Beyond direct trauma: Vicarious exposure, media-induced stress, and external stress overload as emerging public mental health challenges

Figure 1 External stress overload: A conceptual framework for understanding indirect threat exposure and distress. The figure illustrates how repeated exposure to threat-related information may become psychologically burdensome when it is emotionally intense, difficult to disengage from, and combined with insufficient recovery. Cognitive processes such as intolerance of uncertainty and rumination, together with behavioral patterns such as repeated checking or doomscrolling, may help sustain distress over time. The framework also highlights the possible role of impaired recovery, including sleep disruption, in amplifying anxiety, emotional dysregulation, and broader functional effects. The model is intended as a clinical and public mental health framework and should not be interpreted as a formal diagnostic model.