community engagement, and political will were identified as critical factors in responding to infectious disease outbreaks in conflict settings. Through identifying commonly reported risk pathways as well as mitigation strategies, the findings of this review may assist decision-makers to implement evidence-based preparedness and response strategies for the timely and effective mitigation of future infectious disease outbreaks in conflict areas.

Data availability

Not applicable.

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Acknowledgements

We would like to thank Katerina Papathanasaki and Stella Vogiatzidaki for their assistance in data archiving.

This report was produced under the service contract No22 ECD.13154, within Framework contract ECDC/2019/001, Lot 1B, with the European Centre for Disease Prevention and Control, acting under the mandate from the European Commission. The information and opinions presented in the current report are those of the authors and may not necessarily reflect the official opinion of the Commission/Agency. The Commission/Agency does not guarantee the accuracy of the data included in this analysis. Neither the Commission/Agency nor any person acting on the Commission’s/Agency’s behalf may be held responsible for any use which may be made of the information contained therein.

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CV, JLB, CD, and JES designed the study. JLB developed the search code and provided the initial search ground. KA and ZP performed the title-abstract screening, while KA and KN with assistance from CV performed the full-text screening of the eligible studies. VM and CV extracted, analysed and interpreted the data. VM and KA prepared figures and tables. VM and CV prepared the first draft of the paper with input from OC, FL and JES. All authors reviewed and revised subsequent drafts of the paper and have approved this version for publication.

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Marou, V., Vardavas, C.I., Aslanoglou, K. et al. The impact of conflict on infectious disease: a systematic literature review. Confl Health 18 , 27 (2024). https://doi.org/10.1186/s13031-023-00568-z

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War and peace in public health education and training: a scoping review

• Lisa Wandschneider 1 , 2 ,
• Anna Nowak 1 , 2 ,
• Marta Miller 4 ,
• Anina Grün 1 , 2 ,
• Yudit Namer 2 , 5 ,
• Tomasz Bochenek 6 ,
• Lukasz Balwicki 7 ,
• Oliver Razum 1 , 2 &
• Colette Cunningham 3  

BMC Public Health volume  24 , Article number:  2303 ( 2024 ) Cite this article

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Metrics details

Armed conflict and war are public health disasters. Public health action has a crucial role in conflict-related emergencies and rehabilitation but also in war prevention and peace promotion. Translating this into public health training and competencies has just started to emerge, especially in Europe.

We conducted a Scoping Review to map and identify the role of public health education and training of public health workforce relating to the prevention of war and promoting peace, as reflected in the scientific literature. We searched in PubMed, CINAHL, PsycINFO, Embase, Web of Science Core Collections as well as the reference list of included material in English, German and Polish. Focusing initially on the European region, we later expanded the search outside of Europe.

We included 7 publications from opinion pieces to an empirical assessment of curricula and training. The educational programs were predominantly short-term and extra-curricular in postgraduate courses addressing both public health professionals in conflict-affected countries as well as countries not directly affected by war. Publications focused on public health action in times of war, without specifying the context and type of war or armed conflict. Competencies taught focused on emergency response and multi-disciplinary collaboration during emergencies, frequently drawing on experience and examples from natural disaster and disease outbreak management.

Conclusions

The scientific discourse on competences in public health education for times of war and for the promotion of peace, predominately focuses on immediate emergency response actions. The prevention of war and the promotion of peace are missing foci, that need to feature more prominently in public health training. Public Health Education and training should ensure that war prevention and peace promotion, as well as public health action in times of war, are included in their competencies for public health professionals.

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Introduction

War has profound adverse effects on public health [ 1 ].

War and armed conflict have far-reaching consequences, affecting the lives of millions of people, resulting in the loss of human life, but also in the disruption of social infrastructure such as safe food and water supplies, housing, and access to health services, leading to increased mortality and morbidity. War-torn countries and populations experience an increase in Disability Adjusted Life Years (DALYs) lost [ 2 ]. In addition, mass displacement, which disproportionately affects women, children, the elderly and vulnerable groups, exposes people to precarious living conditions and arduous travel, affecting their health and well-being. War and armed conflict have profound long-term physical and psychological consequences for those involved. They destroy communities and the fabric of society is often irreversibly undermined. This affects public health as well as legalizing and promoting violence as a way of solving problems [ 2 ]. In this paper, war and armed conflict is defined as ‘hostile contention by means of armed forces, carried on between nations, states, or rulers, or between parties in the same nation or state; the employment of armed forces against a foreign power, or against an opposing party in the state [ 3 ]. The International Committee of Red Cross (ICRC) casebook differentiates between an international armed conflict which “occurs when one or more States have recourse to armed force against another State, regardless of the reasons or the intensity of this confrontation” and a non-international armed conflict in which one or more non-State armed groups are involved (the vast majority of conflicts since 1945) [ 4 ]. Other authors differentiate wars by causes or intentions, for example imperial wars [ 5 ] or wars of annexation, such as Russia’s invasion of Ukraine. The reason is that preventive measures may be quite different. Much of the literature such as Levy et al. [ 1 , 6 ] covers armed conflict but not wars of annexation [ 2 , 7 ]. Today’s wars are often hybrid, meaning they are being fought by military as well as by destabilizing, non-military means [ 8 ]. Debates on preventing wars of annexation need to cover the role of the military, and the way in which public health relates to it, but also political determinants. For reasons of readability, however, the term ‘war’ will be used consistently throughout the text to include armed conflict and wars of annexation, as well as hybrid elements of warfare.

Conceptualizing war in public health is a relatively recent development, while international relations and defense studies have a longstanding tradition of analyzing and theorizing war and peace (e.g. [ 5 , 9 , 10 ]). Public health approaches focusing primarily on emergency response and relief care [ 11 , 12 , 13 ]. However, there is a growing shift in public health to emphasize its preventive role in peacetime, with the aim of minimizing the health impact of war on affected populations [ 14 , 15 , 16 ]. At the same time, one of public health’s major aims – reducing and dismantling (health) inequities — is also a crucial determinant for preventing armed conflict [ 17 , 18 , 19 ] presenting another valuable angle for public health’s role in peacebuilding and preventing war. This shift is consistent with modern public health care, given the emergence of complex global public health crises such as climate change, biodiversity loss, migration, cybersecurity, inequities, and pandemics such as COVID-19 [ 20 ]. We are looking at syndemics, whereby a set of linked health problems interact synergistically and contribute to the excess burden of disease in a population [ 21 ]. The preventative role provides an opportunity to develop a comprehensive public health framework that can effectively address the needs during war, its prevention, and post-conflict periods. Hagopian and Jabbour (2022) [ 22 ] proposed such a framework, using the Primary, Secondary and Tertiary Prevention (PSTP) Framework to address global inequalities and injustices that may contribute to war. It includes primary prevention, which focuses on addressing the root causes and social determinants of war; secondary prevention, which aims to reduce harm and damage during conflict; and tertiary prevention, which involves rebuilding health systems in post-conflict settings [ 22 ]. Wars of annexation have more to do with (re-)building imperia, rather than with inequalities and injustices. Nonetheless, there is no agreed-upon theory on the cause(s) of war [ 10 ].

While the role of public health in emergencies is increasingly well explored in public health research and in interdisciplinary collaboration, the translation of this knowledge into public health training and competencies is only just beginning to emerge, particularly in Europe. The literature is increasingly recommending that public health education and training programs should include an understanding of the health impacts of war and conflict, including the epidemiology of war-related injuries and illnesses, environmental impacts of war, and mental health effects of war on soldiers and civilians [ 2 , 23 , 24 , 25 ]. Additionally, public health professionals should be trained to respond to the health impacts of war, including strategies for preventing and treating war-related injuries and illnesses, as well as promoting peace and non-violent conflict resolution [ 2 , 23 , 24 , 25 ]. ,.

In light of contemporary conflicts and geopolitical tensions, such as the war in Ukraine, as well as those in Syria, Yemen, Myanmar, Israel and Gaza, and other regions, training on effective and systematic public health practice to support affected populations is needed. The role of public health in both the prevention of war and the promotion of peace work is increasingly recognized and calls for its inclusion in public health education, and in the training of public health professionals [ 7 , 25 , 26 ]. Considering the present circumstances, there is a need for public health professionals to develop a skill set that enables them to address the challenges of war, prevention, as well as peacebuilding, so that they can confidently navigate an increasingly multi-disciplinary role and take an active place in the dialogue on the prevention of war and its consequences. We conducted a Scoping Review of the scientific literature in public health to map available evidence and discourse on war. We covered public health perspectives on war prevention, reaction to war, rehabilitation, and peace promotion within public health education and training. More specifically we aimed to answer the following research questions:

How is public health education addressing competencies related to war and peacebuilding? Are there existing examples of teaching and can we build on them for future training?

What are the gaps in public health education on war and how can we address them?

Are there existent frameworks which can be used or adapted to develop public health education programs focused on war, war prevention, and peace promotion?

The research team, representing expertise from schools of public health across Europe, developed the search strategy with the help of the Population, Comparison and Context (PCC) Framework [ 27 ]. We opted for a Scoping Review methodology, since it allows for ‘a preliminary assessment of potential size and scope of available research literature’ as well as ‘identify the nature and extent of research evidence’ [ 28 , 29 ]. It enabled us to map a diverse range of evidence e.g., implementation research on training programs as well as commentaries and opinion pieces, as indicators of an on-going discourse within the public health community. War and peacebuilding in public health education represent an under-researched area, therefore our Scoping Review allowed for the capture and extent, as well as the type of available evidence. Our methodology was developed using the PRISMA-ScR Checklist to comply with reporting and methodological standards (supplementary material 1) [ 30 ]. A review protocol was not published, but the authors used an internal methods protocol which has been updated throughout the process (Supplementary material 3).

Search strategy

We searched in academic databases PubMed, CINAHL, PsycINFO, Embase, Web of Science Core Collections (using keywords and MeSH terms) to explore the scientific discourse on war and peacebuilding in public health education. Exploring grey literature, such as the extent of material at the level of Schools of Public Health exceeded the scope of this review and requires additional data collection tools. As related fields like disaster management and preparedness in public health are well represented within the scientific discourse, limiting this first mapping to scientific databases only, allows for a direct comparison and therefore seemed reasonable.

In our review, we defined the population as the body of interest, i.e., education and teaching body. Our search terms were chosen to identify literature that focused on public health education and training on war, war prevention and peace promotion. This method allowed the authors to capture examples of a broad range of education programs and training, both from individual courses to curricula. The concept element represents the thematic focus on war and peacebuilding. We aimed to integrate different stages of war e.g., armed conflict, active war and peacebuilding. In addition, we linked these search terms with closely-related fields, such as disaster management and preparedness, especially as these are competencies that are frequently linked to the context of war [ 31 ]. These terms have been informed by conflict-related health research as well as conceptual models systematizing the impact of war and peace promotion on public health [ 11 , 12 , 13 , 15 , 16 ]. For the context, being the third and last element of the PCC Framework, we used public health as the discipline and added global health since this is a field where the topic of war is frequently documented and addressed.

An experienced librarian supported the development of the search strategy (Table  1 , search protocols for all databases can be found in supplementary material 2). We conducted the searches on 8th September 2022 and extracted the records into the reference manager Zotero. In addition to the search in scientific databases, we checked the reference lists of included sources for further records that could warrant inclusion.

Eligibility criteria and study selection

In our review, we only included sources that had a primary interest in war and peacebuilding in the public health education context. This included publications that identified curricula, workshops, competencies, skills-sets and capacity-building trainings. For the war and peacebuilding element, this required an explicit definition of war and/or peacebuilding as the field of action or interest. We included academic literature, ranging from peer-reviewed articles to commentaries and editorials to capture a broad spectrum of the scientific discourse. We did not exclude any publication based on study design or period of the study.

We excluded sources that mentioned war or peacebuilding but did not elaborate further on how the courses addressed the specific needs or circumstances. Also, any material that solely addressed terrorist attacks was considered ineligible despite representing a potential weapon or strategy of war. Terrorist attacks were considered ineligible because they pertained to one, timely limited event that usually did not destroy the infrastructure of a complete region or country. Other competencies and frameworks for public health professionals is therefore warranted. The scoping review languages of the potential sources was limited to English, German, Polish.

For the screening process, we conducted a pilot with a random sample of 5% of the total records. This ensured inter-rater reliability between the reviewers by detecting inconsistencies and allowed us to adapt the eligibility criteria accordingly. Then, the reviewers (LW, MM, CC) started with the title and abstract screening. For the full texts, the reviewers changed (LW, MM, AG, AN), so we again conducted a pilot of a random 5% sample of the records identified in the abstract and title screening. Disagreements on the eligibility of full texts were discussed with all reviewers (LW, MM, AG, AN, CC) and resolved through discussion.

Data charting and analysis

The data charting and extraction focused on the context of war and the education/teaching element of the material, rather than the study details. The data charting table includes basic study characteristics, information on the context of war and peacebuilding as well as the teaching intervention ( Table  2 ). The standardized form guided the data charting process and was also tested in another pilot round between the reviewers. LW, MM, AG and AN extracted the data and modified the charting form in an iterative process, which was then discussed with the core reviewer team LW, MM, AG, AN and CC.

The data charting form also guided the descriptive and narrative synthesis of the findings. To structure the narrative analysis, we categorized the findings by the phase of war differentiating between a) preparedness and prevention, b) ongoing conflict and emergency, as well as c) recovery and rehabilitation based on Hagopian and Jabbour’s framework [ 22 ].

The initial literature search resulted in a total of 4922 citations (Fig.  1 ). After removing duplicates, a total of 2913 articles were screened. In the subsequent stages of this process, a total of 272 full‐text reports were assessed for eligibility, of which 264 studies were excluded because the focus was not on war or peacebuilding, or not on public health education/training.

Flowchart on the process identifying studies. This Study Flow Chart details the flow of information throughout the distinct phases of the review: identification, screening and included studies for final review

A total of seven articles reported on existing education/training or recommendation for training fulfilling the inclusion criteria (Fig.  1 ) [ 20 , 32 , 33 , 34 , 35 , 36 , 37 ]. We classified the study design of the 7 articles into three groups: 4 were reports [ 32 , 33 , 34 , 36 ]; two were commentaries [ 20 , 37 ]; and one was an empirical qualitative study [ 35 ].

Study characteristics

The 7 articles were published between 1998 and 2019, with most of them produced in the Global North, including the US ( n  = 3) [ 20 , 32 , 35 ], Croatia and Bosnia-Herzegovina ( n  = 1) [ 33 ] and Sweden ( n  = 1) [ 34 ]. Only one was conducted in the Global South, the empirical study from South Sudan [ 37 ]. The included publications take different phases of war into account, some take on several within one study: 4 publications reported on early warning/prevention and preparedness [ 33 , 34 , 35 , 36 ]; 4 publications on conflict situations [ 20 , 33 , 35 , 37 ]; 3 on emergency [ 20 , 32 , 37 ]; and one study on recovery / rehabilitation [ 35 ]. Four publications related to specific armed conflicts and time periods; (Balkan (1994–2001) [ 32 ], Sweden (time period not specified) [ 34 ], South Sudan (2013) [ 37 ], and after the First World War (1920–1939) [ 36 ]. Three studies did not specify the geographical region or period of the study. The characteristics of each study are shown in Table  3 , depicting the type of publication, type of war, period, geographic setting, and phase of military operations. Table 3 provides an overview of the teaching interventions recommended or described by the included studies.

Prevention and Preparedness

Four ( n  = 4) publications reported or commented on early warning, prevention and preparedness for war or war-like situations on a professional level. McDonnell et al. recommend that applied epidemiologists should be prepared for war by acquiring knowledge on international law, human rights, and complex interventions by working on specific case studies during training to be able to conduct assessments of the conflict setting and to communicate health-related interventions effectively with stakeholders and the local population [ 35 ]. Joshi strengthens this approach to take into account the psychological burden of mental health professionals working with war-affected children. He recommends analyzing the situation properly, gaining knowledge about the region, culture, and people, but also reflecting on one’s own limitations and resources [ 33 ]. Both commentaries point to the importance of (interdisciplinary) collaboration and training [ 33 , 35 ].

Kulling & Holst and McGann have shown what a training module could look like. While Kulling & Holst refer to the Swedish context, McGann describes in a historical analysis what the training of public health nurses looked like after the First World War [ 34 , 36 ]. On a national level, according to Kulling & Holst different topics should be addressed in regional and local courses for health professionals, such as disaster medicine, management of the healthcare system in a disaster/crisis, command and control at an accident site, chemical accidents, decontamination methods, radiation accidents, microbiological preparedness / bioterrorism, psychiatric / psycho-social support and planning preparedness for chemical, biological, or nuclear/radiological (C B N R) events on a national level [ 34 ]. McGann describes that the training of public health nurses in the 1920s consisted of both a theoretical and a practical part [ 36 ]. In the theoretical part there are already overlaps with the modules recommended by Kulling & Holst [ 34 ]. McGann shows that lectures were given on public health nursing, hygiene, bacteriology, psychology, social conditions, and social administration [ 36 ]. The practical part consisted of work placements in nursing-related fields, such as child welfare centers, TB dispensaries or in a district nursing association [ 36 ].

Conflict and emergency

Burkle et al. and McDonnell et al. refer to the importance of combining medical skills and knowledge in emergency and crisis situations [ 20 , 35 ]. Both reports discuss advanced courses for the development of specific skills for work in humanitarian settings. According to the authors, knowledge of legal frameworks, communication skills, documentation of human rights violations, and the design and management of needs-based health services are necessary skills for public health professionals, with McDonnell et al. also emphasizing competence in qualitative and quantiative data [ 20 , 35 ]. Burkle et al. recommend developing an all-encompassing international program which should be continously evaluated and adapted according to emergency sitations [ 20 ]. Joshi adds the importance of compentency in interdisciplinary cooperation and training of local populations [ 33 ].

Evans et al. and Rathner & Katona describe specific training programs in more detail [ 32 , 37 ]. While Evans et al. describe a program for graduated professionals and mid-careers public health leaders [ 32 ], Ratner & Katona’s training program focuses not only on public health professionals but also on the general public [ 37 ]. Both programs consist of lectures and hands-on-activities or practical work. Evans et al. describe a graduate program based at the Center for Humanitarian Emergencies at Emory University in Atlanta, US. The program covers topics on emergency preparedness, logistics, mental health, needs assessment, nutrition, and risk communication through lectures and group discussions, followed by a field practica at in-country host institutions. The field practica cover areas such as emergency management or global health security [ 32 ]. Ratner & Katona’s program is set in South Sudan and involves first aid courses, providing participants with the skills and knowledge to care for themselves and others in times of medical emergencies. The training brings together people from different tribes or community groups and focuses on specific medical needs. Supported by the local community and local leaders, the training leads to intergroup communication, stigma reduction, and health-related collaboration between different population groups. It not only provided essential healthcare skills, but also served as a platform for peacebuilding and community-building [ 37 ].

Recovery, rehabilitation and peacebuilding

All authors understand their programs as preparation for war-like situations but only two focus specifically on peacebuilding [ 35 , 37 ]. Ratner & Katona’s teaching activity in South Sudan lead to peacebuilding, communication, and interaction between different groups in the local communities [ 37 ]. McDonald et al. emphasize conflict assessment for peacebuilding, using quantitative and qualitative methods and effective communication skills for policy changes and interdisciplinary and interinstitutional cooperation. According to the authors, knowledge about predictors of violent conflict is necessary [ 35 ]. None of the studies in our review pertain to recovery or rehabilitation-related competencies or training programs.

We identified 7 publications dealing with education and/or training for public health professionals that related to war and peacebuilding [ 20 , 32 , 33 , 34 , 35 , 36 , 37 ]. Most of the publications covered public health training from prevention and preparedness, conflict and emergency to recovery, rehabilitation and peacebuilding. Literature is scarce regarding public health education in the context of war, armed conflict and peace promotion. We found a broad range of different manuscripts including commentaries and opinion pieces on different types of war and armed conflict, but only 7 publications met the review’s inclusion criteria. We did not identify research studies comparing different teaching methods, training modules or evaluating programs. However, there is a growing awareness of the topic and not least since Russia’s invasion of Ukraine (e.g. [ 19 , 38 , 39 , 40 ].). Nevertheless, more in-depth research needs to be done in this area.

The included publications are heterogeneous in terms of population, time, and war phases. Most of the programs described in the publications are aimed at public health professionals. Three studies ( n  = 3) focused on specific professional groups (e.g. psychologists, surgeons, nurses) [ 20 , 33 , 36 ]. Only Evans et al. targeted undergraduate and postgraduate students [ 32 ]. Just one publication included the local population in their education program and, in contrast to the other publications the context of the education program was within an emergency situation whereby there was an acute need for action due to the war-like situation in South Sudan [ 37 ]. Two studies described the educational program in more detail: While Kulling & Holst presented a current program in Sweden [ 34 ], McGann took a historical perspective and described the education of public health nurses between the First and Second World War [ 36 ]. Both studies pointed to similar teaching content for preparedness of professionals. Two other studies addressed general principals such as knowledge on human rights and complex interventions or self-reflection [ 33 , 35 ]. None of these publications used a conceptual educational framework.

We note from our scoping review that teaching war in public health education programs or in the training of public health professionals is predominately short-term and extra-curricular in post-graduate courses. A better understanding is needed of the intersections between war and health and of the indispensable role public health practitioners, academics and advocates could play particularly given the increasing significance of war as a determinant affecting population health [ 31 ].

The immediate emergency response in times of war was the main area of action in and for public health education. Some of the studies drew from or were also closely entangled with emergency management and/or disaster management (without any specific reference to war or peacebuilding). This finding is not surprising, given the relevance of this much more advanced and established field of public health practice. Emergency response and management, including infectious disease outbreaks and/or disasters especially natural disasters, are widely included in international standards and recommendations. For example, US [ 41 ] for public health education [ 42 ]. These topics are also frequently and systematically implemented in dedicated public health degrees [ 43 , 44 , 45 , 46 ]. These competencies play a major role for public response in the context of war, e.g. for first response, multidisciplinary coordination and crisis situation [ 44 ]. However, we also found that emergency management and public health education on war were often entangled, which led to a high number of full-text screenings. Few of the studies and commentaries explicitly differentiated between natural disasters or outbreaks and war/armed conflicts; yet wars require additional skillsets and competencies. For example, conflicts frequently result in waves of trauma cases and public health hazards depending on conflict intensity. Also, infrastructure can be repeatedly destroyed or supplies to rebuild cannot reach communities in need – again depending on conflict activities. Accordingly, we encourage studies and commentaries on public health practice and analysis to more explicitly differentiate between natural disasters and armed conflicts [ 6 ].

Highlighting the different disciplines involved as well as the range of competencies required in different phases of war and peacebuilding, our review reiterates the importance of interdisciplinary collaboration for developing and implementing public health education on war and peacebuilding. Building on this evidence, the growing conceptual understanding [ 6 , 14 , 16 , 22 ] and existing content-analyses of war-related public health education [ 20 , 31 ] will help to systematically advance public health training as well as the scientific discourse on this topic to support evidence-based decision-making for curriculum adaptations, teaching methods as well as adaptation for peacebuilding and in times of war.

Peacebuilding and war prevention were less discussed in the publications included in this review compared to other phases of war. Whoerle et al. suggest that health education can serve as a potential platform for integrating peace education into school curricula. The integration of health and peace involves four key approaches that could be translated into competencies: adopting a socio-ecological perspective; employing complexity thinking and problem mapping, recognizing the continuum of resilience and trauma, and considering the community as a site for practical implementation, calling for interdisciplinary cooperation [ 16 ]. Barry S. Levy, one of the long-standing experts in this field, proposes that citizens should confront the powerful in their country [ 6 ]. This is important advice in democratic societies, and there are precedents of successful protest and civic disobedience such as Daniel Ellsberg’s activism against the Vietnam war, which gave a boost to the US anti-war movement [ 47 ]. We reiterate this call and encourage to focus in on the competencies in public health required to specifically include peace promotion and war prevention in addition to the emergency war response. This is particularly important in an ‘era of geopolitical uncertainty’ [ 48 ] where peace and war play a dominant role and should be reflected as determinants of health and accordingly systematically addressed in public health education [ 49 ]. However, we also realize that advice such as Levy’s is tailored more at civil wars and wars attempting regime change, rather than wars of annexation. Russia’s full-scale invasion of Ukraine in 2022, was the first such event in Europe since World War II. Internal civic action, as recommended by Levy, carries grave personal risk when applied against the Putin regime. Diplomacy has not been successful as Russia, in the eyes of many observers, violates international treaties and security assurances [ 50 ]. In consequence, neighboring states may have to rely on a sufficiently funded military to protect their populations. This conclusion may come counter-intuitive to public health proponents [ 51 ], while in defense theories and international law and relation studies it is widely discussed and elaborated on [ 52 , 53 ]. Again, drawing from interdisciplinary collaboration could ensure deeper analytical and theoretical understandings of the terminology or concepts used in war and peacebuilding and comparability across fields. Moreover, given the contentious nature of these issues, students and teaching institutions should learn how to discuss conflicts constructively and fairly, avoiding the escalations of recent campus discourses in the Israel-Gaza conflict.

Strengths and limitations

In this Scoping Review, we analyzed the scope and extent of scientific discourse on war and peace promotion in public health education. Using a scoping review methodology allowed for a systematized and comprehensive mapping, which has been the first of its kind on the topic, at least to our knowledge. We included studies solely with a primary interest in war and peacebuilding in the public health education context. This allowed for a nuanced analysis of education programs, initiatives, or similar, which is of particular value for the overall aim of advancing public health education.

We thereby contribute to the identification of gaps and addressing them in an important area of public health work. Specifically, we have identified gaps in the European literature arena, where the topic of war and peace promotion has been mostly neglected over the past decades. In addition, we have synthesized war and peace promotion in public health education, which are usually assessed in parallel.

We limited our review to scientific databases aiming to assess the scientific discourse on war and peacebuilding in public health education and training. As a result, the review has not captured any grey literature relating to the topic; it exceeded the scope of this review. Nonetheless, it would be an important next step to assess the status quo at institutions of public health education and training within the European region. This includes Schools of Public Health and Higher Institutes or Centers for Public Health Education, many of whom lead to a graduate degree in public health and which is accredited by a recognized body, or bodies approved for such purpose. This could include for example the Secretary of Education in each European Region country or other authorizing bodies. Of note, a study in this regard, has been undertaken for specific schools of public health in the United States of America [ 31 ]. Such a study in Europe would allow for a more detailed overview of resources and expertise to advance and support the development of initiatives integrate war more systematically into public health education programs.

Since we only included studies with a primary interest in war and peacebuilding in the public health education context, we did not consider the scientific discussion touching on this topic. This was reflected many of full texts screened that ended with just a few publications with findings that could be generalized. The variability in the studies in terms of the type of war described, e.g., armed conflict or war of annexation, may present a challenge in drawing generalizable conclusions.

This scoping review identified a lack of scientific discourse on the role of war and peace promotion in public health education. The few public health education and training programs identified primarily focus on the immediate emergency response in conflict-affected areas. These were often entangled with emergency preparedness in different contexts such as infectious disease outbreaks. Peace promotion and war prevention are missing foci. This suggests a need for a far greater emphasis of the topic in public health training as well as its inclusion in competency frameworks. In addition to training public health professionals for emergencies, training with an emphasis on war prevention and promoting peace should be developed and implemented.

Availability of data and materials

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

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LW, YN, CC, TB, LB and OR conceptualized and designed the Scoping Review with important intellectual input from all co-authors. LW, MM, AG, AN and CC, conducted the screening. LW, MM, AG, AN extracted the data. LW, MM and AN analyzed the data. LW, MM, AN, AG and CC created the first draft of the manuscript. CC and LW edited the manuscript prior to submission to all authors, who then contributed input to the final manuscript. CC and LW edited the final draft manuscript. All authors contributed to the final manuscript and provided important intellectual input.

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Wandschneider, L., Nowak, A., Miller, M. et al. War and peace in public health education and training: a scoping review. BMC Public Health 24 , 2303 (2024). https://doi.org/10.1186/s12889-024-19788-w

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Analyzing digital propaganda and conflict rhetoric: a study on Russia’s bot-driven campaigns and counter-narratives during the Ukraine crisis

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The dissemination of disinformation has become a formidable weapon, with nation-states exploiting social media platforms to engineer narratives favorable to their geopolitical interests. This study delved into Russia’s orchestrated disinformation campaign, in three times periods of the 2022 Russian-Ukraine War: its incursion, its midpoint and the Ukrainian Kherson counteroffensive. This period is marked by a sophisticated blend of bot-driven strategies to mold online discourse. Utilizing a dataset derived from Twitter, the research examines how Russia leveraged automated agents to advance its political narrative, shedding light on the global implications of such digital warfare and the swift emergence of counter-narratives to thwart the disinformation campaign. This paper introduces a methodological framework that adopts a multiple-analysis model approach, initially harnessing unsupervised learning techniques, with TweetBERT for topic modeling, to dissect disinformation dissemination within the dataset. Utilizing Moral Foundation Theory and the BEND Framework, this paper dissects social-cyber interactions in maneuver warfare, thereby understanding the evolution of bot tactics employed by Russia and its counterparts within the Russian-Ukraine crisis. The findings highlight the instrumental role of bots in amplifying political narratives and manipulating public opinion, with distinct strategies in narrative and community maneuvers identified through the BEND framework. Moral Foundation Theory reveals how moral justifications were embedded in these narratives, showcasing the complexity of digital propaganda and its impact on public perception and geopolitical dynamics. The study shows how pro-Russian bots were used to foster a narrative of protection and necessity, thereby seeking to legitimize Russia’s actions in Ukraine whilst degrading both NATO and Ukraine’s actions. Simultaneously, the study explores the resilient counter-narratives of pro-Ukraine forces, revealing their strategic use of social media platforms to counteract Russian disinformation, foster global solidarity, and uphold democratic narratives. These efforts highlight the emerging role of social media as a digital battleground for narrative supremacy, where both sides leverage information warfare tactics to sway public opinion.

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1 Introduction

In today’s age of social media, state actors utilize digital propaganda and manipulation to shape narratives, and foster discord to push their geopolitical agendas. This form of propaganda is a calculated and coordinated process designed to disseminate and amplify deceptive content across multiple social media platforms (Jowett and O’Donnell 2012 ). The Russian state’s persistent efforts to create confusion and chaos within social media mediums to achieve their goal is a testament to the systematic manipulation that they employ (Council 2022 ). For instance, during the Crimea crisis in 2014, the Russian state employed an extensive network of bots and trolls to flood social media platforms with pro-Russian stances, spreading misinformation about the situation in Ukraine and creating a narrative that justified its annexation of Crimea (Helmus et al. 2018 ). This strategy exemplifies the principles of social cybersecurity, which focuses on understanding and forecasting cyber-mediated changes in human behavior, as well as social, cultural, and political outcomes (Carley 2020 ).

With diminishing international prestige, the Russian state employs a situational and diligence-driven approach, meticulously exploiting vulnerabilities to their advantage (Berls 2019 ). This approach is demonstrated by Russia’s Internet Research Agency (IRA), known for its role in online influence operations. The IRA carefully crafts messages that are tailored to specific audiences and use data analytics to maximize the impact of their campaigns (Robert S. Mueller 2019 ), a tactic that aligns with the methodologies used in social cybersecurity for analyzing digital fingerprints of state-led propaganda campaigns (Carley 2020 ). This is further shown in Syria where Russian forces used disinformation campaigns as a tool to weaken the opposition forces and shape international perception of the conflict, including spreading false narratives about the actions of the rebel groups and the humanitarian situation (Paul and Matthews 2016 ).

Putin’s regime’s information operation campaigns against Ukraine are a significant development in their warfare strategy, with disinformation campaigns becoming an integral part of their military operations. The development of Russia’s “Gerasimov Doctrine,” which emphasizes the role of psychological warfare, cyber operations, and disinformation campaigns, marks this new shift in their military strategy (Fridmam 2019 ). This doctrine emphasizes the importance of non-military tactics, such as disinformation campaigns to achieve strategic military objectives. The Russian state has continuously increased the use of cyber warfare in its military objectives, utilizing social media platforms to spread its objectives through disinformation campaigns to curate public opinion. Through bot-driven strategies, the Russian state aims to polarize communities and nations, destabilizing political stability while undermining democratic values under a facade of disinformation operations (Schwartz 2017 ).

The escalation of Russian disinformation operations following the February 2022 invasion of Ukraine was met with a robust Ukrainian response. Ukraine has strengthened its information and media resilience by establishing countermeasures against Russian narratives, including disseminating accurate information and regulating known Russian-affiliated media outlets (Paul and Matthews 2016 ).

To understand the complexities of information warfare campaigns and counter-narratives to those campaigns, this research studies the impact of these bot-driven strategies on social media platforms. The study uses a blend of stance analysis, topic modeling, network dynamics, and information warfare analysis, integrated with principles of social cybersecurity, to understand the prominent themes, and influence that bot communities have on platforms like Twitter, while also exposing the most influential actors and communication patterns.

Research Question: The central question of this investigation is: How have bot-driven strategies influenced the landscape of digital propaganda and counter-narratives? We follow up by inquiring, what are the implications of these strategies for Ukraine’s political and democratic landscape and the broader geopolitical arena.

This paper seeks to understand the role that bot communities have in the propagation and amplification of these narratives that nation-states are pushing. By examining only bot-driven ecosystems and their effectiveness in promoting Russia’s political agenda through narrative manipulation, we aim to assess the global impact that these bot communities have in achieving their overall strategic objectives.

It is important to note that when referring to ’Russia’ in this paper, we distinguish between the ’Russian state’, ’Putin’s regime’, and the broader population of Russia. The term ’Russian state’ refers to the governmental and institutional structures of Russia. ’Putin’s regime’ specifically refers to the current administration and its policies under President Vladimir Putin. Meanwhile, ’Russia’ encompasses a diverse populace, many of whom may not align with Putin’s strategies or values but are unable to protest due to political repression. This distinction is crucial for understanding the multifaceted nature of Russian involvement in information warfare and the varied perspectives within the country.

The study will expand this research to include an analysis of the counter-narrative of the overwhelming support for Ukraine, which has also been overwhelmingly exemplified within these bot communities. Utilizing BotHunter, a tool specifically designed to detect bot activity (Beskow and Carley 2018 ), this research will identify and analyze the bot networks that have been central to the propagation of this support. This counter-narrative, emerging from the data and shaped by bot-driven dialogues, represents a significant aspect of the overall response to the conflict.

By integrating the following: the BEND framework to analyze information warfare strategies, TweetBERT’s domain-specific language modeling, and the moral compass provided by Moral Foundations Theory, with insights from social cybersecurity, this study aims to provide a comprehensive understanding of the strategic narratives and counter-narratives in the wake of the conflict. The goal is to contribute a detailed analysis of what these effects have on geopolitical stability and to delineate the methods by which narratives can be both a weapon of division and a shield of unity.

2 Literature review

Russian disinformation tactics

The Russian state’s disinformation tactics have substantially evolved over the last several years, especially since the 2008 incursion into Georgia. Their tactics intensified during the 2014 annexation of Crimea and have continued vigorously throughout the ongoing conflicts in Ukraine and Syria. These tactics are not only a continuation of Cold War-era methods but also leverage the vast capabilities of modern technology and media (Paul and Matthews 2016 ). The digital landscape has become a fertile ground for Russia to deploy an array of propaganda tools, including the strategic use of bots, which create noise and spread disinformation at an unprecedented scale (Politico 2023 ).

The modus operandi of Russian disinformation has been aptly termed “the firehose of falsehood,” characterized by high-volume and multichannel distribution (Paul and Matthews 2016 ). This approach capitalizes on the sheer quantity of messages and utilizes bots and paid trolls to amplify their reach, not only to disrupt the information space but also to pose a significant challenge to geopolitical stability (Paul and Matthews 2016 ). By flooding social media platforms with a barrage of narratives, the Russian state ensures that some of its messaging sticks, even if they are contradictory or lack a commitment to objective reality (Organisation for Economic Co-operation and Development 2023 ). This relentless stream of content is designed not just to persuade but to confuse and overpower the audience, making it difficult to discern fact from fiction, demonstrating how narratives can be weaponized to create division.

Moreover, these tactics exploit the psychological foundations of belief and perception. The frequency with which a message is encountered increases its perceived credibility, regardless of factual accuracy (Paul and Matthews 2016 ). Russian bots contribute to this effect by continuously posting, re-posting, and amplifying content, thereby creating an illusion of consensus or support for viewpoints. This strategy has the potential to influence public opinion, thereby extending the reach of disinformation campaigns (Politico 2023 ). This demonstrates how narratives may undermine democratic values and geopolitical stability.

Recent research has expanded on these findings, highlighting the sophisticated nature of bot-driven propaganda. Chen and Ferrara ( 2023 ) present a comprehensive dataset of tweets related to the Russia-Ukraine conflict, demonstrating how social media platforms like Twitter have become critical battlegrounds for influence campaigns (Chen and Ferrara 2023 ). Their work highlights the significant engagement with state-sponsored media and unreliable information sources, particularly in the early stages of the conflict, which saw spikes in activity coinciding with major events like the invasion and subsequent military escalations (Chen and Ferrara 2023 ). The use of bots in this military campaign is notable for their ability to operate around the clock, mimic human behavior, and engage with real users (Politico 2023 ). These bots are programmed to push Russian narratives, attack opposing viewpoints, and inflate the appearance of grassroots support (Paul and Matthews 2016 ). These bots are a key component in Russia’s strategy to structure public opinion and influence political outcomes. Note that we use the terms the “Russian state” and “Putin’s regime” in this article to indicate the group of people who align with the political values of the regime.

Russian disinformation efforts have shown a lack of commitment to consistency, often broadcasting contradictory messages that may seem counter-intuitive to effective communication (Paul and Matthews 2016 ). However, this inconsistency can be a tactic, as it can lead to uncertainty and ambiguity, ultimately challenging trust in reliable information sources. By constantly shifting narratives, Russian propagandists keep their opponents off-balance and create a fog of war that masks the truth (Organisation for Economic Co-operation and Development 2023 ). This strategy emphasizes the dual role of narratives in geopolitical conflicts, serving as a shield of unity for one’s own political agenda whilst being a weapon of division against adversaries.

The advancement of Russian disinformation tactics represents a complex blend of traditional influence strategies and the use of modern technological tools. Russia has crafted a formidable approach to push propaganda narratives by leveraging bots, social media platforms, and the vulnerabilities of human psychology (Alieva et al. 2022 ). The international community, in seeking to counter these tactics needs to understand the threat that this poses and develop comprehensive strategies to defend against the flood of disinformation that undermines democratic processes and geopolitical stability (Organisation for Economic Co-operation and Development 2023 ).

Information warfare analysis

Information warfare in social media is the strategic use of social-cyber maneuvers to influence, manipulate, and control narratives and communities online (Blane 2023 ). It is used to manipulate public opinion, spread disinformation, and create divisive discourses. This form of warfare employs sophisticated strategies to exploit the interconnected nature of social networks and the tendencies of users to consume and share content that aligns with their existing beliefs (Prier 2017 ). The strategy of “commanding the trend” in social media involves leveraging algorithms to amplify specific messages or narratives (Prier 2017 ). This is achieved by tapping into existing online networks, utilizing bot accounts to create a trend or messaging, and then rapidly disseminating that narrative. This exploits the natural inclination towards homophily-the tendency of individuals to associate and bond with others over like topics (Prier 2017 ). Social media platforms enable this by creating echo chambers where like-minded users share and reinforce each other’s views. Consequently, when a narrative that is disinformation aligns with the user’s pre-existing beliefs, it is more likely accepted and propagated within these networks (Prier 2017 ).

Peng ( 2023 ) adds to this understanding by conducting a cross-platform semantic analysis of the Russia-Ukraine war on Weibo and Twitter, showing how platform-specific factors and geopolitical contexts shape the discourse (Peng 2023 ). The study found that Weibo posts often reflect the Chinese government’s stance, portraying Russia more favorably and criticizing Western involvement, while Twitter hosts a more diverse range of opinions (Peng 2023 ). This comparative analysis highlights the role of different social media environments in influencing public perception and the spread of narratives, emphasizing the multifaceted nature of information warfare across platforms.

The Russian state illustrates the effective use of social media in information warfare, where they have used it for social media propaganda, creating discourse and confusion, and manipulating both supporters and adversaries through targeted messaging (Brown 2023 ). The goal is to exploit existing social and political divisions, amplifying and spreading false narratives to manipulate public opinion and discredit established institutions and people (Alieva et al. 2022 ).

Social cybersecurity, integrating social and behavioral sciences research with cybersecurity, aims to understand and counteract these cyber-mediated threats, including the manipulation of information for nefarious purposes (National Academies of Sciences, Engineering, and Medicine (2019) ). The emergence of social cybersecurity science, focusing on the development of scientific methods and operational tools to enhance security in cyberspace, highlights the need for multidisciplinary approaches to identify and mitigate cyber threats effectively.

There are many methods and frameworks to analyze information warfare strategies and techniques. One such is SCOTCH, a methodology for rapidly assessing influence operations (Blazek 2023 ). It comprises six elements: source, channel, objective, target, composition, and hook. Each plays a crucial role in the overall strategy of an influence campaign. Source identifies the originator of the campaign, Channel refers to the platforms and features used to spread the narrative, Objective is the goal of the operation, Target defines the intended audience, Composition is the specific language used, and Hook is the tactics utilized to exploit the technical mechanisms.

While SCOTCH provides a structured approach to characterizing influence operations, focusing on the operational aspects of campaigns, the BEND framework offers a more nuanced interpretation of social-cyber maneuvers. BEND categorizes maneuvers into community and narrative types, each with positive and negative aspects, providing a comprehensive view of how online actors manipulate social networks and narratives (Blane 2023 ). This framework is particularly effective in analyzing the subtle dynamics of influence operations within social media networks, where the nature of communication is complex and multi-layered (Ng and Carley 2023b ). Therefore, when deliberating what framework to utilize, while SCOTCH excels in operational assessment, BEND offers greater insights into the social and narrative aspects of influence operations, making it more suitable for analyzing the elaborate nature of social media-based information warfare operations.

Moral Realism Analysis

Moral realism emphasizes the complex interplay between moral and political beliefs and suggests that political and propaganda narratives are not only policy tools but also reflect and shape societal moral beliefs (Kreutz 2021 ). This perspective suggests that the political narratives and propaganda disseminated by countries imply that moral justifications embedded in these narratives, both Russian and Ukrainian, are likely shaped by deeper political ideologies, influencing how these narratives are constructed and perceived on the global stage (Hatemi et al. 2019 ). Similar findings can be seen where political ideologies significantly influenced the framing of vaccines for COVID-19, this understanding becomes essential in the geopolitical concept, particularly in the Russian-Ukraine conflict (Borghouts et al. 2023 ).

Developed by social psychologists, the Moral Foundations Theory delineates human moral reasoning into five foundational values: Care/Harm, Fairness/Cheating, Loyalty/Betrayal, Authority/Subversion, Sanctity/Degradation, and Liberty/Oppression (Theory 2023 ). This theory was applied and utilized to understand the moral reasoning of political narratives and public opinion. For instance, this theory helps to understand the moral reasoning behind major political movements and policy decisions, emphasizing how different groups may prioritize certain moral values over others (Kumankov 2023 ). Application of the theory in a study on attitudes towards the COVID-19 vaccine reveals that liberals and conservatives expressed different sets of moral values in their discourse (Borghouts et al. 2023 ).

In the context of the Russian-Ukraine War, moral realism is an essential method in understanding international politics. Russia’s narrative often emphasizes the protection of Russian speakers in Ukraine, which can be interpreted as an appeal to the Loyalty/Betrayal Foundation (Dill 2022 ). On the other hand, Ukraine’s emphasis on self-determination and resistance to aggression may resonate more with Care/Harm and Fairness/Cheating foundations (Polinder 2022 ).

While moral realism hasn’t been directly applied to analyzing information warfare discourse, the COVID-19 case study shows the impact of understanding moral reasoning on political narratives (Kumankov 2023 ). Moral realism, in the context of information warfare for this conflict, provides a way to analyze the moral justifications and narratives used by Russia and Ukraine. We can then identify the ethical implications and the underlying values that they are trying to promote. By integrating moral realism, we can begin to understand the effectiveness that these narratives have in shaping public opinion and influencing international response to the Russian-Ukraine conflict.

Topic Modeling

Topic modeling is a machine learning technique used to discover hidden thematic structures within document collections, or “corpora” (Hong and Davison 2011 ). This technique allows researchers to extract and analyze dominant themes from large datasets, such as millions of tweets, to understand public discourse and the spread of propaganda or counter-propaganda narratives. It is particularly useful for examining social media data, where bots often attempt to control narratives (Hong and Davison 2011 ).

The topic modeling process involves several steps:

Data Collection Gathering tweets related to key events and statements.

Pre-processing Cleaning the data by removing noise, such as stop words, URLs, and user mentions, to focus on relevant content.

Vectorization Transforming the pre-processed text into a numerical form usable by statistical models (Ramage et al. 2009 ).

Algorithm Application Using methods like Latent Dirichlet Allocation (LDA) to identify topics (Ramage et al. 2009 ). Each topic is characterized by a distribution of words, highlighting topics relevant to our research.

For Twitter data, topic modeling faces unique challenges due to the platform’s character limit and the use of non-standard language like hashtags and abbreviations. This requires models that can capture the concise and often informal nature of tweets. The conflict-specific jargon, hashtags associated with the war, and the multilingual nature of the involved parties make traditional models like Document-Term Matrix (DTM), Term Frequency-Inverse Document Frequency (TF-IDF), and LDA less effective (Qudar and Mago 2020 ).

Ultimately, we chose TweetBERT, a variant of the BERT (Bidirectional Encoder Representations from Transformers) model pre-trained on Twitter data, which is designed to handle the peculiarities of Twitter’s text (Qudar and Mago 2020 ).

Data Pre-processing framework

3 Data and methodology

3.1 data collection.

The data for this study was sourced from Twitter, a widely used social media platform known for its role in news consumption across global regions including Western, African, and Asian countries (Orellana-Rodriguez and Keane 2018 ). Unlike other platforms with narrower user bases, Twitter’s widespread popularity enabled us to explore multiple sources that are either pro-Ukraine or pro-Russian support.

We utilized a pre-existing curated Twitter dataset that focused on English-language content featuring specific keywords: “Russian invasion,” “Russian military,” “military buildup,” and “invasion of Ukraine.” The dataset covered the period from January 2022 to November 2022, aligning with critical events including the Russian invasion of Ukraine in February 2022, the Russian advancement into Ukraine in May 2022, and the Ukrainian Kherson counteroffensive in August 2022.

Our dataset consisted of 4.5 million tweets. In our analysis, we concentrated on 1.6 million tweets of a refined social-network discourse exclusively centered on bot-generated content. This focus stems from the increasing recognition of bot communities have in information warfare, often surpassing that of human interactions. Bots, programmed to amplify specific narratives and disinformation, can operate continuously, creating an echo chamber effect that significantly distorts public perception (Smith et al. 2021 ). This approach enabled us to thoroughly investigate interactions within bot communities by excluding human conversations.

We employed temporal segmentation to focus on specific high-impact timeframes: (1) the Russian Invasion (08 February–15 March 2022), (2) the Mid-point (15 May–15 June 2022, and (3) the Kherson counteroffensive (20 July–30 August 2022).

The Russian invasion (08 February–15 March 2022): this marked the initial phase of the invasion, characterized by the rapid advance of Russian forces into Ukraine, including the capture of key cities and regions (Meduza 2022 ). This timeframe marked the beginning of intense fighting, particularly around Kyiv and in the Donbas region, and significant civilian displacement and casualties (TASS 2022 ). International responses included widespread condemnation and the imposition of sanctions against Russia.

The mid-point of the escalation of the war (15 May–15 June 2022): during this period, the conflict transitioned into a prolonged war of attrition. Russian forces focused on consolidating control in the east and south (News 2022 ), facing stiff resistance from Ukrainian forces (Axe 2022 ). This timeframe saw significant urban warfare and efforts by Russia to absorb occupied territories. The international community continued to respond with humanitarian aid to Ukraine and further sanctions on Russia (Desk 2024 ).

The Ukrainian Kherson counteroffensive (20 July–30 August 2022): this phase was marked by a strategic shift with Ukraine launching successful counteroffensives, particularly in the Kherson region (Blair 2022 ). Ukrainian forces made significant territorial gains, reversing some of Russia’s earlier advances (Sands and Lukov 2022 ). This period highlighted Ukraine’s resilience and the effectiveness of its strategy, significantly impacting the course of the war.

3.2 Impact of Twitter policies on data collection and propaganda campaigns

Our analysis considers the influence of Twitter’s content moderation policies on the visibility and spread of propaganda during the 2022 Russian-Ukraine War. Initially, Twitter’s policies aimed to curb misinformation, using automated algorithms and human reviewers to filter out harmful content (de Keulenaar et al. 2023 ).

However, significant shifts occurred with Twitter’s change in ownership in late 2022. Under Elon Musk’s management, the platform adopted a more lenient approach to misinformation, emphasizing ”free speech” and ceasing strict enforcement against misleading information (Kern 2022 ). This included stopping the enforcement of its COVID-19 misinformation policy, which previously led to many account suspensions and content removals.

These policy changes impacted our dataset. During data collection, tweets with overt disinformation, hate speech, or content inciting violence were more likely to be blocked, while tweets with subtle propaganda or opinion-based misinformation were more likely to remain. This selective enforcement likely skewed our data, with more pro-Ukraine stance observed early in 2022 and a rise in pro-Russian stance later in the year. Fewer pro-Russian hashtags were found and used early in 2022 compared to later.

By examining these policy shifts and their impacts, we understand how moderation influenced narrative visibility. Initial strict policies likely contributed to dominant pro-Ukraine stance early on, while later leniency allowed for increased pro-Russian content. This context is critical for interpreting temporal changes in propaganda and narrative dominance within our dataset.

3.3 Data pre-processing

In this portion, we describe our data pre-processing framework which involves extraction of bot tweets, removal of duplicate tweets, data cleaning, and data processing (i.e., stance detection, topic modeling, stance analysis). Figure  1 illustrates the data processing framework used in this paper.

The data that was originally collected through the Twitter API contained text not needed for further analysis. To remove these texts, we employed comprehensive data pre-processing methods to enhance the effectiveness of our study methodology. As depicted in Fig.  1 , our pipeline began with the use of a Bot Detector to ensure that only bot tweets were analyzed, emphasizing our focus on automated accounts which are a significant component in the spread of digital propaganda. We then conducted a temporal analysis to understand bot behavior over three specific timeframes, which allowed us to track the evolution of narratives in sync with the development of the conflict. Utilizing the NLTK library, Footnote 1 known for its text-handling features, was a critical step. Pre-processing included transforming tweets into a structured format via tokenization, removing stop words, and employing lemmatization techniques.

Tokenization, a key process in our methodology, involved breaking down textual content into discrete tokens such as words, terms, and sentences. This turned unstructured text into a structured numerical data form, enabling a more concentrated stance analysis. NLTK’s ability to filter out irrelevant words and stop words greatly shaped our focus on significant textual elements from the dataset. Footnote 2 Additionally, RegexpTokenizer, a part of the NLTK library, allows us to customize our tokenization process. This enabled us to define specific models for tokenization, making it particularly useful for handling the unique characteristics of social media text.

3.4 Bot detection

Bot detection algorithms utilize various methods to identify automated accounts on social media platforms. One simple approach is analyzing temporal features, which involves examining patterns in the timing and frequency of posts (Chavoshi et al. 2016 ). Bots often post at higher rates with more regular intervals compared to human users. Another advanced method involves deep-learning-based algorithms that assess complex patterns in account behavior, language use, and network interactions (Ng and Carley 2023a ). These algorithm distinguish bots from human users by learning from large datasets of known bot and human behaviors.

To further refine the dataset for this study, we utilized a bot detector to parse through the collection, identifying and isolating accounts likely to be automated bots. BotHunter, a hierarchical supervised machine learning algorithm (Beskow and Carley 2018 ), differentiates automated bot agents from human users via features such as post texts, user metadata, and friendship networks. This algorithm can be implemented on pre-collected data rather than requiring live input. Its proficiency in processing data, particularly during large-scale runs, proves BotHunter as a valuable tool for bot detection.

We refined our initial dataset, which consisted of 4.5 million tweets, down to a more manageable subset of over 1.5 million tweets. Within this subset, we identified and categorized accounts as probable bots if they achieved a BotHunter score of 0.7 or higher. This threshold was established based on findings from a previous systematic study that determined optimal values for bot detection algorithms. We used both original and retweets of the data because these two types of tweets, in totality, represent the content disseminated by bots, thereby enhancing the precision of our study’s insights into automated activity on Twitter (Ng et al. 2022 ). By focusing on accounts that surpassed this reliability score, we concentrated our analysis on the influence and behavior of bots within the discourse of the Russian-Ukraine conflict.

3.5 Stance detection

After undergoing pre-processing, the dataset was parsed through the NetMapper software to enhance narrative understanding. Footnote 3 This software contains lexicons of language traits in over 40 languages, including those studied within this work. These lexicons enable insights into stance dynamics that enhance later stance analyses.

A major step of our stance analysis involved classifying tweets based on their stances, which were indicated using specific hashtags. We adopted the hashtag propagation method, which entails identifying and categorizing the 130,000 tweets according to their usage of pro-Russian (including anti-Ukraine stance) and pro-Ukraine (including anti-Russian stance) hashtags. The hashtag propagation method involves the tracking and analysis of network interaction among Twitter users based on specific hashtags (Darwish et al. 2023 ). This method identifies clusters of users sharing similar hashtags, revealing their stances and associated hashtags. Examining these networks allows us to understand the predominant stances and interactions within each group (Darwish et al. 2023 ).

For effective hashtag selection representing both pro-Russian and pro-Ukraine stances, two criteria were applied: firstly, the exclusivity of the hashtag to a specific stance pole, and secondly, its prevalence to ensure reliable agent stance detection. Initially, The process involved sorting hashtags based on frequency to identify probable pro-Russian and pro-Ukraine stances. Subsequently, selected hashtags were examined further using network analysis to confirm their exclusive association with the intended stance and to uncover any additional related hashtags. We manually reviewed a few hundred tweets for specific hashtags within each timeframe, identifying over 2000 unique hashtags to categorize tweets according to their stances.

By accurately classifying tweets into pro-Russian or pro-Ukraine stance, we can track the shifts in public opinion facilitating the ability to identify misinformation campaigns and understand how digital solidarity or opposition is manifested. Furthermore, stance detection aids in showing bots’ influence in shaping narratives, providing a more comprehensive view of the conflict.

3.6 Validation of stance analysis and bot detection

To ensure the reliability and accuracy of our stance analysis, we utilized the TweetBERT model, pre-trained on a large dataset of tweets annotated by human coders. This pre-training involved rigorous manual annotations to capture the nuances of stance, as recommended by Song et al. ( 2020 ). The human annotations provided a robust foundation for training the model, allowing it to accurately classify stances in the large dataset of tweets related to the Russia-Ukraine conflict.

Our validation approach involved several key steps to ensure the robustness of the stance analysis:

Human Annotations The stance analysis model was initially trained using manually annotated tweets. We reviewed a few hundred tweets for specific hashtags within each timeframe, identifying over 2,000 unique hashtags to categorize stances. This manual validation ensured accurate stance detection, providing a solid foundation for sentiment analysis with examples of positive, negative, and neutral stances.

Sample Size and Sampling Methods Our dataset comprised over 1.6 million tweets. We used stratified random sampling to select a representative subset for manual annotation, ensuring the sample reflected the diversity of stances and topics in the full dataset.

Quality Assurance in Pre-processing During data pre-processing, we used the NLTK library for tokenization, stop word removal, and lemmatization. This ensured clean and consistent text data for accurate sentiment analysis. Removing stop words like ’the’, ’is’, and ’in’ streamlined the dataset, allowing algorithms to focus on words with substantial emotional or contextual weight. Lemmatization ensured different forms of a word were analyzed as a single entity, enhancing sentiment assessment consistency.

Validation of Stance and Bot Analysis We grabbed a random subset of tweets and labeled them as pro-Russia, pro-Ukraine, or Neutral. We compared these labels to the model’s predictions. This step ensured that our analysis was reliable and accurately reflected the sentiments expressed in the tweets. For stance detection, we achieved an accuracy score of 91.28% for all pro-Ukraine stances and 84.78% for all pro-Russian stances. This highlights the model’s high accuracy in identifying the stance of tweets related to the Russia-Ukraine conflict. We also manually reviewed a subset of accounts labeled as bots by the model, examining activity patterns, content, and other indicators to confirm classification. We only analyzed accounts with a bot probability score above 0.7, ensuring high confidence in bot detection results. The results of this validation, along with the comparison between human annotations and model predictions for both stances and bot detection, can be found in Appendices A and B.

3.7 Topic modeling

Topic modeling uses algorithms to sift through large text datasets, like social media posts, to identify recurring themes or topics. In our research, it is crucial to understand the narratives, sentiments, and discussions on Twitter during the Russian-Ukraine conflict. This method helps pinpoint prominent themes, phrases, and words characterizing the war’s narratives.

In this context, topic modeling shows how different actors within the bot community shape the conversation. By tracking topics or hashtags over time, we can identify misinformation campaigns, state-sponsored propaganda, and grassroots movements, often correlating with events like military escalations or diplomatic negotiations.

Twitter’s informal language and brevity pose challenges for traditional NLP models like BERT and BioBERT (Qudar and Mago 2020 ). TweetBERT, designed for large Twitter datasets, handles these challenges by analyzing text that deviates from standard grammar and includes colloquial expressions. It effectively detects trends and movements, making it ideal for analyzing diverse datasets (Qudar and Mago 2020 ).

TweetBERT’s capabilities are vital for this study, focusing on Russia’s bot-driven campaigns and Ukraine’s counter-narratives. By using TweetBERT, we can uncover attempts of narrative manipulation methods and assess the impact of bot-driven campaigns on public opinion and geopolitical dynamics. We further used word clouds to explore the strategic deployment of themes and terms by bots during key conflict phases.

This approach shows how bots exploit social media algorithms, favoring content that generates interaction. Consequently, bots create and perpetuate echo chambers. Topic modeling with TweetBERT provides insights into how information warfare campaigns are conducted, demonstrating how bots systematically disseminate polarizing content to influence public opinion.

3.8 BEND framework and moral foundations theory integration

The BEND framework offers a robust method for interpreting social-cyber maneuvers in information warfare, distinguishing between community and narrative maneuvers with positive and negative stances (Blane 2023 ). This framework enables a detailed examination of social media dynamics, addressing content, intent, and network effects. By employing BEND, we can identify strategies to build or dismantle communities, engage with or distort narratives, and enhance or discredit messages, which is critical for understanding the impact of these campaigns.

The BEND maneuvers are categorized as follows:

Community Maneuvers

Positive (’B’): Back, Build, Bridge, Boost.

Negative (’N’): Neutralize, Negate, Narrow, Neglect.

Narrative Maneuvers

Positive (’E’): Engage, Explain, Excite, Enhance.

Negative (’D’): Dismiss, Distort, Dismay, Distract.

For instance, the “build” maneuver creates groups by mentioning other users, while the “neutralize” maneuver discredits opposing opinions. Narrative maneuvers like “excite” elicit positive emotions, whereas “distort” alters perspectives through repeated messaging (Blane 2023 ).

To further contextualize these maneuvers, we integrate Moral Foundations Theory, which segments moral reasoning into core values: Care/Harm, Fairness/Cheating, Loyalty/Betrayal, Authority/Subversion, Sanctity/Degradation, and Liberty/Oppression (Graham et al. 2013 ). This theory provides insights into the stances and narratives in our dataset, revealing moral undertones that resonate with and mobilize individuals on an ethical level. For example, Care/Harm is evident in protective rhetoric in pro-Russian narratives and victimization themes in Ukrainian messaging. Fairness/Cheating surfaces in accusations of deception, while Loyalty/Betrayal, Authority/Subversion, and Sanctity/Degradation are present in discussions of national allegiance and cultural institutions.

Integrating the BEND framework with Moral Foundations Theory offers a multi-dimensional approach to sentiment analysis, mapping out the emotional and ethical dimensions of the narratives. This analysis uncovers how orchestrated maneuvers resonate with foundational moral values, magnifying their impact. The dual-framework application explains the strategies and moral appeals used to shape public perception and international responses, highlighting the potency of sentiment as a weapon in modern information warfare.

4 Results and discussion

4.1 dominance of pro-ukraine stance versus pro-russian stance.

Normalized weekly bot tweet volume (Jan-Oct 2022)

While we don’t know for sure whether these contents are bot-created or human-created content that is propagated by bots, we know that these contents have a high probability of being bot-communicated. The study of bot-communicated content is important, as it reveals the content and extent of the information that bots prioritize to communicate to the general reader during the period of study. This distinction is critical for understanding the mechanisms of influence and narrative control within the digital warfare domain, especially in the context of the temporal segmentation employed to focus on specific high-impact timeframes.

It is also important to note, that while there is a significant concern about the potential of bots to manipulate public opinion, the evidence remains inconclusive. For example, a study by Eady et al. ( 2023 ) found minimal and statistically insignificant relationships between exposure to posts from Russian foreign influence accounts on Twitter and changes in voting behavior in the 2016 U.S. election (Eady et al. 2023 ). This suggests that while attempts to manipulate public opinion are evident, actual successful manipulation may be far less effective than often assumed. It is important to distinguish between the presence of such attempts and their effectiveness in achieving the intended outcomes.

During the initial invasion phase (08 February–15 March 2022), these bots disseminated misleading information, justifying Russian state military actions and downplaying the severity of the invasion. Marked by heavy fighting, particularly in the Donbas region, (15 May–15 June 2022), bot activity intensified, mirroring the escalation in military engagement and aiming to influence international opinion. During the Kherson counteroffensive (20 July–30 August 2022), Bots supporting Putin’s regime attempted to counter the narrative of Ukrainian resilience, highlighting their strategic use in narrative control and the manipulation of public opinion.

Figure  2 represents a normalized weekly bot tweet volume from January to October 2022. The normalization process involves scaling the weekly number of bot tweets against the minimum volume observed in any given week within the dataset, thus ensuring that the peak activity is set at a value of 1.0 for relative comparison. This process allows us to observe the proportional intensity of bot activity over time, offering a clear visual representation of bot-driven disinformation campaigns during key phases of the conflict.

The graph shows a surge in bot activity coinciding with the onset of the Putin’s regime invasion, a noticeable uptick around the mid-point period from May to June, and another increase during the Ukrainian counteroffensive in Kherson while aligning with the strategic timing of narrative manipulation and the heightened need for controlling the information flow by state actors through automated means.

Figure  3 shows the normalized patterns of the top hashtag usage from January to September 2022 by scaling the frequency of each hashtag against the peak usage observed within the dataset. The timeframes of interest – marked by purple overlays – correspond to the periods of the Russian invasion, the mid-point of intensified military engagement, and the Ukrainian Kherson counteroffensive.

It is evident from the visualization that hashtags demonstrating Ukraine, designated by the outlined blue boxes, dominated the conversation. This prevalence is consistent across the entire timeline but shows notable peaks during key conflict events. The dominance of pro-Ukraine hashtags reveals a significant trend in bot sentiment on Twitter, reflecting widespread global support for Ukraine during these periods. We will explore further into this and how bots were programmed and utilized during this period. We will also study the utilization of these hashtags and how they can be interpreted as a form of digital “solidarity” with Ukraine, as well as a means of countering pro-Russian narratives on the platform and vice versa.

Top hashtags utilized overtime (Top hashtags support Ukraine as shown in blue outline) (Color figure online)

The results in Figs.  4 and 5 provide a visual representation of the stance associations and stances expressed using specific hashtags on Twitter during the Russian-Ukraine conflict.

Figures 4 and 5 depict the ego network of the most popular hashtag for each stance, which refers to a specific type of network centered around a single node (the “ego”) where the network includes all the direct connections or interactions that the ego has with other nodes (called “alters”), as well as the connections among those alters.

Figure  4 depicts the ego network for a pro-Ukraine stance, centered around the hashtag #StandWithUkraine . The orange node represents the selected hashtag (the ego), which serves as the focal point of the network. The blue nodes indicate hashtags associated with a positive stance towards Ukraine, suggesting support and solidarity with the Ukrainian cause. Red nodes, on the other hand, signify negative stance but, in this context, they are against Russia, thereby reinforcing the pro-Ukraine stance. Green nodes denote neutral hashtags that are neither exclusively pro-Ukraine nor pro-Russian but are possibly used in discussions that involve a broader or neutral perspective on the conflict.

The prevalence of blue nodes surrounding the ego, #StandWithUkraine , highlights the strong positive stance and support for Ukraine within the Twitter discourse. The interconnectedness of these nodes suggests a cohesive community of Twitter bots who are programmed to align their support for Ukraine and in opposition to Russia. This network structure implies digital solidarity, where bots and users rally around common hashtags to express support, spread awareness, and potentially counteract pro-Russian narratives. However, it is still important to recognize that the presence of these coordinated bot activities does not necessarily equate to effective manipulation of public opinion.

Ego-network for Pro-Ukraine stance: #StandWithUkraine (Orange - Hashtag selected, Blue - positive stance, red - negative stance, green - neutral stance) (Color figure online)

Ego-network for Pro-Russian stance: #istandwithRussia (Orange - Hashtag selected, Blue - positive stance, red - negative stance, green - neutral stance) (Color figure online)

Figure  5 illustrates the ego network for the pro-Russian stance, with #IstandwithRussia as the ego node. Like Fig.  4 , the colors denote the stances associated with each hashtag. Blue nodes reflect positive stance towards Russia, red nodes represent negative stance but, like the pro-Ukraine stance, these are against Ukraine, and green nodes are neutral. This network indicates a less dense clustering of hashtags around the central node compared to the pro-Ukraine network. This implies a less cohesive or smaller group of Twitter bot accounts that share pro-Russian sentiment. This could also reflect a strategic use of varied hashtags to spread pro-Russian stance messages across different Twitter communities. The prevalence of green nodes (neutral nodes) implies a strategy to engage a wider audience or to introduce a pro-Russian stance message into broader, potentially unrelated discussions.

These networks were completed over multiple iterations. The structure and composition of these multiple networks showed not only the sentiments and stances of Twitter bots but also the dynamics of how these stances are presented and propagated. By analyzing the connections between different hashtags, we can deduce the strategic use of language and digital behavior that defines these online events (Figure  6 ).

By completing this process, we created a list of 2,0000 hashtags for stance detection that contained both pro-Russian (including anti-Ukraine) and pro-Ukraine (including anti-Russian) stances to conduct further sentiment analysis. As shown in Fig.  7 , the heatmap visually represents some of the stance occurrences over time. The top portion of the heatmap, indicated by the black horizontal line, is composed of pro-Ukraine stances. These stances are characterized by support for Ukraine, opposition to Putin and Russia, and criticism of the Russian regime. The lower portion represents pro-Russian stances, which predominately consist of support for Russia, antagonism towards NATO, and pejorative references to Ukraine as a Nazi state.

Some of the most notable ones for pro-Ukraine which can be seen throughout all three timeframes: #StandWithUkraine , #istandwithzelensky , #PrayingforUkraine , #standwithNATO , #PutinWarCrimes , #PutinWarCriminal , #StopPutinNow .

The hashtags such as #StandWithUkraine and #istandwithzelensky signify clear rallying for solidarity with Ukraine. Their significant appearance in the heatmap during all three phases of the conflict demonstrates a sustained and widespread digital mobilization in support of Ukraine. #PrayingforUkraine reflects the global community’s concern and hope for the welfare of the Ukrainian people, while #standwithNATO suggests an alignment with Western Military alliances, which are seen as protectors and allies within this conflict.

The frequency of hashtags like #PutinWarCrimes and #PutinWarCriminal indicates an accusatory stance against the Russian leadership, branding their military actions as criminal. This not only conveys condemnation but also echoes calls for international legal action.

Some notable ones for Pro-Russian which can be seen throughout all three timeframes: #istandwithrussia , #istandwithPutin , #abolishNATO , #noNATO , #UkroNazi , #WarCrimesUkraine , #StopNATOExpansion , #NATOterrorists .

The hashtags #istandwithrussia and #istandwithPutin represent a digital front of support for Russian actions and policies. These hashtags demonstrate support for Russian narratives and reject Western critiques. #abolishNATO and #noNATO indicate a stance against NATO, suggesting that it is viewed as an aggressor within the conflict, aligning with Russian claims of being threatened by NATO expansion to their borders. #UkroNazi and #WarCrimesUkraine are utilized to delegitimize the Ukrainian government and its actions, employing historical references to vilify Ukraine’s position and justify Russia’s actions.

Figure  8 depicts a sample of pro-Ukraine and pro-Russian hashtags discovered through stance detection where it shows how the narratives progressed during the three major phases of the conflict. Their usage patterns across the timeframes of the conflict show how both sides leverage social media to build and maintain support, counteract opposition narratives, and potentially influence undecided or neutral observers.

During the three timeframes, the hashtags display their efforts to rally communities to their causes. Their repeated use, particularly during critical events, suggests a bot-centric strategy to amplify certain narratives. The predominance of specific hashtags and similar like hashtags, as identified in the heatmap, indicates areas where bot activity is concentrated, representing an attempt to shape discourse around key narrative points.

These hashtags and their distribution over time provide quantitative backing to the qualitative observations derived from the ego networks. Understanding the rise and fall of these hashtags usages provides valuable insight into the role and reach of these bots is critical for both sides of the conflict, as it can significantly affect international perception and policy decisions. The network analysis depicted in Figs.  4 and 5 shows how bots are interconnected and Fig.  8 measures the intensity and prevalence of opinions during critical events of the Russian-Ukraine conflict, while Fig.  6 shows the frequency at which these bots are posting.

Figure  6 depicts the frequency at which bots are posting across all three timeframes. Figure  6 , with its delineation of pro-Ukraine and pro-Russian hashtags, shows a pronounced skew towards pro-Ukrainian stances, especially during key moments of the conflict. This skew is not just indicative of public opinion but also reflects a concerted effort by bot networks to amplify the Ukrainian narrative. The graph shows a persistent dominant use of pro-Ukrainian hashtags, suggesting a strong and continuous bot engagement by those behind the automated accounts supporting Ukraine’s cause. The sharp fluctuations in pro-Ukrainian hashtag frequency, particularly at the points marked “Russian Invasion”, “Mid-Point,” and “Counteroffensive,” suggest that key military or political events trigger significant spikes in bot activity.

Content moderation policies also played a significant role, with a higher pro-Ukraine stance observed in the beginning and a lower pro-Russian stance. However, as the year progressed and new policies were established, pro-Russian sentiment grew, particularly towards the end of 2022. This shift is evidenced by the increased use of hashtags such as “istandwithrussia”, “UkraineNazis”, “NATOized”, and “StopNaziUkraine” during the counteroffensive period, highlighting how changes in content moderation policies increased bot activity promoting pro-Russian stance messaging.

The relatively stable line of pro-Russian hashtags in Fig.  6 usage suggests a consistent, albeit less pronounced usage of the hashtags by bots. This implies several things: it suggests a more restrained approach to social media, a less mobilized base of support, or it could also reflect countermeasures taken by platforms to limit the reach of pro-Russian messaging, which has been a policy of several social media platforms.

The normalization of data in Fig.  6 is critical as it allows for the comparison of relative changes over time, controlling for the absolute number of messages sent. This method of data representation highlights the relative intensity of information warfare campaigns rather than the raw numbers, providing insight into how the conflict is being fought on social media platforms. This figure, along with the heatmap (Fig.  8 ) and the ego-centric networks (Figs.  4 and 5 ), provides a comprehensive picture of how information warfare campaigns are taking place, allowing us to have a deeper understanding into those themes.

Overall stance hashtag usage over the three timeframes

4.2 Operational narratives: the role of bots in conflict storytelling

When performing stance analysis, TweetBERT processes tweets by considering their content, language style, and structure. Its underlying architecture, pre-trained on millions of tweets, captures the informal and idiosyncratic language of Twitter (Qudar and Mago 2020 ). The model classifies tweets as positive, negative, or neutral based on learned patterns from its training data, encompassing a wide spectrum of expressions, from straightforward statements to subtle or sarcastic comments. This sentiment analysis was applied to our dataset, covering a range of emotions, opinions, and perspectives conveyed through informal language and hashtags.

TweetBERT sentiment analysis for Pro-Ukraine and Pro-Russian within bot communities

Stance hashtags usage over the three timeframes

In the sentiment analysis of Fig.  7 , it is apparent that pro-Russian tweets are more inclined to convey very negative sentiments, with an average probability of 35%, in contrast, pro-Ukraine tweets are more predisposed to express very positive sentiments, evidenced by a higher average probability of 40%. This stark disparity in sentiment distribution is indicative of a deliberate strategic approach, where negative sentiments often serve to undermine or vilify the opposition, while positive sentiments are utilized to promote unity and garner support.

Specifically, the 35% probability of very negative sentiments in pro-Russian tweets suggests a calculated effort to sow discord and foster a hostile perception of Ukraine and its allies, aiming to erode international support by casting their efforts in a negative light. Conversely, the 40% probability of very positive sentiments in pro-Ukraine tweets likely aims to bolster the legitimacy and morale of the Ukrainian cause, seeking to strengthen and consolidate global backing for their stance.

Figure  9 , generated from this analysis, is a visual representation of the tweets’ embedding reduced to two principal components through PCA. The two-dimensional PCA plot provides a simplified yet insightful visualization of the high-dimensional data. The PCA serves as a powerful tool to highlight the distinction between the pro-Ukraine and pro-Russian clusters formed by the K-means algorithm, based on the semantic content of the tweets as encoded by TweetBERT.

Figure  9 illustrates two clusters with a clear dichotomy in the narrative propagated by bots: one distinctly pro-Ukraine and the other pro-Russian. This plot not only shows the presence of two opposing narratives but also the degree to which these narratives are being propagated, as evident from the clustering patterns. The spatial distribution suggests that there is minimal crossover or ambiguity in the messaging of these bots; they are programmed with specific narratives and don’t typically engage with or share content from the opposing viewpoint.

The distribution of points within each cluster could be telling the strength and coherence of the messaging. For example, the tight clustering in each pro-Ukraine and pro-Russian indicates a highly focused and consistent narrative push. There is some disperse within each cluster, suggesting that there is some variability of sub-narratives within each messaging strategy, but they mostly follow the same main narrative for each viewpoint.

Figure  9 shows that there is a level of sophistication to the narrative warfare at play. Bot are not merely spreading information; they are curating a specific emotional sentiment that aligns with their programmed objectives. This emotional manipulation can have a profound impact on human users who encounter these tweets, potentially swaying public opinion and influencing the social media discourse surrounding the war.

TweetBERT cluster analysis for Pro-Ukraine and Pro-Russian within bot communities

The analysis of bot activity, as visualized in Fig.  9 , again shows a stark division between pro-Ukraine and pro-Russian clusters, with no apparent overlap. This segregation is characteristic of echo chambers, which are typically strengthened by the absence of dissenting or alternative viewpoints. Our findings are supported by recent research, which highlights the significance of bipartisan users in bridging divided communities and disrupting the formation of such echo chambers (Zhang et al. 2023 ). When human bipartisan interactions are present, these users can introduce variance and mitigate the polarizing effects of echo chambers by connecting different narrative threads (Zhang et al. 2023 ).

However, in our bot-only dataset, the lack of this bipartisanship shows the potential for echo chambers to thrive unchecked. Without the moderating influence of bipartisan users, be they human or bots programmed with diverse narratives, the clusters formed are highly polarized and exhibit a high degree of narrative consistency. This raises important questions about the design and intention behind these bots. If bots were programmed to mimic the bipartisan behavior observed in human users, could they serve a similar function in diluting the echo chamber effect? Or would their artificial nature render such efforts ineffective or even counterproductive?

It is not surprising that the two groups are disjoint, as most bots do not interact, indicating that simple bots, which relay messages but don’t engage in adaptation, are being used. This absence of interaction among bots highlights the use of a more rudimentary form of artificial intelligence in these information campaigns, focusing on message distribution rather than engaging in complex conversations or altering strategies based on audience response. Such an approach reveals a deliberate choice to prioritize volume and consistency over adaptability and engagement, hinting at a strategic emphasis on shaping narratives and controlling discourse rather than fostering genuine interaction.

The absence of human users in this dataset allows for unique observation of how bots alone create and sustain narrative echo chambers. The homogeneity within each cluster indicates a sophisticated level of narrative control, likely intended to shape public discourse. This highlights the potential for bots to be used in information warfare, significantly influencing social media in the absence of human counter-narratives. Zhang et al. ( 2023 ) suggest that the inclusion of bipartisan elements could introduce complexity and interaction, preventing such insulated informational environments (Zhang et al. 2023 ). Integrating these insights could inform future strategies for digital platform governance and algorithm design to detect and mitigate polarized content.

The stark separation of sentiment and narrative between pro-Ukraine and pro-Russian bots reveals a deliberate effort to not only inform but also emotionally influence public opinion. By highlighting the operational simplicity and strategic focus of the bots used in these campaigns, we can better understand the dynamics at play in digital propaganda efforts and the critical role of human engagement in countering the formation of narrative echo chambers. However, it is important to recognize that while these findings show the potential for bots to shape narratives and control discourse, the overall influence of these echo chambers and coordinated disinformation efforts on public opinion remains limited. This nuanced understanding can guide future efforts in digital platform governance and the development of strategies to foster more diverse and interactive online environments.

Narrative Dynamics Across Conflict Phases

By employing topic analysis in our dataset, the analysis of bot-driven sentiment presents how narratives evolve in their efforts of information warfare. Our results try to understand the patterns of how bots have strategically broadcast both pro-Ukraine and pro-Russian stances during critical key events of the conflict.

Topic modeling: Russian invasion stance for both pro-Ukraine and pro-Russia

Russian Invasion Analysis

Figure  10 features the narratives propagated by bot-driven communities during the Russian invasion from 08FEB-15MAR 2022. The Pro-Ukraine word cloud focuses on rallying cries such as #supportukraine and calls to action like #stoprussianaggression , reflecting a clear call for international support and immediate action to counter Russian aggression. The emphasis on hashtags talking about war crimes such as #putinwarcriminal and #warcrimesofrussia aligns with efforts to draw global attention to the humanitarian impact that the invasion had to the Ukrainian people.

The term #putinwarcriminal and #arrestputin suggests a concerted effort to personify the conflict, concentrating the narrative against a single figure of Vladimir Putin to simplify the complex geopolitical situation into a clear-cut story of who is the main aggressor behind the military actions of Russia.

Conversely, the pro-Russian word cloud is dominated by terms such as #stopnato and #nazis , which appear to be part of a broader strategy to undermine the legitimacy of NATO’s involvement and to cast aspersions on the motivations behind Ukraine’s defense efforts. The repeated use of #nazi in conjunction with various entities ( #kosovoinnato , #germannazis , and #ukronazis ) is a provocative attempt to invoke historical animosities and paint the opposition as not just wrong, but morally reprehensible.

The presence of terms like #zelenkylies and #fuckbiden suggests an aggressive stance against international figures who are critical of Russia’s actions. This aggressive language is likely intended to resonate with and amplify existing anti-Western sentiment, rallying support by tapping into such strong emotions.

The word clouds in Fig.  10 demonstrate the capacity of bot-driven communities to disseminate targeted messages that can influence public discourse. The strategic repetition of these specific terms and the emotional weight they carry can have a significant impact on the public perception of the conflict. For example, the repeated association of Ukraine with Nazism by pro-Russian bots could, over time, influence on-the-fence observers to view the Ukrainian resistance with skepticism. Similarly, the pro-Ukraine bots focus their strategies on war crimes and heroism can bolster a narrative of moral high ground and rightful resistance, influencing international opinion and potentially swaying public policy.

Topic modeling: mid-point Russian military escalation stance for both pro-Ukraine and pro-Russia

Mid-Point Analysis

Figure  11 from the midpoint of the conflict shows how the intensified narratives are being pushed by bot-driven communities, highlighting how these automated accounts adapt their messaging in response to evolving circumstances of the Russian-Ukraine conflict.

The pro-Ukraine bots, during the midpoint timeframe, focus sharply on the characterization of Russian leadership as criminal, with #putinwarcrimes and #putinisaterrorist featuring notably. This indicates a strategic push to hold the Russian state accountable for its actions and to appeal to the international community’s sense of justice. The word cloud also shows a call for solidarity and support for Ukraine, with terms like #saveukraine and #standwithukraine appearing frequently. The repeated use of #stopputin and #stoprussianaggression serves as a rallying cry to mobilize international pressure against the Russian military campaign.

The pro-Russian word cloud exhibits a significant focus on terms that escalate the dehumanization of Ukraine and its allies. The prominent display of #nazi related terms in conjunction with #ukronazis and #stopnato suggests a continuation and intensification of the strategy to vilify Ukraine by associating it with historical evils. The use of such charged terms is a common tactic in information warfare, aimed at delegitimizing an opponent and swaying public sentiment by drawing on emotional and historical connotations.

This phase also shows an increased effort to reinforce narratives that support Russian actions, with terms like #isupportputin and #russianato , which indicates a defensive posture in response to global criticism of the invasion.

The word clouds suggest a battle for the narrative high ground, where each side’s bots work continuously to sway public opinion and influence international perception. Having the focus on emotionally charged and historically weighted language demonstrate bots role in amplifying existing narratives.

Bots are used not only to disseminate information but also to engage in psychological operations. The stark contrast between the two sets of word clouds highlights the polarized nature of the conflict as perceived through social media, with bots acting as catalysts for these divisive narratives. As the war progresses, these automated agents continue to play a crucial role in the information warfare that accompanies the physical fighting on the ground.

Topic modeling: Kherson counteroffensive stance for both pro-Ukraine and pro-Russia

Kherson Counteroffensive Analysis

In Fig.  12 , the word cloud from the Kherson Counteroffensive shows how bot-driven communities target and continuous amplification of specific narratives. The word cloud shows how these strategies and thematic focuses of bot activity continued when entering the turning point of the conflict with the Ukrainian counteroffensive.

The pro-Ukraine stance word cloud responds to the Pro-Russian narrative with a heightened focus on justice and accountability. Terms like #putinwarcriminal and #warcrimainlputin dominate, suggesting a strategic emphasis on the legal and ethical implications of the conflict. This shift towards highlighting war crimes and the criminality nature of it serves to erase the perceived illegitimacy of Russian military actions and to bolster international support for Ukraine’s counteroffensive.

The recurrent mention of #stoprussianaggression and the calls to #standforukraine reflect a continued urgency in the pro-Ukraine narrative. They serve not only as a plea for support but also as a means of reinforcing the identity of Ukraine as a nation under unjust attack, striving to defend its sovereignty and people.

The pro-Russian bots during the Kherson Counteroffensive continue to push a narrative that is heavily laden with historical and nationalistic sentiments. The use of #nazis in conjunction with #ukronazis and #nato persists, emphasizing an attempt to paint the Ukrainian defense efforts and their Western allies in a negative light. This continued usage of such incendiary terminology suggests a relentless drive to cast the conflict not just as a territorial dispute but as a moral battle against perceived fascism that is viewed from a Russian standpoint.

The terms #traitorsofukraine and #standwithrussia indicate a dual strategy of internal division and external solidarity. By labeling opposition elements as traitors, these bots aim to sow discord and delegitimize the Ukrainian resistance while simultaneously calling for unity among pro-Russian supporters.

BEND results normalized across all three timeframes for Pro-Ukraine Stance

BEND results normalized across all three timeframes for Pro-Russian Stance

The thematic content of these word clouds during the Kherson Counteroffensive highlights how bots can adapt their messaging to the changing dynamics of war. As Ukraine takes a more offensive stance, the pro-Russian bots ramp up their use of divisive language, likely to counteract the rallying effect of Ukrainian advances. Similarly, pro-Ukraine bots amplify their calls for justice and international support, aiming to capitalize on the momentum of the counter-offensive.

These bot-driven narratives are engineered to provoke specific emotional responses and attempt to manipulate the perception of the conflict. The use of emotionally charged language and polarizing terms highlights the sophistication of these information warfare campaigns, designed not just to report on the conflict but to actively shape the discourse around it.

Throughout the various stages of the Russia-Ukraine conflict, bot-driven narratives strategically attempted to influence public perception and opinions. During the invasion phase, pro-Russian bots discredited NATO and rallied support for Russia, while pro-Ukraine bots highlighted the urgency of resisting Russian aggression and focused on humanitarian issues. As the conflict escalated, pro-Russian narratives intensified the vilification of Ukraine using historical antagonisms. In contrast, pro-Ukraine bots condemned Russian leadership and emphasized accountability. During the Kherson Counteroffensive, pro-Russian bots amplified divisive rhetoric to undermine Ukrainian unity, whereas pro-Ukraine bots stressed criminal accountability and valor.

4.3 Analyzing strategic information warfare tactics in Russia–Ukraine Twitter bot networks

The impact of information warfare, particularly in the context of social media, became a defining strategy of modern-day warfare. Information warfare leverages the interconnections and immediacy that social media platforms provide to spread disinformation, manipulate narratives, and sow discord among target populations. Its tactics can shape public opinion, influence political processes, and destabilize entire nation-states by eroding trust in institutions and democratic processes. The normalization of disinformation and the exploitation of existing social platforms amplify the potency of such disinformation campaigns.

Figures 13 and 14 highlight the thousands of tweets associated with our results from our stance detection against the overall BEND analysis for each pro-Russian and pro-Ukraine sentiment through the selected three timeframes.

We performed the BEND analysis separately on communities segregated based on stance detection. The analysis was also used to focus the topic analysis portion and show how these maneuvers manifest across all three timeframes and how they affect the narrative and community dynamics. This analysis aligns with social cybersecurity’s focus on understanding the digital manipulation of community and narrative dynamics, highlighting the strategic use of social media in modern conflicts. Aggregation and normalization of the data were applied to ensure a clear comparison across the timeframes to understand how each maneuver changed in each stance across the selected timeframes.

Figure  13 illustrates the evolution of pro-Ukraine narratives within the Twitter bot community. During the Russian invasion, there was a significant Boost and Build effort, using hashtags like #westandforukraine and #istandwithzelensky to foster solidarity and support for Ukraine, reflecting the BEND framework’s principles of community building (Carley 2020 ). As Russian activities escalated at the mid-point, Engage and Excite maneuvers increased, aiming to make the conflict more globally relevant and counter Russian disinformation. During the Ukrainian counteroffensive, Dismay, Distort, and Distract maneuvers surged, with hashtags like #putinisawarcriminal , #russiaisaterroriststate , and #PutinGenocide challenging pro-Russian narratives and diverting attention from Russian messaging.

Figure  14 illustrates the evolution of pro-Russian narratives within the Twitter bot community. During the Russian invasion, there was a focus on Negate and Neutralize maneuvers, using hashtags like #abolishNATO and #endNATO to diminish opposing narratives. Increased Russian military activity saw Distort and Dismiss maneuvers, skewing the narrative in favor of Russia by highlighting negative aspects of Ukraine, such as Nazi associations. In response to the Ukrainian counteroffensive, Dismay and Distort efforts surged, with hashtags like #westandwithrussia and #naziNATO , aiming to cause fear and discredit Ukraine while garnering support for Russia. This reflects the social cybersecurity concept of narrative manipulation, where digital platforms reshape public perception.

BEND results normalized for hashtags: Pro-Ukraine Stance - #istandwithukraine and Pro-Russian Stance - #istandwithrussia during the Russian Invasion

BEND results normalized for hashtags: Pro-Ukraine Stance - #putinwarcriminal and Pro-Russian Stance - #stopnato during the Mid-Point

The BEND framework shows that pro-Ukraine efforts predominantly utilize the ’B’ (Boost and Build) and ’E’ (Engage and Excite) maneuvers, focusing on community building and positive narrative development. Conversely, pro-Russian bot activities rely heavily on the ’N’ (Negate and Neutralize) and ’D’ (Distort and Dismay) maneuvers, aiming for community disruption and negative emotional influence.

Applying the BEND framework shows the contrasting online strategies employed by both sides. Pro-Ukraine bots emphasize strengthening solidarity and support, using the Back maneuver to amplify pro-Ukraine voices and the Engage maneuver to foster online camaraderie. This proactive stance aims to rally support and create a collective pro-Ukraine sentiment. In contrast, pro-Russian bots supporting Putin’s regime focus on disrupting communities and spreading negative sentiment to weaken opposition and influence perceptions negatively.

These strategies extend beyond bot communities and are designed to influence the perceptions and behaviors of human users. To better understand the impact of these hashtags, we investigated selected hashtags across the three timeframes to identify the maneuvers each stance represented in bot activity and community engagement on Twitter during the key phases of the Russia-Ukraine conflict.

BEND results normalized for hashtags: Pro-Ukraine Stance - #putinhitler and Pro-Russian Stance - #naziukraine during the Kherson counteroffensive

The Russian invasion, as shown in Fig.  15 , highlights the predominant themes during that time through the #istandwithukraine and #istandwithrussia hashtags.

For the pro-Ukraine stance, the Excite maneuver is prominent, suggesting a focus on eliciting positive emotions like joy and happiness to boost morale and support. The Engage maneuver follows, indicating efforts to increase the topic’s relevance, sharing impactful stories, and suggesting ways for the audience to contribute to the cause.

Conversely, the Dismay maneuver is also significant, indicating a strategy to invoke worry or sadness about the invasion’s impacts. This humanizes the conflict, attracting global empathy and support for Ukraine by highlighting the gravity of the situation and the suffering of the Ukrainian people.

For the pro-Russian stance, the dominant maneuver is Dismay, aiming to evoke negative emotions like worry or despair, potentially to demoralize or create a sense of hopelessness regarding the situation in Ukraine. The Distort maneuver suggests an attempt to manipulate perceptions, promoting pro-Russian viewpoints while questioning the legitimacy of Ukrainian narratives. The Excite maneuver is also prevalent, indicating efforts to rally support by justifying Russia’s actions and uniting pro-Russian communities under sentiments of patriotism or anti-Western sentiment.

The strategic deployment of these maneuvers highlights the sophisticated use of social media as a battleground for psychological and narrative warfare. Pro-Ukraine bots focus on building support and maintaining positive sentiment, while pro-Russian bots concentrate on narrative manipulation and fostering negative emotions to influence opinions.

During the mid-point of the war, when Russia escalated its military efforts as shown in Fig.  16 , there was a notable shift in topics from both pro-Ukraine and pro-Russian standpoints. Key themes include NATO engagement by the Russian state and criticisms of Vladimir Putin by Ukraine. We analyzed the hashtags #putinwarcriminal and #stopnato .

For the pro-Ukraine stance, the Excite maneuver maintains positive sentiment by highlighting Ukrainian resilience and rallying international support. The Engage maneuver keeps the conflict relevant to international observers, sharing developments and ways to contribute. The Explain maneuver counters misinformation with detailed clarifications. There is also a transition to Dismay, Distort, and Distract maneuvers, invoking concern about Russia’s intensified actions and amplifying perceived threats and injustices. Pro-Ukraine bots focus on preserving Ukraine’s integrity and maintaining support by highlighting resilience and humanitarian efforts.

For the pro-Russian stance, the prominent maneuver is Neutralize, aiming to dismantle opposing narratives. This is followed by the Negate maneuver, minimizing Ukrainian actions. The Distract maneuver shifts the conversation away from Ukrainian narratives to topics like NATO, aligning the Russian state’s narrative against NATO. Dismay and Distort evoke fear and anxiety, promoting the idea that NATO’s lack of intervention showcases its ineffectiveness. While less prominent, Excite and Engage maneuvers foster a sense of righteousness about Russia’s actions, portraying them as necessary for security against NATO.

These maneuvers indicate a deliberate narrative clash. Pro-Ukraine bots engage the global audience and clarify misinformation, while pro-Russian bots undermine Ukraine’s stance and frame NATO negatively. Pro-Russian bots adopt a defensive strategy, seeking to invalidate and overshadow pro-Ukrainian narratives. This phase reflects the heightened information warfare, with both sides vying for the psychological upper hand.

Moral foundations found in topic modeling results, in expressing attitudes toward the Russian-Ukraine conflict from a pro-Ukraine stance

Moral foundations found in topic modeling results, in expressing attitudes toward the Russian-Ukraine conflict from a pro-Russian stance

During the Kherson counteroffensive, bot activity intensified, highlighting the narrative combat with both sides accusing each other of Nazism and terrorism, and comparing Putin to Hitler, as shown in Fig.  17 .

For the pro-Ukraine stance, the Excite maneuver is prominent, promoting positive emotions like triumph and optimism about the counteroffensive, energizing supporters and reinforcing narratives of Ukrainian resilience and success. Dismay is also significant, evoking concern and sadness about the conflict to sustain international attention and highlight perceived Russian aggression. The use of Distract shifts focus to Putin’s actions and his similarities to Hitler, framing Russian leadership negatively. The Back maneuver reinforces the effectiveness of these narratives.

For the pro-Russian stance, Dismay leads, instilling fear and portraying the counteroffensive as provocative or violent, akin to historical Nazism. Distort is extensively used to manipulate narratives, justifying Russian actions and recasting the Ukrainian counteroffensive as illegitimate. Neutralize and Negate aim to undermine pro-Ukrainian narratives, reducing their significance or credibility. The Boost maneuver enhances the appearance of widespread support for Russia’s stance by increasing connectedness among pro-Russian groups.

The use of #putinhitler and #naziukraine by both sides indicates a heated exchange of historically charged accusations. The BEND maneuvers reveal a strategy where both sides defend their actions while actively delegitimizing the other through historical parallels, creating a polarized and emotionally charged information warfare campaign. This phase underscores the strategic use of social media to shape global perceptions and gather support for respective causes.

Overall, the BEND maneuvers demonstrate the dynamic and strategic use of social media by both pro-Ukraine and pro-Russian bots. Throughout these key phases, the consistent use of emotionally charged narratives highlights the sophistication of modern information warfare, where shaping perceptions and emotions is crucial to influencing public opinion and international policy.

4.4 Moral maneuvers: the strategic use of ethics in Russia–Ukraine social media campaigns

Applying the dataset to the Moral Foundations Theory (Graham et al. 2013 ) displays the emotional complexities underlying the Russian-Ukraine conflict (Schuman 2018 ). This theory, encompassing dimensions like Care/Harm, Fairness/Cheating, Loyalty/Betrayal, Authority/Subversion, Sanctity/Degradation, and Liberty/Oppression, illustrates the nuanced moral landscape of the conflict.

Pro-Ukraine Analysis

The analysis of pro-Ukraine stance, as depicted in Fig.  18 , highlights the evolving narrative within the bot community. The increasing emphasis on the Care Foundation throughout the selected timeframes shows an online rally of support for the Ukrainian people, fostering solidarity and compassion for their plight. The Harm Foundation shows a minor presence initially, spikes sharply during the military escalation, and then diminishes during the counteroffensive, mirroring the real-time reactions to unfolding events.

Loyalty remains a significant theme, peaking at the midpoint of the conflict, emphasizing unity and steadfastness in support of Ukraine. The minor presence of the Betrayal Foundation suggests that narratives of disloyalty are not a focal point, maintaining a consistent push for solidarity through supportive hashtags.

Moral foundations found in topic modeling results, in expressing attitudes toward the Russian-Ukraine conflict from pro-Ukraine tweets and pro-Russian stance tweets

The consistently high presence of the Authority Foundation, particularly during the midpoint escalation, reinforces the legitimacy of Ukrainian sovereignty. The slight decrease during the counteroffensive indicates a perceived restoration of authority through Ukrainian advances. The Subversion Foundation continually increases across all three timeframes, showing how bots increasingly challenge the established power structure, particularly targeting the Russian state and Vladimir Putin.

The Sanctity Foundation remains consistently low, suggesting that moral purity or sacredness is not heavily invoked. However, the high and increasing presence of Degradation, especially during the counteroffensive, indicates a strategic amplification of messages framing the opposition’s actions as morally reprehensible.

The increasing emphasis on Care, alongside the strategic use of other foundations, suggests a concerted effort to shape public sentiment toward empathy for Ukraine and condemnation of Russian actions. This bot-driven narrative could significantly influence public opinion and the global moral compass regarding the conflict, highlighting the role of automated social media agents in constructing the moral narrative within geopolitical events.

Pro-Russian Analysis

The Moral Foundation Theory applied to the pro-Russian stance, as seen in Fig.  19 , shows a coordinated narrative by bots aimed to legitimize the Russian state and undermine Ukraine. The dataset indicates a moderate presence of the Care Foundation in the pro-Russian narrative, with an increase during the midpoint of the conflict. This reflects a strategic focus on humanizing the Russian cause and emphasizing care for Russian nationals and Russian-speaking communities in Ukraine. The Harm Foundation follows a similar trajectory but with greater intensity, suggesting a narrative that frames Russia’s actions as necessary to prevent greater harm.

Loyalty is highlighted from the beginning and spikes at the midpoint, consolidating support for Putin’s military campaign. The near absence of Betrayal, especially after the invasion phase, suggests that the bots aim to maintain a narrative of unity and cohesion within Russia.

Authority is consistently invoked, dipping during the midpoint, reflecting challenges to Russia’s authority during heightened military actions. The increase during the counteroffensive phase represents a reclaimed narrative of Russia reasserting its power. The Subversion foundation is moderately high throughout, aligning with the portrayal of Russia countering the subversion of its interests and those of Russian-speaking communities.

Sanctity is not a dominant theme, indicating that bots do not heavily rely on notions of purity or sacredness. However, Degradation is consistently employed to degrade the moral standing of Ukraine, framing its actions and Western support as morally reprehensible. This consistent use of hashtags by Russian bots degrades NATO, its members, and the Ukrainian government.

The bot-driven moral narrative supporting Russia shows the advanced use of moral foundations to justify and legitimize Russian military actions, portraying Russia as a protective and liberating force. This manipulation of moral rhetoric by bots significantly impacts public perception and discourse, highlighting the critical role of determining the sources and intentions behind digital narratives, especially in the context of international conflict.

Moral Realism Tweet Analysis

Both pro-Ukraine and pro-Russian tweets leverage moral foundations but in markedly different ways, each tailored to validate their stance and vilify the other as seen in Fig.  20 . The use of moral rhetoric is indicative of moral realism within the digital space of information warfare, where bots amplify their perceived objective morality of a cause to influence public perception.

The pro-Ukraine narrative emphasizes the harm inflicted on civilians and the care for human life, positioning the Russian state as an aggressor comparable to historical tyrants like Hitler. This portrayal is designed to elicit empathy and support for Ukraine, framing the conflict as unjust aggression. Conversely, the pro-Russian narrative emphasizes protective measures by Putin’s regime to bring Russian speakers in Ukraine back to Russia, suggesting their military actions are necessary to prevent greater harm. This dual interpretation of care and harm showcases a conflict over the moral justification for war.

Emphasizing loyalty, pro-Ukraine tweets unify support against Russian aggression, casting pro-Russian stance as criminal. Pro-Russian tweets, however, depict the Ukrainian government as Nazi-like and corrupt, betraying historical Russian unity. This narrative seeks to justify Russian intervention as a defense against betrayal.

Pro-Ukraine tweets uphold the authority of the Ukrainian government, denouncing Russian subversion. Conversely, pro-Russian tweets present Russia as a stabilizing authority against the subversive influence of NATO and the allegedly Nazi-sympathetic Ukrainian government. These narratives demonstrate a battle over legitimate power and authority, each side striving for moral high ground.

Pro-Ukraine tweets highlight Russian war crimes, calling attention to moral and ethical degradation. Meanwhile, pro-Russian tweets condemn Ukraine and NATO as corrupt. This highlights each side’s attempt to claim the moral high ground.

The strategic use of moral foundations in bot-generated tweets aims to shape public opinion by portraying each side as morally superior. This manipulation of moral values in social media narratives significantly impacts the global perception of the Russian-Ukraine conflict, potentially affecting international policy, humanitarian aid, and military support.

These narratives, steeped in moral realism, provide each side with an appearance of objective moral truth, asserting that their actions are justified and necessary. The result is an online battleground where moral values are weaponized to validate conflict, sway public sentiment, and garner international support. The influence of these tweets lies in their ability to shape the moral compass of the international community, thereby affecting real-world outcomes of the conflict.

5 Limitations and Future Work

While this study provides valuable insights into the deployment of bot-generated narratives during the Russia-Ukraine conflict, several limitations should be acknowledged:

Language Restriction Our dataset was limited to English-language tweets. This excludes non-English discourse, which might present different perspectives or intensities in sentiment analysis, particularly in regions directly affected by the conflict. The linguistic focus potentially overlooks the full scope of the international conversation surrounding the conflict.

Future Work Future research could include a multilingual dataset, analyzing Russian, Ukrainian, and other relevant languages. This would provide a more comprehensive view of the global discourse on the conflict and offer insights into regional perspectives.

Keyword Dependency The curated dataset relied on specific keywords related to the conflict. This method might omit relevant discussions that do not utilize these keywords, thus potentially narrowing the breadth of the captured narrative and overlooking subtler, yet significant, aspects of the conversation.

Future Work Following studies can employ more diverse and sophisticated data collection methods, such as semantic analysis or machine learning algorithms, to capture a broader range of discussions associated to the conflict, beyond those defined by specific keywords.

Bot-Generated Content Focus Concentrating exclusively on bot-generated content provides insights into the strategies of information warfare but it does not account for human users. The influence of human user engagement, which can counter or endorse bot narratives, is therefore not considered in this analysis.

Future Work Future research should include a comparative analysis of human and bot interactions on social media. This would show how human users respond to, amplify, or counteract bot-driven narratives, providing a more holistic understanding of the digital landscape during conflicts.

Potential Biases The selection of tweets based on keywords and the identification of bots could be influenced by the inherent biases in the algorithms used. These biases may affect the dataset’s overall analysis for our results in conducting sentiment analysis.

Future Work To mitigate this, future research should involve the examination and adjustment of algorithmic biases. Employing a diverse range of algorithms for data collection and analysis, and validating results with expert human analysis, could enhance the accuracy and reliability of the findings.

Time Frame Segmentation While temporal segmentation allows for an in-depth examination of critical events and periods, it may not capture the evolving nature of the discourse outside these high-impact timeframes. Subsequent developments post-August 2022 are not shown, which might alter the trajectory of the narratives.

Future Work Continued research should focus on a longitudinal study that spans a more expanded period, possibly including real-time analysis. This would allow for tracking the evolution of narratives over time, providing insights into the long-term effects of information warfare strategies and the resilience of various narratives.

6 Conclusion

Our analysis discovered that bot-driven strategies significantly shaped the social media narrative of the Russian-Ukraine conflict. These strategies, executed on Twitter, effectively amplified specific narratives, swayed public opinion, and created a polarized information environment. Bots were strategically deployed to push pro-Ukraine or pro-Russian stances, using emotional appeals, moral justifications, and targeted messaging to influence public opinion and global perceptions.

Influence on Digital Propaganda and Counter-Narratives

Topic modeling analysis uncovered the underlying themes and narratives propagated by bot communities. It highlighted the strategic use of language and themes that aligned with the conflict’s phases. Pro-Ukraine and pro-Russian bots selectively amplified themes like humanitarian concerns, historical antagonisms, and nationalistic sentiments to sway public opinion and create a polarized digital environment.

The BEND framework provided a nuanced understanding of the narrative and community maneuvers employed by both sides. Pro-Ukraine bots utilized positive community-building tactics and narrative enhancement strategies, rallying support and maintaining a positive portrayal of Ukraine. In contrast, pro-Russian bots utilized negative maneuvers to undermine the pro-Ukraine narrative, fostering negative sentiments and distorting perceptions in favor of Russian actions.

The moral realism aspect of the study provided insight into the ethical and moral justifications of both sides. Pro-Ukraine tweets emphasized the Care/Harm and Fairness/Cheating foundations, portraying Ukraine as a victim of unjust aggression and rallying global empathy. Pro-Russian tweets focused on the Authority/Subversion and Loyalty/Betrayal foundations, framing Putin’s actions as protective and necessary for the security of Russian-speaking communities. This manipulation of moral rhetoric was a critical component of information warfare, providing each side with a semblance of moral high ground and objective justification for their actions.

Implications for Political and Democratic Landscapes The implications of these bot-driven strategies on Ukraine’s political and democratic processes, as well as in the wider geopolitical context, are profound:

Narrative Control and Public Perception The ability of bots to attempt to manipulate narratives and public perception represents a significant evolution in the tools of modern warfare. This manipulation has explicit consequences for political decision-making, both within Ukraine and in the international community, influencing policy and response strategies.

Polarization and Democratic Processes The polarized narratives propagated by bots pose challenges to democratic processes and institutions. By manipulating public opinion through one-sided narratives and emotional applications, these strategies can challenge democratic discussions, making it difficult for citizens to participate in informed and factual discussions.

Moral and Ethical Implications The study’s findings on moral realism and the use of moral justifications in digital narratives stress the ethical intricacies of modern information warfare. The exploitation of moral values to justify actions can have widespread implications on international policy and humanitarian responses.

Implications for the Geopolitical Arena In the wider geopolitical context, the study illustrated the emerging complexity of digital warfare and its implications:

Evolution of Warfare The conflict highlighted the evolution of warfare on social media platforms, where control for narratives and public opinions are as critical as physical conflicts.

Global Perception Management The study highlighted the growing importance of perception management in international relations. The ability to control narratives through social media means has become a powerful tool in the geopolitical toolkit.

Challenge to Democratic Values The manipulation of information and the creation of echo chambers pose significant challenges to democratic values. The spread of disinformation and digital propaganda erodes confidence in democratic processes and institutions.

Bot-driven strategies have profoundly influenced the social media platforms of digital propaganda and counter-narratives. These strategies have not only shaped the immediate narrative dynamics of the Russian-Ukraine conflict but also hold significant consequences for the political and democratic processes in Ukraine. This study emphasizes the importance of recognizing and understanding digital propaganda’s role in geopolitical conflicts, highlighting the need for strategies to counteract these influences and protect democratic values within the digital medium of modern warfare.

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Acknowledgements

This research for this paper was supported in part by the following organizations and grants: Scalable Technologies for Social Cybersecurity (W911NF20D0002 US Army) and the Scalable Tools for Social Media Assessment (N000142112229 Office of Naval Research). This material is based upon work supported by the U.S. Army Research Office and the U.S. Army Futures Command under Contract No. W519TC-23-F-0055. The content of the information does not necessarily reflect the position or the policy of the government and no official endorsement should be inferred.

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Appendix A: Annotations of Stances

Appendix B: Annotations of Users being Bots

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Marigliano, R., Ng, L.H.X. & Carley, K.M. Analyzing digital propaganda and conflict rhetoric: a study on Russia’s bot-driven campaigns and counter-narratives during the Ukraine crisis. Soc. Netw. Anal. Min. 14 , 170 (2024). https://doi.org/10.1007/s13278-024-01322-w

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