Holman · Proceedings of the National Academy of Sciences of the United States of America 2024 · narrative review · n=?

It matters what you see: Graphic media images of war and terror may amplify distress.

Cited 31 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and commentary synthesizing prior literature without a systematic review protocol.

PubMed 38968094 · doi:10.1073/pnas.2318465121 · record verified 2026-08-31

What was done

The authors conducted a narrative review examining published literature on the relationship between exposure to graphic media imagery of terrorism and war (such as 9/11, the Boston Marathon bombings, and the 2023 Israel-Gaza war) and psychological distress, discussing public health and media literacy implications.

What was found

The abstract reports no numerical values, effect sizes, or confidence intervals. It states that heavy daily media exposure after the Boston Marathon bombings correlated more strongly with acute distress than direct exposure, that graphic image viewing independently predicts stress symptoms and poorer functioning across events, and that exposure and distress appear to form a mutually reinforcing cycle over time.

Why it matters

It highlights that graphic digital media coverage of violence can act as an independent public health stressor for broad populations, emphasizing the need for public education and media literacy initiatives to reduce vicarious trauma.

Limits

The paper is an unsystematic narrative commentary without predefined search criteria, study counts, or risk-of-bias assessments. No quantitative data are reported in the abstract, and the underlying cited literature is primarily observational, precluding firm causal claims regarding the bidirectional exposure-distress relationship.

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