Social support, resilience, and mental health in a low-intensity warfare context: the effects of siege on university students in Gaza

Abstract

Background

Gaza has long been enduring a quasi-total siege that significantly undermines quality of life in the region. Gazan youth are particularly affected by the ongoing economic recession, a disrupted environment, and health and food insecurity. These critical circumstances are worsened by the ongoing conflict between Palestine and Israel, which is a cause of death and destruction.

Aims

This cross-sectional study investigated the effects of living under protracted siege conditions on mental distress, resilience, and social support among a sample of Palestinian university students living on the Gaza Strip.

Methods

Five hundred fifty Palestinian university students were recruited at four universities in Gaza. They completed a battery of instruments, including the Gaza Siege Checklist, Depression, Anxiety and Stress Scale (DASS), Resilience Scale (RS), and Berlin Social Support Scales (BSSS). We used structural equation modelling (SEM) to test a conceptual model of social support and resilience as protective factors against the impact on mental distress of living under siege.

Results

Our findings indicate that living under siege has direct adverse effects, leading to increased mental distress in the form of anxiety, depression, and acute stress. Enduring siege conditions compromises resilience and sources of social support, thereby increasing subjects' risk of developing psychological distress.

Keywords:

• Siege
• mental health
• resilience
• social support
• war
• military violence

Ethical approval

The research followed Helsinki ethic principles and was approved by Helsinki ethic committee at MoH in Gaza with protocol n. PHRC/HC/284/17.

Author contributions

GV, AK, MD, research planning, article writing. AP, GV: Data analysis, article writing and revision; Final revision: GV, AP, MD, YA, AK. Competing interests: The authors declare that they have no competing interests.

Disclosure statement

No potential conflict of interest was reported by the author(s).