Tracking Resilience in Syrian Refugee Children and Adolescents

Background

How do refugee children adapt to war and displacement?

The Syrian conflict has displaced millions, half of whom are children. These young people have often witnessed violence, lost their homes, and now live in unstable refugee settlements. Some struggle with mental health issues like PTSD and depression, while others show surprising strength. Understanding what drives this resilience can help us better support children facing extreme hardship and inform intervention.

 

What were the aims of this study?

Tracking mental health over time in refugee children

Researchers aimed to explore how mental health in Syrian refugee children changed over a year and to identify which factors predicted improvement or deterioration. The aim was to discover what supports or undermines children’s resilience in one of the world’s most vulnerable populations.

 

How was this study carried out?

A year-long study in Lebanon’s refugee camps

The study followed 982 Syrian children aged 8–16 and their caregivers in Lebanon’s Beqaa region. Researchers interviewed participants twice, a year apart, using structured questionnaires to assess mental health (PTSD, depression, behaviour), well-being, and other psychological and social factors. Children were grouped into four categories: stable high risk, improving, deteriorating, or stable low risk for mental health issues. Analysis involved comparisons across these groups and used cross-lagged panel models (CLPMs) to examine which factors predicted changes in symptoms and vice versa. Interviews were conducted in Arabic, and all tools were adapted to be culturally appropriate.

 

What were the key findings?

Resilience as a dynamic trait

The children’s mental health changed significantly over the year.

Over half (56%) stayed in the high-risk group, but nearly a quarter (24%) improved, showing fewer signs of PTSD, depression, or behavioural problems. Around 10% worsened, and just 9% remained consistently low-risk throughout the year.

Children who improved tended to have better relationships at home, including more maternal acceptance and less psychological control. These social and family factors were more important than individual traits like optimism. The researchers also found that mental health was a two-way street: a child’s distress could affect their caregiver’s wellbeing and parenting, and vice versa.

Researchers found:

• Maternal acceptance helped reduce child symptoms over time.

• Higher self-esteem predicted fewer future problems—and children with fewer problems felt better about themselves.

• Caregiver depression and child maltreatment predicted higher child symptoms, but the reverse was also true—children’s struggles worsened their caregivers’ mental health and parenting behaviours.

• Children’s distress increased their experiences of loneliness, bullying, and parent–child conflict.

These findings show that resilience is dynamic and deeply influenced by the family environment. Children’s wellbeing can both shape and be shaped by those around them.

What are the implications of this research?

Supporting refugee children begins with strengthening their support systems

This study demonstrates that resilience in refugee children is not a static trait, but one that evolves in response to their social environment – particularly the quality of family relationships and caregiver wellbeing. Interventions that focus solely on the child are unlikely to be sufficient. Instead, approaches that address caregiver mental health, parenting practices, and family dynamics are essential to support positive outcomes. The bidirectional nature of mental health between children and their caregivers further reinforces the importance of targeting the family system as a whole.

Additionally, improvements in living conditions and access to social support can play a vital role in promoting resilience. Overall, a systemic and relational approach is key to effectively supporting the mental health of displaced children.

About the study team

This study was carried out by a team of experts in psychology, including Cassandra Popham (Queen Mary University of London), Fiona McEwen (Kings College London), Elie Karam, J. Fayyad and G.Karam (IDRAAC, Balamand University), D. Saab (IDRAAC), Patricia Moghames (IDRAAC) and Michael Pluess (University of Surrey).