Psychological Distress and Trauma Response Among War-Exposed Young Adults in Gaza

The Gaza Strip has suffered massive civilian harm, widespread displacement, and near-total disruption of health services since the assault began on 7 October 2023, creating an acute humanitarian and mental-health emergency. In this study, we measured anxiety, depression, and post-traumatic stress disorder (PTSD) and examined their associations with displacement, accommodation, and war-related traumatic events among young adults from Gaza. A cross-sectional online survey conducted between October and December 2024 included 604 participants (mean age 21.4 ± 1.6 years) who lived through the war, using validated measures for anxiety, depression, PTSD, and a war-traumatic events checklist. Clinically significant symptoms were highly prevalent, with abnormal anxiety in 60.8% of participants, abnormal depression in 18.2% (plus 41.7% borderline), and probable PTSD in 76.5%. High trauma exposure (≥ 10 events) affected 37.1% of respondents, and displacement as well as residence in shelters were associated with greater overall distress. Cumulative trauma correlated positively with depression severity but inversely with self-reported PTSD and anxiety scores, and depression was linked to specific trauma types such as being besieged and witnessing the prevention of an ambulance from providing aid. These findings indicate a severe and complex mental-health crisis among Gaza’s young adults, in which repeated exposure appears to shift symptom expression toward depressive and morally injurious presentations and away from fear-based arousal. The results underscore the need for culturally sensitive, targeted mental-health interventions.