Individual and collective determinants of mental health during wartime. A survey of displaced populations amidst the July–August 2006 war in Lebanon

Abstract

It is well known that war has negative effects on the mental health of civilian populations. However, different perceptions and reactions to trauma have different impacts on the psychological well-being of affected populations. This study assessed the mental health status of adult internally displaced persons (IDPs) at an early stage of the summer 2006 war in Lebanon, and investigated the relationship between their mental status and socio-demographic determinants, and individual and collective experiences of the war. Two hundred and eighteen IDPs were surveyed for the prevalence and determinants of acute trauma symptoms. The reporting of anxiety symptoms was assessed using a version of the Hamilton Anxiety Rate Scale that was translated into Arabic.

The prevalence of self-reported anxiety symptoms was relatively low, at 25.8%. After adjustment, the outcome variable was significantly associated with being female (OR=2.9), experiencing bombing while fleeing (OR=2.8) and being surveyed in days of bad political news (OR=2.7). Factors related to displacement circumstances and coping strategies showed no significance. This result suggests that individual and collective war experience had an equal importance in predicting anxiety. This study recommends the consideration of factors operating at a collective level for better understanding civilians’ mental health in times of war.

Keywords:

• mental health
• displaced
• Lebanon 2006 war

Acknowledgements

The authors would like to thank Huda Zurayk, who was Dean at the time of this study, and the students of the Faculty of Health Sciences at the American University of Beirut, for material, theoretical and logistic support, and Iman Nuwayhid, Afamia Kaddur, Farah Barbir and Nabil Tabbal for useful comments. The authors would also like to acknowledge the efforts of volunteers from the Sanayeh Relief Centre – Samidoun who participated in the data collection in extremely difficult circumstances.

Notes

1. For the last two decades, the influence of Hezbollah, a Shiite political party claiming the ideal of armed resistance against Israel, increased among the Lebanese Shiite community. On the eve of the July 2006 war in Lebanon, both Hezbollah and Amal, an elder sectarian political party, shared the leadership over this community, and have been almost exclusively winning parliament seats reserved for Lebanese Shiites.

2. Samidoun is a grassroots, student volunteer relief movement that was launched the first day of the war and is still operational.