Understanding PTSD and Dissociation in Wartime: Direct and Indirect Trauma Exposure.

This study explores the mental health impact of potentially traumatic events (PTEs) during wartime, focusing on the prevalence and severity of post-traumatic stress disorder (PTSD) and dissociative symptoms among a sample of 1,511 Israeli adults exposed to the recent war. Data were collected during the third month of the Israel-Hamas war. Our findings reveal elevated clinical PTSD symptoms (36.8%) and dissociation (16.3%) across the population, including 17.8% of individuals not directly exposed to trauma who nonetheless reported PTSD symptoms above the clinical threshold. These results challenge the adequacy of DSM-5 Criterion A in ongoing conflict contexts, where indirect exposure can contribute significantly to psychological distress. Furthermore, participants exposed to three or more PTEs demonstrated markedly higher PTSD and dissociative symptoms, emphasizing the cumulative burden of repeated trauma. These findings suggest that clinicians must consider both the number and nature of PTEs when developing treatment plans. Additionally, mental health policies should account for the psychological effects of indirect trauma, particularly in settings of ongoing conflict, where the entire population is at risk. The study highlights the urgent need for tailored interventions that address the complex and enduring mental health challenges associated with both direct and by-proxy trauma exposure.