Mental Health
Risk and Protective Factors of War-related PTSD in an Israeli Civilian Population in the Aftermath of October 7th Sharon Stein Merkin* Sharon Merkin Merkin Merkin Merkin Merkin Gertner Institute Sheba Medical Center; David Geffen School of Medicine UCLA
Background/Objective: Identify risk and protective factors related to post-traumatic stress disorder (PTSD) among civilians during armed conflict.
Methods: Participants (ages ≥18) completed a population-based survey 6 months after the onset of the October 7th war and again 9 months later (n=813). PTSD was based on the PTSD checklist for the Diagnostic and Statistical Manual of Mental Disorders 5th edition (PCL-5, score >31) among those reporting their most bothersome traumatic event (n=435). Sociodemographics, social wellbeing (social support, social integration, resilience) and coping behaviors (sleep, physical activity, weight gain, smoking/alcohol use, volunteering intensity) were based on the baseline survey. Type of exposure to traumatic events included direct (experienced/witnessed), indirect (occurred to family/friend), or secondary (via media or work). Cumulative exposure to trauma included a count of traumatic experiences throughout the follow-up, having a family member in combat and previous trauma.
Results: Overall population prevalence of PTSD was 15.6%, and 29.2% among those reporting a traumatic event. Multivariable models estimated statistically significant risk and protective factors for PTSD after adjusting for all covariates. Risk factors included low income (OR 2.6 95% CI 1.2-5.4), high count of traumatic experiences (OR 3.5 95% CI 1.4-9.1), worse sleep (OR 2.2 95% CI 1.2-4.1) and increased perceived threat (OR 1.3 95% CI 1.1-1.4). Protective factors included resilience (OR 0.8 95% CI 0.6-0.9) and moderate volunteering (OR 0.3 95% CI 0.1-0.8).
Conclusion: These findings indicate that among those who experience traumatic events during wartime, there are several factors that may increase the risk of developing PTSD and other factors that may reduce this risk. Uniquely, this study utilized a civilian population sample during an ongoing war, yielding findings that may inform policy and interventions to prevent and mitigate PTSD during armed conflict.