War and non-war stressors, family resources, coping and family adaptation among Lebanese families

Abstract

The Lebanese war (1975-1991) represented a continuing source of difficulty and disruption for the people of Beirut. The negative impact on individuals mental health has been documented, but little is known about its impact on families. The study was undertaken to describe the objective stressors, perceived stress, coping and resources of families living in Beirut during the Lebanese war and to test a model based on McCubbin's double Abcx theory predicting the relationships of these variables to family adaptation. The study was a secondary analysis of cross-sectional data collected in Beirut in 1987. The cluster sample consisted of 438 families chosen at random. Independent variables included objective stressors and perceived stress. The mediating variables were family resources and coping strategies. The dependent variables were health and interactional indicators of the outcome family adaptation: physical and psychological health, depression, and interpersonal and marital relationships. Families reported a medium to low number of objective war and non-war events stressors but a more severe perceived stress and moderate level of physical and psychological symptoms, depression, a problematic pattern in their interpersonal relationships, and good quality of marital relations. Findings provided support for the theoretical framework. Multiple regression analyses revealed that perceived stress, rather than the objective occurrence of events that predicted family adaptation. However, the more objective events experienced, the greater their perception as stressful, which led, in turn, to less positive family adaptation. Family resources particularly social support, directly and positively impacted family adaptation, and was also associated with increased use of cognitive coping. Cognitive coping did not predict either health or interactional outcomes; however behavioral coping predicted poor family adaptation. Discriminant analysis indicated a high degree of consistency in the prediction and classification of high/low perceived stress groups. Families in the low perceived stress groups had a more positive adaptation than those in the high perceived stress groups. The findings provide a beginning theoretical model which, upon further testing, can serve as a basis for practice by nurses and other health professionals when working with traumatized families.