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Research Article: Understanding anxiety disorders among Iranian mothers and their children exposed to conflict using an extended transactional model of stress and coping

Date Published: 2026-10-16

Abstract:
The psychological impact of war on families is profound. However, the mechanisms linking war-related stressors to anxiety among mothers and their children remain insufficiently understood, particularly in Middle Eastern contexts. Grounded in an extended transactional model of stress and coping, this study examined the direct and indirect relationships between war-related stressors, cognitive appraisal, coping strategies, and anxiety among Iranian mothers and their children following a recent military conflict. The study also investigated the mediating roles of appraisal and coping processes and the moderating roles of religiosity and social support. A cross-sectional design was employed approximately three months after a major military escalation. A stratified proportional sample of 343 Iranian mothers (aged 24 years and older) with at least one child aged 5–10 years living in conflict-affected areas completed validated self-report measures. Data were analyzed using partial least squares structural equation modeling (PLS-SEM). The extends model explained substantial variance in maternal anxiety ( R ² = .80) and child anxiety ( R ² = .72). War-related stressors were significantly and positively associated with both maternal anxiety and child anxiety. In addition, maternal anxiety was significantly associated with child anxiety. Challenge appraisal, problem-focused coping, and cognitive restructuring mediated the relationship between war-related stressors and maternal anxiety. Emotion-focused coping positively mediated the relationship between war-related stressors and child anxiety. Religiosity and social support were found to buffer the association between war-related stressors and maternal anxiety, such that higher levels of religiosity and social support weakened the positive relationship between war-related stressors and anxiety among mothers. This study extends the transactional model of stress and coping by supporting an integrated framework within a conflict-affected Middle Eastern population. The findings indicate distinct pathways linking war-related stressors to maternal and child anxiety and highlight the importance of interventions that address cognitive appraisal, strengthen adaptive coping strategies, and mobilize spiritual and social resources in conflict-affected families.

Introduction:
Armed conflicts are among the most severe collective stressors affecting family well-being, with mothers and children particularly vulnerable to prolonged uncertainty, fear, displacement, and disruption of daily life. Exposure to war-related stressors has been associated with elevated anxiety and other psychological difficulties. Studies have reported maternal anxiety prevalence rates ranging from 38.1% to 61%, depending on the conflict context and assessment methods ( 1 , 2 ). Children living in conflict-affected…

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