The mental health impact of the October 7th terror attack on Jews and Arabs in Israel: A nationwide prospective study

Abstract

Introduction: On October 7, 2023, Israeli citizens came under an unprecedented terrorist attack that impacted the entire country. Recent research has begun to document the mental health impact of the attack but has yet to address the question of whether the attack had a differential impact across ethnic communities. In this nationwide prospective cohort study, we aimed to determine possible differences in psychopathology between Jews and Arabs in the post-October 7th attack. Specifically, we aimed to understand the role ethnicity may play in changes in probable PTSD, depression, and anxiety diagnoses from pre- to post-attack.

Methods: The sample comprised 656 participants (332 female, 50.7%) aged 18-85 (M = 41.01, SD = 13.72). Of this cohort, 557 participants (84.9%) were Jews, and 99 (15.1%) were Arabs, reflecting their national proportionality. Validated self-report questionnaires were completed to assess PTSD, depression, and anxiety at two time points: August 20 to 30th^, 2023 (T1; 6-7 weeks before the attack) and November 9-19, 2023 (T2; 5-6 weeks after the attack).

Results: At T2, Arab Israeli participants reported significantly higher prevalences of probable PTSD, depression, and anxiety diagnoses than Jewish Israeli participants. A series of hierarchical logistic regressions revealed that, compared with Jews, Arab participants presented with higher prevalence of probable PTSD (OR = 2.53 95% CI = 1.46-4.37, p < 0.0001), depression (OR = 1.68 95% CI = 1.35-3.01, p < 0.0001) and anxiety (OR = 6.42 95% CI = 3.95-10.52, p < 0.0001), controlling for prevalences of probable diagnoses at T1 as well as for trauma-related variables.

Discussion: Citizens belonging to the Arab ethnic minority in Israel were found to be at higher risk for psychopathology in the aftermath of the October 7, 2023, terrorist attack compared with their Jewish majority counterparts. Thus, it becomes critical to employ culturally sensitive assessments and interventions following the attack to prevent the development of chronic symptoms and disorders.

Keywords: Anxiety; Depression; Ethnicity; PTSD; Prospective.