Prevalence and Predictors of Post-Traumatic Stress Disorder Among Displaced Children in East Mediterranean Conflict Zones: A Multi-Nation Cross-Sectional Study

James Walker¹, Olivia Bennett², Samuel Green³

Abstract

Armed conflict and forced displacement have significantly disrupted the lives of millions of children across the Eastern Mediterranean region. This cross-sectional study investigated the prevalence and key predictors of post-traumatic stress disorder (PTSD) among 1,382 displaced children aged 6–17 years residing in refugee camps across Syria, Lebanon, and Sudan between 2022 and 2024.

PTSD symptoms were assessed using the Child PTSD Symptom Scale (CPSS), and trained mental health professionals conducted clinical interviews. Of the total sample, 46.3% met the criteria for probable PTSD. The prevalence was highest among children aged 10–13 (52.1%) and among females (49.6% vs. 42.7% in males, p = 0.008).

Key trauma exposures included witnessing violence (71.4%), death of a family member (38.6%), and personal injury (24.9%). Children exposed to three or more traumatic events had a 4.2-fold increased risk of PTSD (OR = 4.21, 95% CI: 3.32–5.34). Those without parental presence had a significantly higher PTSD rate (62.8%) compared to those accompanied by at least one caregiver (39.5%, p < 0.001).

Protective factors included participation in school (PTSD prevalence: 38.2% in school-enrolled vs. 54.6% in non-enrolled, p < 0.001) and access to psychosocial support services. Multivariate regression identified age, trauma load, parental loss, and school absence as independent predictors of PTSD (model AUC = 0.89).

This study provides the largest regional dataset to date on mental health in displaced children, underscoring the urgent need for integrated psychosocial support and education access within refugee settings. Tailored mental health interventions targeting school-aged displaced children could mitigate the long-term psychological impact of war-related trauma.