The cost of ongoing war: escalation of continuous traumatic stress response over time and later functional, adjustment, and affective difficulties.

BACKGROUND

Continuous Traumatic Stress Response (CTSR) refers to psychological, emotional, and behavioral reactions that emerge under conditions of ongoing, realistic, and future-oriented threat. Recently, CTSR received empirical attention in areas affected by political armed conflict; studies have been cross-sectional. Therefore, there is limited understanding of CTSR dynamics over time.

METHODS

The current longitudinal study examined changes in CTSR during the Israel-Hamas war and its associations with functioning problems, maladjustment, and psychological burden (anxiety and depression). The study included 519 Israeli adults assessed during weeks 4-6 of the war (T1), and 264 participants during weeks 23-36 (T2). CTSR was evaluated at both waves, and war exposure, functioning problems, maladjustment, and psychological burden at follow-up. Latent change score models estimate within-person change in CTSR and the prospectively associaitons with follow-up outcomes.

RESULTS

Higher baseline CTSR and greater increases in CTSR were prospectively associated with greater functioning problems, maladjustment, and psychological burden at follow-up.

CONCLUSIONS

CTSR may be a dynamic indicator of accumulating psychological risk. Monitoring changes in CTSR during prolonged conflict may help identify individuals at increased risk for later functional impairment, maladjustment, and emotional difficulties. CTSR-informed assessment may improve early identification, triage, and prevention efforts in populations exposed to continuing danger.