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Cited by 108Migration, Health and TraumaMaternal Mental Health During Pregnancy and PostpartumPosttraumatic Stress Disorder Research

Modeling the effects of war exposure and daily stressors on maternal mental health, parenting, and child psychosocial adjustment: a cross-sectional study with Syrian refugees in Lebanon

Open access
Sim, Amanda, Bowes, Lucy, Gardner, Frances·2018·Global Mental Health
DOI 10.1017/gmh.2018.33PMC PMC6315283
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Abstract

Background.: The psychological effects of war trauma are well-documented, but comparatively little research has focused on the mechanisms underlying intergenerational impacts of war and displacement. Specifically, the effects of armed conflict on family processes such as parenting behavior, and subsequent impacts on child psychosocial outcomes, are less understood. Methods.: This study tests a conceptual model linking past war trauma and current displacement-related stressors to maternal mental health, parenting behavior, and child psychosocial problems. Cross-sectional data were collected in 2016–2017 from a sample of 291 Syrian refugee mothers in Lebanon. We used structural equation modeling to examine associations between war trauma, daily stressors, mothers’ general psychological distress and post-traumatic stress (PTS), negative parenting, and child psychosocial problems. Results.: Exposure to war-related events was directly associated with maternal PTS and general psychological distress, as well as indirectly via daily stressors. Mothers’ general psychological distress, but not PTS, was directly associated with negative parenting and child psychosocial difficulties. Negative parenting mediated the association between maternal general psychological distress and child psychosocial problems. Model fit statistics indicate that the measurement and structural models provided a good fit to the data. Conclusions.: Results suggest that the adverse effects of past war trauma and ongoing displacement on refugee mothers’ general mental health can increase the risk of negative parenting behavior, and in turn contribute to poorer psychosocial outcomes for children. Interventions should focus on psychosocial and parenting support for war-affected caregivers, as well as address structural challenges that debilitate caregiver and child mental health.

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  • These caregiving changes correspond with increased emotional and behavioral vulnerability in children, even in the absence of direct trauma exposure.

    “These caregiving changes correspond with increased emotional and behavioral vulnerability in children, even in the absence of direct trauma exposure (61, 62).”

    From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [61]

    The Results (Structural model testing; page unavailable) report an indirect association between maternal distress and child psychosocial difficulties through negative parenting. The paper does not establish that this association holds for children with no direct trauma exposure; its Discussion instead cites another study that found an association after accounting for children’s war trauma exposure. (LLM, conf=0.88)

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  • Chronic displacement is associated with caregiver psychological distress, emotional dysregulation, and reduced caregiving stability.

    “Chronic displacement is associated with caregiver psychological distress, emotional dysregulation, and reduced caregiving stability (61, 62).”

    From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [61]

    The Conclusions link ongoing displacement to poorer maternal mental health and increased risk of negative parenting; the Discussion reports associations between maternal psychological distress, parental rejection, and harsh punishment among Syrian refugee families. The paper does not establish emotional dysregulation or caregiving stability as distinct outcomes, and its findings do not establish the claim across displaced caregivers generally. (LLM, conf=0.83)

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Cited by

Sorted by citations

Authors
Sim, A., Bowes, L., & Gardner, F.
Affiliations
University of Oxford (GB)
Corresponding author
Sim, Amanda
ORCID
Venue
Global Mental Health
Publisher
Cambridge University Press (CUP)
Published
2018
Volume
5
Pages
e40-e40
ISSN
2054-4251 (ISSN-L)
DOI
10.1017/gmh.2018.33
PMC
PMC6315283
OpenAlex
W2902753806
Cited by
108
References
10
Citations by year
2026: 14 · 2025: 13 · 2024: 20 · 2023: 18 · 2022: 20 · 2021: 6 · 2020: 14 · 2019: 1 · 2012: 1
FWCI
6.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Cambridge Prisms Global Mental Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • UNICEF
  • University of Cambridge
Topics
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
war trauma, Syrian refugees, maternal mental health, parental behavior, child psychosocial problems, daily hassles, displacement, post-traumatic stress, psychological distress, refugee mothers, Lebanon

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