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Social determinants of student mental health before and after the Beirut port explosion: two cross-sectional studies

Conflict and Health volume 19, Article number: 4 (2025) Cite this article

Abstract

Background

Students in Lebanon are facing the devastating impact of multiple national crises, including an unprecedented economic collapse and the Beirut port explosion that killed hundreds, injured thousands, and displaced hundreds of thousands of people. The aim of this study was to identify key social determinants of common mental health symptoms before and after the Beirut port explosion for students at the American University of Beirut, a university based around 4 km from the port.

Methods

Two cross-sectional studies were conducted using a representative sample of undergraduate and graduate students at the American University of Beirut. The study was conducted just before (Study 1) and repeated after the Beirut port explosion (Study 2).

Results

A total of 217 students participated (n = 143 in Study 1 and n = 74 in Study 2). In Study 1 before the explosion, poorer family functioning and social support were correlated with higher levels of depressive symptoms, but not with anxiety or trauma symptoms. Financial stress was correlated with depressive and trauma symptoms. In the partially adjusted regression model (adjusting for demographics), only financial stress was significantly associated with depressive symptoms. In the fully adjusted model (adjusting for adversity), financial stress was associated with depressive and anxiety symptoms. In Study 2 after the explosion, poorer family functioning and poorer social support were correlated with higher levels of depressive symptoms, while only poorer social support was correlated with higher levels of anxiety symptoms—trauma symptoms were not correlated with either. Financial stress was correlated with all symptoms. In the partially adjusted regression model, only financial stress was significantly associated with all symptom clusters. In the fully adjusted model, no variables were significant.

Conclusion

Findings indicate a detrimental impact of financial stress on the mental health of students in Lebanon, beyond the otherwise protective effects of family and social support, in the context of an unprecedented economic crisis and extremely high levels of distress after the explosion. Findings indicate that mental health interventions for college students in Lebanon should include addressing financial stress, and that further research is needed to identify protective factors during acute emergencies.

Background

Globally, one in eight young people suffer from mental health difficulties [1], while in Lebanon following the devastating Beirut port explosion the number is closer to two in three [2]. College students are particularly at risk of developing mental disorders [3], largely due to additional pressures like social isolation, financial stress, and academic pressure [4]. Risk and protective factors for college student mental health have helped to inform college-wide support for students, including free counselling, peer support and awareness campaigns [5]. However, little research has been done in low-and middle-income countries and in humanitarian settings, where students face even greater adversities. In addition, few studies have included interpersonal and family systems factors, despite strong evidence for the impact of family and friends on the mental health of this age group [6] especially in the Middle East where social networks are the cornerstone of everyday life [7].

Lebanon is a lower middle-income country, severely affected by a debilitating economic crisis and government corruption that has pushed two-thirds of the population into poverty [8], as well as reeling from the devastation of the Beirut port explosion. The largest non-nuclear explosion in history occurred on August 4, 2020, causing over 170 deaths, leaving more than 6500 people injured and displacing approximately 300,000 people [9]. The explosion was felt more than 120 km away in Cyprus [10]. The culminating effects of the port explosion, political corruption, and the economic crisis, exacerbated by the COVID-19 pandemic, have created a pervasive sense of uncertainty and anxiety throughout the country [11]. This has since been exacerbated by a 7.8 magnitude earthquake in neighbouring Syria in 2022 and the escalation of cross-border armed conflict with Israel since October 2023.

Even before these multi-layered crises, the prevalence of mental disorders in Lebanese adolescents and young adults was higher than the population average, at 26%, with only 6% accessing treatment [12]. College students at the American University of Beirut, the largest university in the country, reported an even higher level of distress, with 38% meeting criteria for major depression and 39% for generalised anxiety [13]. The impact of the economic crisis, as well as the COVID-19 pandemic, the Beirut port explosion, and socio-political insecurity are all likely to have further exasperated the mental health of students [11]. Community studies since the onset of the devastating devaluation of the local currency and following the Beirut port explosion have found even higher prevalence of mental health difficulties in adolescents [2] and adults [14]. In these studies, more than half of the population were suffering from anxiety and traumatic stress. Amongst college students, over a third of students at the American University of Beirut reported severe symptoms of depression and anxiety, and this was strongly associated with food insecurity [15].

The evidence for the social determinants of mental health—non-biological socio-economic factors linked to the aetiology or worsening of psychological health—is increasingly well supported. A recent review of social determinants identified strong evidence for the role of conflict, violence and maltreatment, life events and experiences, racism and discrimination, culture and migration, social interaction and support, structural policies and inequality, financial factors, employment factors, living conditions, and demographic factors, on mental health [16]. Research in low-and-middle income countries has long established the impact of poverty [17] and, in humanitarian contexts, of violence and conflict [18]. At the micro-system level, family functioning and social support have been found to have protective effects on mental health [19,20,21,22,23,24] and mitigate the effects of humanitarian emergencies [22, 23]. However, gaps remain in our understanding of social determinants of mental health for college students in such settings. Huggard et al. [16] advocates for further research to identify the impact of multiple social determinants and across time, to better understand their relationships and most importantly to inform targeted interventions and college policy.

This study, therefore, aimed to identify the differential associations of multiple determinants of mental health (social, family, and demographic characteristics), all of which have been under-researched in Lebanon and other settings affected by humanitarian emergencies, especially for college students. In addition, in response to the sudden-onset disaster of the Beirut port explosion during data collection, our additional secondary aim was to identify the differential impact before and after the explosion.

Methods

Study design

Two cross-sectional studies were conducted. In Study 1, before the port explosion, data collection took place from May 20th to the afternoon of August 4th, 2020. After the August 4th port explosion, we added additional questions with Institutional Review Board (IRB) approval, and continued data collection. Data collected after the port explosion, which we will refer to as Study 2, was collected from August 19th to October 21st, 2020. Data was split in this way because 1) the sample was no longer homogenous given the devastating impact of the explosion, and 2) it was a naturally occurring opportunity to observe differences between samples before and after a humanitarian disaster. The timeline of events and data collection are outlined in Fig. 1.

Fig. 1
figure 1

Timeline of events in Lebanon before and during data collection

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Participants

Participants were recruited from a random and representative sample of undergraduate and graduate students enrolled at the American University of Beirut (AUB) at the time of the study. The sample was identified independently from the research team by the Student Affairs office. In line with overall student numbers, 20% of the sample were graduate students. All students were included as long as they met the inclusion criteria of 1) enrolled at AUB as a graduate or undergraduate student, and 2) aged 18 years old or more (any gender or nationality). An online survey was first sent to a total of 1400 students in May 2020. Due to a low response rate, a further 1400 students—selected using the same criteria—were contacted in July 2020. After the port explosion, additional questions were added after an IRB amendment for all students completing the survey after the explosion. The invitation and reminder emails were also amended to acknowledge the impact of the explosion, and to signpost students to support systems in the university.

Measures

The full online survey was developed with multiple rounds of feedback from the Psychiatry Department, Counselling Centre, Department of Psychology and Student Affairs office. The survey consisted of 8 self-report questionnaires. The survey took approximately 20 min to complete, including the consent form and debriefing. The survey was delivered via LimeSurvey 3.0 in English.

Mental health and wellbeing

Depression symptoms were assessed using the Patient Health Questionnaire (PHQ-9) [25]. This 9-item self-report measure has been found to have high internal reliability with a Cronbach’s alpha of 0.86–0.89 [25]. In our study, Cronbach’s alpha was 0.81 in Study 1 and 0.87 in Study 2.

Anxiety symptoms were assessed using the General Anxiety Disorder Scale (GAD-7) [26]. This 7-item self-report measure has been found to have high internal reliability with a Cronbach’s alpha of 0.92 in the original developmental study, and 0.89 in subsequent-studies [27]. In our study, Cronbach’s alpha was 0.89 in Study 1 and 0.90 in Study 2.

Trauma symptoms were assessed using the Child Revised Impact of Events Scale (CRIES-8) [28]. Participants were asked to report how they felt in the past two weeks. Reports were not linked to any specific stressful life event. This 8-item self-report measure has good evidence of internal reliability, with a Cronbach’s alpha of 0.81–0.86 [29] including for adolescents and young adults [30]. In our study, Cronbach’s alpha was 0.86 in Study 1 and in Study 2.

Social and family characteristics

Social support was assessed using The Brief Social Support Scale (BS6) [31]. This 6-item self-report measure has good evidence of reliability, with a Cronbach’s alpha of 0.86 [31]. In our study, Cronbach’s alpha was 0.85 for Study 1 and 0.77 for the Study 2.

Family functioning was assessed using the General Family Functioning Subscale of the Family Assessment Device (FAD) [31]. This 12-item self-report measure has evidence of good internal reliability with a Cronbach’s alpha of 0.70 [32]. In our study, the Cronbach’s alpha was 0.93 for Study 1 and 0.89 for Study 2.

Demographic characteristics

Age, gender, and nationality were assessed with single item questions. Age was recorded as a continuous variable. Gender was recorded categorically as male, female, or other, with an option to specify. Nationality was recorded from a list of the most common nationalities and an option to write the nationality/ies if the option was not present. Due to low numbers of non-Lebanese students, categories were labelled as Lebanese or other in the analysis.

Financial stress was assessed using a single item designed for the study; ‘are you personally experiencing budget difficulties to make necessary payments?’ Students then rated their answers on a scale of 1–5, with 1 corresponding with “not at all,” and 5 corresponding with “a great deal”.

Proximity to explosion was assessed for students responding after 4th August (Study 2) and was designed for the study with a dual item; ‘were you in Beirut at the time of the August 4th port explosion?’ with the option of yes/no/prefer not to say. For those who answered yes, a secondary question asked, ‘in which area of Beirut were you?’ and participants could write the neighbourhood they were in. Locations were grouped using the ‘Beirut explosion site with infrastructure sites and vulnerability’ map from MapAction [33], (Fig. 2) into distances of 0 km (not in Beirut at the time of the explosion), 0–1 km, 1–4 km, and greater than 4 km away from the explosion site.

Fig. 2
figure 2

Map of Beirut by level of damage incurred by the Beirut Port Explosion (reprinted with permission)

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Injury to Self in Study 2 was assessed with one question asking, ‘were you injured?’ and given the option of yes/no/prefer not to say.

Family or Friends Injured in Study 2 was assessed using one question ‘Was anyone within your network of family or friends injured?’ and given the option of yes/no/prefer not to say.

Any Other Adverse Event was measured to assess all events in the student’s lives that could contribute to trauma. This was measured in both studies with the question ‘Have you ever experienced an adverse event(s)? (Any adverse event that is distressing or disturbing, such as a sexual assault, a beating, a car crash, death of a loved one, divorce of parents, or bullying?’. After the explosion the team added ‘excluding the Beirut pot explosion’. Students were given the option to answer with ‘no’, ‘yes, one’, ‘yes, multiple’.

Procedure

Potential participating students were sent a brief email with a link to the information sheet, consent form and survey. After completion of the survey, students were sent a link to enter a drawing for three cash prizes of $50, $100, or $200, using their email address.

A sample size calculation was conducted using G*Power (version 3.1.9.7) [34]. With an expected medium effect size of 0.21, based on a similar study [21], α set to 0.05, and power 0.95, we estimated a required sample size of 105. We added a 20% margin for missing data, making a total sample size of 120. Assuming a response rate of no more than 10%, based on previous experience of online surveys, we estimated the need to contact 1400 potential participants.

Analysis

Data analysis was performed using IBM SPSS version 27 [35]. Participants were excluded if more than 20% of the items for any of the measures were missing. Bivariate correlations were conducted to identify independent relationships. Independent T-tests and Chi-square were conducted to test for differences between participants in Study 1 and Study 2. All variables were tested for test assumptions, including the normal distribution of residuals using histograms outputs and Shapiro–Wilk tests. Due to some non-normal distribution of residuals, bootstrapping was conducted. For the primary aim, we ran unadjusted multiple linear regressions for each of our dependent variables (depression, anxiety, trauma) with social and family characteristics as predictors. Next, we ran a partially adjusted multiple linear regression for our dependent variables with social and family support and demographic variables added (gender, nationality, and financial stress). We then ran fully adjusted linear regressions controlling for demographic variables and other adverse events, for each dependent variable. We conducted the same analysis for Study 1 (before the explosion) and Study 2 (after the explosion), with the exception of the addition of explosion-related experiences in Study 2. For the secondary aim, we visually compared results from the analyses of Study 1 and Study 2 and ran interaction effects to test for any statistically significant differences.

Ethics

Ethical approval was obtained from the IRB at AUB (AUB IRB ID: SBS-2020–0198) and from the Data Protection Risk Assessment at Trinity College Dublin to allow data sharing.

Results

Participant characteristics

A total of 217 participants made up Study 1 (n = 143) and Study 2 (n = 74). An additional 88 participants were excluded across studies due to more than 20% of items missing from one or more questionnaires.

A summary of participant descriptive characteristics can be seen in Table 1.

Table 1 Demographic characteristics
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Participants in Study 1 were predominantly female (60.1%, n = 86), Lebanese (81.11%, n = 116), with a mean age of 21.00 years old (SD = 3.26). Most students experienced one (32.17%, n = 46) or multiple (37.06%, n = 53) adverse events in their lives. Participants in Study 2 were also predominantly female (60.81%, n = 45), Lebanese (83.79%, n = 62), with a mean age of 20.48 years old (SD = 1.32). Most students experienced one (21.62%, n = 16) or multiple (37.84%, n = 28) adverse events in their lives, besides the port explosion. Of those in Beirut at the time of the port explosion, most students were between 1 and 4 km (45.45%, n = 15) or greater than 4 km (39.39%, n = 13) away from the explosion site. Bootstrap independent t-tests and chi-square tests comparing the demographic properties between Study 1 and Study 2 found no statistically significant differences. A summary of measures is presented in Table 2.

Table 2 Descriptives of measures
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Correlation matrix

Bootstrapped correlations are presented in Table 3, which shows that predictor variables social support and family functioning correlate with each other, however VIF factors showed low risk of multicollinearity (VIFs < 2).

Table 3 Bootstrap correlation matrix, Study 1 and Study 2
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Correlations for Study 1 revealed that age did not significantly correlate with anxiety, depression, or trauma. Depression correlated with social support, family functioning, and financial stress. Anxiety and trauma did not correlate with any of the independent variables. Correlations for Study 2 showed that age did not correlate with anxiety, depression, or trauma. Depression significantly correlated with social support, family functioning, and financial stress. Anxiety correlated with social support and financial stress. Trauma correlated with financial stress.

Regression models

Study 1—before the port explosion

Table 4 shows the results of the unadjusted, partially adjusted, and fully adjusted multiple linear regressions for Study 1. Unadjusted models showed that social support was the stronger predictor of depressive symptoms (R2 = 0.10, F (2,131) = 8.61, p = 0.00). Neither social support nor family functioning were predictors of anxiety symptoms (R2 = 0.04, F (2,132) = 3.53, p = 0.03). Social support was the stronger predictor of trauma symptoms (R2 = 0.04, F (2,132) = 3.46, p = 0.03).

Table 4 Bootstrapped regression models for Study 1
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Partially adjusted models (adjusted for demographics) showed that financial stress was the strongest and only predictor of depressive symptoms (R2 = 0.13, F (6,116) = 3.97, p = 0.00). No variables significantly predicted anxiety (R2 = 0.02, F (6,117) = 1.42, p = 0.21), or trauma symptoms (R2 = 0.03, F (6,117) = 1.59, p = 0.16).

Fully adjusted models (adjusted for demographics and adverse experiences) showed that age and financial stress were predictors of depressive symptoms (R2 = 0.15, F (7,114) = 3.98, p = 0.00). Financial stress was the only predictor of anxiety symptoms (R2 = 0.03, F (7,115) = 1.49, p = 0.18). Age significantly predicted trauma symptoms (R2 = 0.04, F (7,115) = 1.74, p = 0.11).

Study 2—after the port explosion

Table 5 shows the results of the bootstrapped unadjusted, partially adjusted, and fully adjusted multiple linear regressions for Study 2.Unadjusted models showed that neither social support nor family functioning were predictors of depressive symptoms (R2 = 0.16, F (2,67) = 7.36, p = 0.00), anxiety symptoms (R2 = 0.06, F (2,69) = 3.16 p = 0.05), or trauma symptoms (R2 = − 0.02, F(2,69) = 0.37, p = 0.70).

Table 5 Bootstrapped regression models for Study 2
Full size table

Partially adjusted models (adjusted for demographics) showed financial stress was the strongest predictor of depressive (R2 = 0.18, F (7,52) = 2.83, p = 0.01), anxiety (R2 = 0.19, F(7,54) = 3.00, p = 0.01), and trauma symptoms (R2 = 0.15, F (7,54) = 2.51, p = 0.03).

Fully adjusted models (adjusted for demographics and adverse experiences, including exposure to the explosions) showed no variables significantly predicted depression (R2 = 0.08, F (10,17) = 1.23, p = 0.34) anxiety (R2 = 0.22, F (10,18) = 1.80, p = 0.13), or trauma symptoms (R2 = − 0.11, F (10,18) = 0.73, p = 0.69).

Comparison of patterns between study 1 and study 2

Depressive symptoms

Before and after the explosion, social support, family functioning, and financial stress had significant correlations with depressive symptoms. In the unadjusted models before the explosion, low social support was the only predictor of depression symptoms, but not afterwards. After adjusting for demographics, before and after the explosion, financial stress was the only predictor. However, after adjusting for adversity as well, financial stress was significant before but not after the explosion. This difference was not statistically significant, as no interaction effects were found between group (before or after) and social determinants for depression (social support b = − 0.35, SE = 0.24, p = 0.15; family functioning b = 1.40, SE 1.15, p = 0.22; financial stress b = 0.35, SE = 0.58, p = 0.52).

Anxiety symptoms

Before the explosion, no variables were significantly correlated with anxiety symptoms, while after the explosion, social support and financial stress were correlated with symptoms. Neither study found any significant predictors of anxiety in the unadjusted models. When adjusting for demographics, after—and not before—the explosion, financial stress predicted symptoms. In the fully adjusted model, adjusted for adverse experiences, before the explosion, financial stress was the only significant predictor of anxiety, but after the explosion there were no significant predictors. This difference was not supported statistically, as no significant interaction effects were found between group (before or after) and social determinants for anxiety (social support b = − 0.18, SE = 0.22, p = 0.40; family functioning b = 1.00, SE 1.11, p = 0.37; financial stress b = 0.63, SE = 0.56, p = 0.25).

Trauma symptoms

Before the explosion, no variables were correlated with trauma symptoms. However, after the explosion, financial stress was significantly correlated with symptoms. Unadjusted models showed that social support predicted trauma symptoms before the explosion, but not after. In the partially adjusted model, adjusted for demographics, no significant predictors of trauma symptoms were found before the explosion, but financial stress did predict symptoms after the explosion. Fully adjusted models, adjusted for adverse experiences, showed that only age was a significant predictor before the explosion (lower age was associated with worse symptoms), but no variables were significant predictors for trauma after the explosion. This was supported statistically, as no significant interaction effects were found between group and social determinants for depression (social support b = 0.40, SE = 0.44, p = 0.37; family functioning b = − 1.54, SE 2.19, p = 0.47; financial stress b = 1.01, SE = 1.19, p = 0.40).

Discussion

This study aimed to identify social determinants of student mental health during multiple national crises, and before and after the port explosion. Whilst we found associations between social support and depressive and trauma symptoms before the port explosion, only financial stress remained a significant predictor of depression after adjusting for demographics. After adjusting also for adverse experiences, financial stress and age were predictors of depression symptoms, while financial stress remained the only predictor of anxiety and trauma symptoms. After the port explosion financial stress was the only statistically significant predictor of depression, anxiety, and trauma symptoms after adjustment for demographics. However, after also adjusting for adverse experiences, which included proximity to the port, injuries sustained after the explosion, and other adverse events, no variables were significant predictors. In addition to these findings, we found no significant differences in relationships before or after the explosions, indicating that differences between the groups were only of small clinical significance. These results highlight that other factors than family and social support are important for the mental health of college students in Lebanon during multiple national crises, and that financial stress does play role, albeit not beyond the impact of adverse events themselves.

Our study clearly demonstrates a role of financial stress on mental health in the context of the multi-layered crises in Lebanon. This is in line with previous research that has found strong links between poverty and mental health, with people of lower socioeconomic status or living in a high-deprivation neighbourhood having a higher likelihood of developing mental health problems [17, 36, 37]. Miller and Rasmussen [38], criticized the tendency of research in humanitarian settings to focus on the direct effect of war and conflict, neglecting the major impact of chronic exposure to daily stressors. Daily stressors can have a cumulative impact on mental health, worsening during crises [38]. Financial stress is an example of a daily stressor, especially during the economic crises facing Lebanon. This is likely to reflect the major financial losses students and their families are facing, including the devaluation of salaries by over 90%, frozen bank accounts, and total or partial loss of life savings [39]. It is also likely to reflect the impact this has had on buying power, including difficulties obtaining basic goods like food, medicine, and electricity [40]. For the first time in the country’s history, Lebanon has been flagged for food insecurity risk by the United Nations [41], with 2.26 million people at risk. Food insecurity has also been found to be linked to poor mental health in students in Lebanon [15]. Without economic and political reform in the country that can reduce financial and food insecurity, we are unlikely to see major improvements in the population’s mental health. For students, higher education institutions may help to support students through more accessible models of education that consider affordability, accessibility, and social (in)equities [42]. This can help to address student financial stress more structurally than can be addressed through financial support alone. Additionally, higher education institutions can support students by recognising the impact of financial stress as part of mental health and counselling campaigns and services. At the American University of Beirut, a University Mental Health Council was set-up to strengthen university systems to address the worsening mental health of the university community [43]. Findings of this study indicate that interventions and support should be targeted to those most at financial risk within the college community.

Social support was found to be a stronger predictor than family functioning of trauma symptoms for students before the explosion, though neither were as impactful as financial stress. Some previous literature on family and peer relations as a protective factor for mental health is in line with this finding. As college students are predominantly older adolescents or young adults, the importance of peers over families is well documented in this age group [44,45,46]. It may be reflective of the typical shift in attachment relationships during adolescence from the inner family to outer social world [45]. This indicates that peers are an important source of support for this population. However, our findings indicate that social support was not able to buffer the impact of financial stress, particularly after the explosion, again emphasising the particularly negative impact of the economic collapse. This may be explained by the collective nature of both the economic collapse, COVID-19, and the port explosion, that affected the entire population. This interpretation is supported by our finding that the significance of financial distress after the explosions was lost after fully adjusting for demographics and explosion-related adversity. The collective nature of the experience may have negatively affected the ability of financial wealth, and families and friends, to buffer its impact, particularly as the explosion occurred during a COVID-19 lockdown. Lockdowns in Lebanon were long and strict, due to the limited public health infrastructure, and people were unable to leave their homes except for medical emergencies for months at a time. The usual buffering effect of social support on mental health and wellbeing found in previous studies in Lebanon [47,48,49] may therefore have been unable to function under the extreme nature of the disaster.

The overwhelming impact of financial stress on the mental health of college students in this sample, as well as the potential for social support, demonstrates the need to take a systems approach to student mental health during humanitarian emergencies. Interventions and services need to respond to the collective nature of distress, and address core social determinants of mental health alongside individual-focused interventions for mental health and stress management.

Strengths and limitations

This study benefits from a naturally occurring opportunity to study the impact of multiple social determinants of mental health in college students before and after a major humanitarian disaster. It is limited, however, by a relatively small and single-university sample limiting generalisability, and the use of brief self-report measures that may not comprehensively capture social determinants of mental health. In addition, the multiple crises occurring in parallel makes it challenging to differentiate impacts, with the freefall of the Lebanese Lira occurring throughout data collection, both before and after the explosion. We were limited in our exploration of financial stress with the use of a single question, and a more structured measure might have afforded a more nuanced picture. However, there is research that supports the use of single-item measures, and that there is no difference in the predictive validity between multiple-item and single-item measures [50]. The use of a single-item measure in our study gave a strong indication of stress in the population.

Conclusion

This study demonstrates the role of financial stress on the mental health of college students in Lebanon, in the context of the economic collapse of the country, port disaster, and the COVID-19 pandemic. This supports the importance of taking a collective and macro-systems approach to mental health in humanitarian settings, to address the wider social determinants that are so devastating for mental health.

Availability of data and materials

Anonymous data can be shared on reasonable written request.

Abbreviations

AUB:

American University Beirut

BS6:

Brief social support Scale

CRIES-8:

Child revised impact of events scale

GAD-7:

General anxiety disorder scale

FAD:

Family assessment device

IRB:

Institutional review board

PHQ-9:

Patient health questionnaire

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Acknowledgements

The authors would like to acknowledge and thank Dr Rim Saab, Dr Leila Dirani, Dr Fadi Maalouf, Anas Mayya, and Rayan Al Baki for their input and support in the early stages of designing the study. We additionally thank Dr. Rim Saab for her continuing input and support in the analyses and write-up of the study. We would also like to thank students for their time in participating in this study.

Funding

This study was conducted with support from the University Research Board (URB) at the American University of Beirut (URB grant number: 103782).

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Authors and Affiliations

  1. Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland

    Julia Scheuring & Tania Bosqui

  2. Department of Psychology, American University of Beirut, Beirut, Lebanon

    Tania Bosqui

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  1. Julia Scheuring
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  2. Tania Bosqui
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Contributions

TB conceived, designed the study, and collected data, JS analysed the data and led the write-up of the study. Both TB and JS drafted and reviewed the manuscript.

Corresponding author

Correspondence to Tania Bosqui.

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Ethics approval and consent to participate

Ethical approval was obtained from the IRB at the American University of Beirut (AUB IRB ID: SBS-2020–0198) and from the Data Protection Risk Assessment at Trinity College Dublin to allow data sharing.

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Not applicable.

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The authors declare no competing interests.

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Scheuring, J., Bosqui, T. Social determinants of student mental health before and after the Beirut port explosion: two cross-sectional studies. Confl Health 19, 4 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s13031-025-00645-5

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Keywords

Conflict and Health

ISSN: 1752-1505