Investigating the Predictors of Psychological Risk and Resilience among Syrian Refugee Children

Background 

Refugee children face the trauma of war and continuous adversity, yet some demonstrate resilience, maintaining their mental well-being 

The Syrian conflict, ongoing since 2011, has displaced over five million people, with children comprising half of this population. These children have endured profound trauma, including violence, loss of loved ones, and the hardships of poverty.  Previous research has identified individual factors (e.g., coping strategies) and social influences (e.g., parenting) that can either buffer or exacerbate the impact of such trauma. However, refugees living in informal settlements and in low- and middle-income countries remain underrepresented in this research. This raises important questions about the true nature of refugee children’s resilience, which is crucial for improving interventions and achieving better outcomes for displaced children. 

 

What were the study aims? 

Identifying the individual and social factors influencing resilience

This study aimed to firstly determine how many Syrian refugee children display resilience (i.e. low risk for mental health problems) despite war exposure and to identify the individual and social factors distinguishing resilient children from those facing mental health challenges in the same war context. Understanding such factors can help to promote resilience and prevent mental health problems through intervention. 

 

How was the study carried out? 

Cross-sectional data were collected from families displaced in Lebanon

The study involved 1,528 Syrian refugee children aged 8–16 years living in informal tented settlements (ITS) in Lebanon. Conducted in 2017–2018, it assessed trauma exposure through the War Events Questionnaire (WEQ) and mental health using validated tools for PTSD, depression, and externalising behaviour. 

Children were grouped as: 

• Low Symptoms (LS): Scoring below clinical cut-offs for all mental health measures. 

• High Symptoms (HS): Scoring above the cut-off for at least one measure. 

LS and HS children were matched by age, gender, trauma exposure, and time since displacement to ensure that differences were not solely due to varying trauma levels. Statistical analyses identified predictors such as self-esteem, coping strategies, and caregiver mental health. 

 

What were the key findings? 

Resilience is rare but promoted by key individual and social factors

Only 19.3% of the children met the resilience criteria, showing no significant symptoms of PTSD, depression, or externalising behaviour despite experiencing an average of 10 traumatic events. 

In terms of individual factors, resilient children reported higher self-esteem and optimism, helping them adapt to their experiences. Children with high environmental sensitivity – those acutely affected by their surroundings – were more likely to face mental health challenges, as were those with poor general health. Surprisingly, even typically positive coping strategies, like problem-solving or seeking support, were linked to the HS group. This suggests these strategies may be less effective in overwhelming circumstances. 

As for social factors, relationships played a critical role in resilience. Resilient children had stronger social support and fewer negative experiences like bullying and loneliness. Conversely, children in the HS group were more likely to experience child maltreatment, maternal psychological control, and caregiver mental health issues, such as PTSD and depression. Further, Caregiver well-being was a key determinant, highlighting the ripple effects of parental mental health on children. 

 

What are the implications of this research? 

Multi-dimensional interventions are key for support refugee children’s mental health

Support at both individual and social levels is crucial for promoting resilience among refugee children and preventing future mental health problems. 

On an individual level, programs that promote self-esteem and optimism can provide children with tools to navigate adversity. Educational initiatives and therapy that foster positive self-concepts are especially promising. Creating stable, nurturing environments can also benefit children with heightened environmental sensitivity. Strengthening social networks within refugee communities is equally important, as it can help combat loneliness and isolation. 

Additionally, supporting caregivers is critical. Addressing caregiver PTSD and depression can improve the home environment and positively impact children’s mental health. Parenting programs that promote positive practices may help reduce risks related to maltreatment or controlling behaviours. 

The findings of this study are relevant not only to Syrian refugees but also to displaced populations worldwide, offering valuable insights into how resilience can be nurtured in children facing profound adversity. 

 

About the study group 

The study was conducted by a team of experts in psychology and mental health including; Cassandra M. Popham, Fiona S. McEwen and Michael Pluess from Queen Mary University of London; Dahlia Saab from IDRAAC Lebanon; Elie Karam, John Fayyad and Georges Karam from IDRAAC and Balamand University and Patricia Moghames from Medecins du Monde, Lebanon.