Children in Syria are suffering from “toxic stress” after six years of exposure to violence and danger in their country’s brutal war, according to a new report.

A study by Save the Children found signs that many Syrian children were struggling with the condition and “living in an almost constant state of fear” even after escaping from the front lines of the conflict.

Parents interviewed for the report said their children were showing more aggressive behaviour, suffering from bedwetting, speech impediments, and chest pains, and in some cases attempting suicide.

The research, conducted with 450 Syrian children and released ahead of the six year anniversary of the war, points to the long-term psychological damage many Syrians may grapple with for years to come.