Collective Ambiguous Loss and Psychological Distress of the Public During War-Related Hostage Crisis: A Three-Wave Longitudinal Study Over 18 Months.

The mass kidnapping of 251 individuals by Hamas on October 7, 2023, created a collective ambiguous loss for Israeli society, marked by prolonged uncertainty over the hostages' fate. While ambiguous loss is typically studied in families, its population-level health associations during continuous armed conflict are unknown. This study provides the first longitudinal evidence of this experience. Israeli adults were surveyed at three (T1; N = 740), six (T2; N = 336), and eighteen (T3; N = 254) months post-kidnapping; a representative subsample (N = 220) completed all waves. We assessed general psychological distress (DASS), abduction-related separation distress (ALI+-SD), and boundary ambiguity (BAS). Within-subject mixed-effects models indicated significant reductions in DASS and BAS scores from T1 to T2 (B = 1.04 and B = 1.28, respectively; ps < 0.01), followed by a plateau thereafter. Separation distress declined significantly only at T3 (B = -1.58, p < 0.01). ALI+-SD and BAS each significantly predicted DASS beyond time effects, with multilevel mediation indicating that ALI+-SD mediated the BAS-DASS association. In the longitudinal sample, ALI+-SD and BAS together explained 44% (T1), 34% (T2), and 41% (T3) of the variance in general distress. The findings suggest that ongoing collective ambiguous loss constitutes a substantial public health concern during war. Unresolved uncertainty surrounding the hostages stalls societal recovery, creating a state of collective limbo and posing a barrier to collective healing. Therefore, ambiguous loss following mass hostage-taking should be considered a widespread societal stressor with consequences extending far beyond directly affected families.