Mindfulness in Posttraumatic Growth of War-Affected People: A Commentary on Expanding Oman’s Public Health Framework for Trauma Recovery in Ukrainian Contexts

Abstract This commentary responds to a recently published comprehensive framework for integrating mindfulness into global public health by evaluating its application to war-affected populations, with primary focus on the context of the Russian-Ukrainian war and Ukrainian populations. While Oman’s framework provides a valuable foundation for the integration of mindfulness within public health systems, we argue that it requires further development to adequately address the complex needs of combat veterans, volunteers, and civilians experiencing ongoing warfare. Drawing on recent developments in posttraumatic growth research and cognitive behavioral therapy, we propose enhancements to mindfulness-based interventions (MBIs) that incorporate interpersonal emotional connections called "attraction relationships"-encompassing companionship, friendship, romantic bonds, and family ties and nature-based activation as critical components. We further identify limitations of existing assessment tools and outline directions for culturally adapted interventions that more accurately reflect the lived realities of war in Ukrainian contexts. This commentary expands Oman’s framework by integrating interpersonal and environmental dimensions into trauma recovery. We identify “attraction relationships” as a significant socio-attentional environment (Axis A8) and a crucial meso-level structure (Axis A7). We argue that for war-affected populations, the restorative environment is no longer solely physical but may also be conditioned by interpersonal bonds that provide the social-ecological foundation for religious and spiritual factors (Axis A12) that foster posttraumatic growth.