Psychological distress and resilient coping among dental students during the Khartoum conflict

Armed conflict generates profound disruptions in safety, stability, and educational continuity, all of which place students at heightened risk for psychological distress. Dental students are particularly vulnerable due to their reliance on structured clinical training and uninterrupted academic progression. This study assessed the levels of depression, anxiety, stress, and resilient coping among dental students during the Khartoum conflict and examined how conflict-related circumstances are associated with these psychological outcomes. A cross-sectional online survey was administered to dental students enrolled in universities affected by the conflict. Psychological distress was measured using the Depression, Anxiety and Stress Scale (DASS-21), and resilient coping was assessed using the Brief Resilient Coping Scale (BRCS). Sociodemographic and conflict-related variables were collected, and multivariable logistic regression models were used to explore associations. Model performance was evaluated descriptively through calibration and discrimination indices, and exploratory moderation and mediation frameworks were applied to consider the potential roles of displacement and academic interruption. High levels of depression, anxiety, and stress were observed among students, reflecting the combined impact of insecurity, educational disruption, and displacement. Resilient coping levels varied across participants. Conflict-related factors, particularly displacement and interruption of education, were associated with increased psychological distress. The regression models demonstrated modest discriminative ability (AUC 0.57–0.66), indicating suitability for identifying group-level associations rather than individual prediction. Exploratory analyses suggested potential roles of displacement and academic interruption; however, these findings were not statistically robust and should be interpreted with caution. Dental students experienced significant psychological strain during the Khartoum conflict, shaped by intersecting academic, social, and environmental stressors. The findings highlight the need for targeted mental health support and educational continuity strategies to protect student well-being in conflict-affected settings. Future research using longitudinal or pathway-based designs is needed to clarify how conflict-related stressors, coping resources, and academic instability interact over time.