{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:00:48Z","timestamp":1791255648663,"version":"4.1.0"},"reference-count":51,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"unspecified","delay-in-days":165,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD083387"],"award-info":[{"award-number":["R01HD083387"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2045796022000191_sec_a1\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Children's responses to war and displacement are varied; many struggle, while others appear resilient. However, research into these outcomes disproportionately focuses on cross-sectional data in high-income countries. We aimed to (1) investigate change in resilience across two timepoints in a highly vulnerable sample of Syrian refugee children in Lebanon, and (2) explore predictors of their mental health problems across time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796022000191_sec_a2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 982 Syrian child\u2013caregiver dyads living in refugee settlements in Lebanon completed questionnaires via interview at baseline and follow-up one year later. We categorised children into groups based on their risk for mental health problems across both timepoints (stable high risk\/SHR, deteriorating, improving, stable low risk) according to locally validated cut-offs on measures of post-traumatic stress disorder (PTSD), depression and behavioural problems. Analyses of covariance identified how the groups differed on a range of individual and socio-environmental predictors, followed up by cross-lagged panel models (CLPMs) to investigate the directionality of the relationships between significantly related predictors and symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796022000191_sec_a3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample showed a meaningful amount of change in mental health symptoms from baseline to follow-up. Over half (56.3%) of children met SHR criteria and 10.3% deteriorated over time, but almost one-quarter (24.2%) showed meaningful improvement, and 9.2% were consistently at low risk for mental health problems at both timepoints. Several predictors differentiated the groups, particularly social measures. According to CLPMs, maternal acceptance (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = \u22120.07) predicted child mental health symptoms over time. Self-esteem (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = \u22120.08), maternal psychological control (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.10), child maltreatment (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.09) and caregiver depression (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.08) predicted child symptoms and vice versa (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>se<\/jats:sub>\n                      = \u22120.11,\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>b<\/jats:sub>\n                      = 0.07,\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>mpc<\/jats:sub>\n                      = 0.08,\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>cm<\/jats:sub>\n                      = 0.1,\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>cd<\/jats:sub>\n                      = 0.11). Finally, child symptoms predicted loneliness (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.12), bullying (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.07), perceived social support (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = \u22120.12), parent\u2013child conflict (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.13), caregiver PTSD (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.07), caregiver anxiety (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.08) and the perceived refugee environment (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = \u22120.09).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796022000191_sec_a4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results show risk and resilience are dynamic, and the family environment plays a key role in children's response to war and displacement. Conversely, children also have a significant impact on the family environment and caregiver's own mental health. Interventions to promote resilience in refugee children should therefore consider family-wide mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s2045796022000191","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T04:47:48Z","timestamp":1655268468000},"source":"Crossref","is-referenced-by-count":25,"title":["The dynamic nature of refugee children's resilience: a cohort study of Syrian refugees in Lebanon"],"prefix":"10.1017","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2418-3097","authenticated-orcid":false,"given":"C. M.","family":"Popham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. 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