One-third of Tigray students show clinical anxiety after war, study finds

In the months after the guns fell silent in Tigray, a different kind of crisis emerged in the classrooms of Adigrat Town. Researchers surveyed 599 secondary school students there in late 2024 and found something stark: nearly one in three carried the weight of clinically significant anxiety. The figure—32.7 percent—represented a threefold jump from the 11.48 percent prevalence recorded before the war began, a grim measure of what two years of siege and violence had carved into the minds of young people.

The study, published in PLOS Mental Health, offers the first school-based assessment of anxiety among Tigray's adolescents since the Pretoria Peace Agreement ended active hostilities. The researchers used the Generalized Anxiety Disorder scale, a validated tool, to measure not casual worry but clinically significant symptoms—the kind that interferes with daily life. What they found was a generation still reeling. Among the 344 female students in the sample, nearly half—47.4 percent—met the threshold for clinical anxiety. Among the 255 males, the rate was 12.9 percent. The disparity was stark and consistent across every analysis.

The war itself had left its fingerprints everywhere in the data. Eighty-four percent of students reported direct exposure to combat or battlefields. Forty-six percent had experienced physical violence. Sixteen percent reported non-contact sexual abuse; thirteen percent reported contact sexual abuse. Twenty-four percent had thought about suicide at some point in their lives. Twelve percent had attempted it. The destruction was not only psychological. The conflict had displaced over two million people, demolished seventy to eighty percent of health facilities, and severed communication and electricity for months. Schools reopened to students whose lives had been fractured.

When the researchers looked at which factors most strongly predicted anxiety, the pattern was unmistakable. Being female increased the odds of anxiety sixfold. Being eighteen or older tripled the risk. But trauma was the dominant force. Students who had witnessed or experienced combat were five times more likely to have clinical anxiety. Those who had endured physical violence faced 2.25 times the odds. Bullying—a form of ongoing, repeated harm—doubled the risk. Contact sexual abuse quadrupled it. Students who had thought about suicide were four times more likely to have anxiety. Those with depression were nearly four times more likely. The conditions often traveled together, compounding each other.

The researchers noted something else: the relationship between sexual abuse and anxiety showed a gender effect. For girls, the link was particularly strong and statistically significant. For boys, it was present but weaker. This suggests that girls carry a specific vulnerability to this form of trauma, shaped perhaps by the broader context of gender-based violence that characterized the conflict.

What makes these numbers urgent is not just their size but their persistence. The war ended. The ceasefire held. Yet the anxiety remained, locked in the nervous systems and thought patterns of teenagers who had grown up under siege. The study offers no easy answers, only a clear call: schools need mental health screening, trauma-informed therapy, and suicide risk assessment. Without intervention, researchers warn, this generation faces the prospect of long-term psychological deterioration—anxiety that hardens into depression, depression that deepens into hopelessness. The work of recovery, it seems, has only just begun.