Post-traumatic stress among adolescents following the October 7th attack in Israel: implications for mental health policy and planning.

BACKGROUND: The October 7th, 2023, attack in Israel and the ensuing war exposed Israeli youth to intense and prolonged traumatic stress. This study aimed to: (1) examine the prevalence of probable post-traumatic stress disorder (PTSD) among Israeli adolescents, and (2) identify associated risk and resilience factors for PTSD symptoms within the context of prolonged exposure to threat and uncertainty due to ongoing war and conflict. METHODS: A cross-sectional digital survey was conducted between October and December 2024. Data were collected from 744 adolescents aged 14-18 years, including the Child PTSD Symptom Scale (CPSS-SR-5), questions about direct war-related consequences and indirect exposure. Personal resilience was assessed using the Connor-Davidson Resilience Scale. Social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). Background questions addressed age, gender, health, and adverse events in the past year. Hierarchical multiple regression analysis was used to examine the contribution of background variables, war-related effects, indirect exposure, and resilience factors to PTSD symptoms. RESULTS: The study revealed that 41.9% of participants met the probable diagnostic threshold for PTSD. Gender (female), poorer health status, and previous adverse experiences correlated with increased symptom severity. Among the direct effects, economic status deterioration and direct war impact emerged as significant predictors. Among the indirect exposure factors, frequent news consumption was associated with higher PTSD symptoms. Personal resilience and family support were associated with reduced PTSD symptoms, although resilience factors did not significantly moderate the adverse impacts of war-related experiences. CONCLUSIONS: The high prevalence of probable PTSD among Israeli adolescents in the wake of the October 7th, 2023 attack suggests an urgent need for action. Evidence-informed mental health policies and services should prioritize adolescents, with targeted support for high-risk groups. Our findings stress the need for a national mental health policy to incorporate youth-centered trauma response systems, including interventions for indirect media trauma. Strengthening personal resilience and bolstering family support systems is vital in order to mitigate the lasting psychological impact of war-related trauma on youth.