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Introduction <p>The ongoing conflict in Sudan has disrupted medical education and affected the mental well-being of students. This study aimed to evaluate the effects of war exposure on psychological inflexibility (the inability to adaptively respond to distressing internal experiences), self-esteem, and mental health outcomes, specifically depression and anxiety.</p> Methods <p>A cross-sectional study was conducted in March 2025 among 148 medical students at Gadarif University, categorized as war-exposed (42.6%) or non-exposed (57.4%). Validated Arabic questionnaires assessed psychological inflexibility (AAQ-II), self-esteem (RSE), depression (PHQ-9), and anxiety (GAD-7). Mann-Whitney U tests and linear regression were used to assess group differences and predictors.</p> Results <p>No significant differences were found between groups in psychological inflexibility (<i>p</i> = 0.451) or self-esteem (<i>p</i> = 0.327). However, war-exposed students had higher depression (<i>p</i> = 0.031) and anxiety (<i>p</i> = 0.025). In regression models, war exposure was associated with increased depression (β = -2.371, <i>p</i> = 0.011) and anxiety (β = -2.529, <i>p</i> = 0.005). Furthermore, in both groups, higher psychological inflexibility predicted worse depression (β = 0.126, <i>p</i> &lt; 0.001) and anxiety (β = 0.150, <i>p</i> &lt; 0.001), while lower self-esteem predicted higher depression (β = -0.295, p = 0.009). A 1-point increase in inflexibility corresponded to a 0.13-point increase in depression symptoms.</p> Conclusion <p>War exposure was associated with increased depression and anxiety, though it did not significantly alter psychological inflexibility or self-esteem. These psychological traits were independently associated with mental health outcomes, suggesting their role as key vulnerability factors. Strengthening resilience and self-worth—through interventions that enhance emotional regulation and coping—may reduce the psychological burden of conflict. Limitations include the cross-sectional design and sampling from a single institution.</p>

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War exposure and mental health in Sudanese medical students: the roles of psychological flexibility and self-esteem

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月26日

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  • Sohaib Mohammed Mokhtar Ahmed,
  • Isra Abdelgafar Hassan Eltaeib,
  • Yasir Abdelrafi Dafalla Fadlelmoula,
  • Hebatallah Fadhl,
  • Mohamed Salah Abdulrazeg Abdulrahman

摘要

Introduction

The ongoing conflict in Sudan has disrupted medical education and affected the mental well-being of students. This study aimed to evaluate the effects of war exposure on psychological inflexibility (the inability to adaptively respond to distressing internal experiences), self-esteem, and mental health outcomes, specifically depression and anxiety.

Methods

A cross-sectional study was conducted in March 2025 among 148 medical students at Gadarif University, categorized as war-exposed (42.6%) or non-exposed (57.4%). Validated Arabic questionnaires assessed psychological inflexibility (AAQ-II), self-esteem (RSE), depression (PHQ-9), and anxiety (GAD-7). Mann-Whitney U tests and linear regression were used to assess group differences and predictors.

Results

No significant differences were found between groups in psychological inflexibility (p = 0.451) or self-esteem (p = 0.327). However, war-exposed students had higher depression (p = 0.031) and anxiety (p = 0.025). In regression models, war exposure was associated with increased depression (β = -2.371, p = 0.011) and anxiety (β = -2.529, p = 0.005). Furthermore, in both groups, higher psychological inflexibility predicted worse depression (β = 0.126, p < 0.001) and anxiety (β = 0.150, p < 0.001), while lower self-esteem predicted higher depression (β = -0.295, p = 0.009). A 1-point increase in inflexibility corresponded to a 0.13-point increase in depression symptoms.

Conclusion

War exposure was associated with increased depression and anxiety, though it did not significantly alter psychological inflexibility or self-esteem. These psychological traits were independently associated with mental health outcomes, suggesting their role as key vulnerability factors. Strengthening resilience and self-worth—through interventions that enhance emotional regulation and coping—may reduce the psychological burden of conflict. Limitations include the cross-sectional design and sampling from a single institution.