Conflict exposure throughout the life-course and mental health among older adults in Lebanon

TL;DR

Older adults in Lebanon who experienced conflict-related harm or losses have worse mental health, including higher depression and anxiety symptoms.

Contribution

This study empirically links lifelong conflict exposure to mental health outcomes in older adults using a representative sample from Lebanon.

Findings

Each conflict exposure variable was significantly associated with higher depressive and anxiety symptoms.

Personal bodily harm had the strongest association with depression, while family possession loss was most linked to anxiety.

Conflict-related exposures, even when not directly affecting the individual, still negatively impact mental health.

Abstract

Lebanon has experienced a prolonged period of political instability and conflict, starting with the onset of the civil war in 1975. Most older adults in Lebanon have been exposed to conflict, violence and losses during most of their life. We examine the mental health associations of these conflict-related exposures, using baseline data from the Lebanon Study of Aging and HeAlth (LSAHA), a population-based survey of 3,027 adults aged > 60 years (69% participation rate). The sample was obtained using a multi-stage random sampling design in two pre-selected areas: the city of Beirut and the Zahle district (southern Beqaa Valley governate). Conflict exposures were summarized in experiences of personal bodily harm (13.3%), bodily harm to close family members (27.4%), loss of own possessions (e.g., houses, jobs, 35.5%), and loss of possessions among close family members (15.7%). After accounting for the complex sampling design, weighted linear regression models controlling for age, sex, education, and sampling area showed that each unit increase in all four conflict exposure variables was significantly (p’s < .01) associated with higher levels of depressive symptoms (CES-8) and anxiety symptoms (GAD-7). The strongest association for depression was found for experiences of personal bodily harm (ß=1.36, p<.005), while the strongest association for anxiety was for loss of possessions among family members (ß=1.42, p<.001). The results suggest that the high prevalence of conflict-related exposures, whether they resulted in harm or losses to self or to family members, has a substantial adverse effect on the well-being of older adults in Lebanon.