Resilience and Associated Factors Among War-Displaced Adolescents Living with Host Families in Butembo, Democratic Republic of the Congo: A Cross- Sectional Study

Abstract Background War-related displacement can disrupt adolescents’ family relationships, education, safety, and access to mental-health care. The role of host-family and community resources in resilience among internally displaced adolescents in Butembo, Democratic Republic of the Congo (DRC), remains insufficiently documented. Objective To describe resilience and mental-health symptoms and identify factors associated with resilience among war-displaced adolescents living with host families in Butembo. Methods We conducted a cross-sectional descriptive and analytical study from 16 to 27 September 2026. Adolescents aged 12–17 years who had been internally displaced and had lived with a host family for at least six months were recruited through snowball sampling. Data were collected using a structured questionnaire, the Child and Youth Resilience Measure-28 (CYRM-28), the Child PTSD Symptom Scale (CPSS), and the Patient Health Questionnaire-8 (PHQ-8). Descriptive analyses and multiple linear regression were conducted. Ethics approval was obtained from the Catholic University of Graben ethics committee (CERM-UCG No. CERM-26-318). Results Of 297 participants, 57.2% were girls. The mean traumatic-event count was 7.76 (SD 3.15). Among participants with available data, 66.5% screened positive for probable post-traumatic stress symptoms (169/254), and 45.1% had moderate-to-severe depressive symptoms (124/275). Using the sample median CYRM-28 score of 74 as an exploratory threshold, 50.2% were classified as having lower resilience (144/287). In the adjusted linear model (n = 272; R²=0.609; adjusted R²=0.585), family support (β = 1.04, 95% CI 0.72–1.37) and community support (β = 1.17, 95% CI 0.83–1.51) were positively associated with resilience. Direct exposure to violence was also positively associated with resilience (β = 4.96, 95% CI 1.08–8.85), an unexpected finding requiring cautious interpretation. Conclusion High levels of probable post-traumatic stress and depressive symptoms coexisted with substantial variation in resilience. Family and community support were associated with higher resilience, but the cross-sectional design, non-probability sampling, and potential overlap between measures limit causal interpretation. Community-based support and accessible mental-health services warrant evaluation in this population.