It has been difficult for Israelis to get used to the constant showering of missiles from Gaza, Lebanon, and Yemen over the last year and a half, but even though it caused only minor damage, the Iranian drone and missile attack on April 13, 2024, had a heightened detrimental emotional effect.
A new study led by Prof. Boaz Ben-David, Dr. Ortal Shimon-Raz, and Tchelet Bressler from the Baruch Ivcher School of Psychology at Reichman University in Herzliya; Dr. Lia Ring from Ashkelon Academic College; and Prof. Yuval Palgi from the University of Haifa presents a worrisome picture of the immediate consequences of the attack.
Conducted just five days after the barrage and published in the European Journal of Psychotraumatology, the study, titled “Trauma echoes: factors associated with peritraumatic distress and anxiety five days following Iranian missile attack on Israel,” was based on a representative sample of over 600 Jewish Israelis above the age of 30.
The key findings reveal that 41% of participants experienced peritraumatic distress – an intense emotional and physical reaction during or immediately after a traumatic event – and 19% reported significant levels of anxiety. These figures are exceptionally high, nearly double the distress rates recorded in Israel during previous rounds of conflict and the COVID-19 pandemic.
In retaliation to the suspected Israeli bombing of an Iranian embassy, Iran launched about 300 drones and missiles at Israel, representing an unprecedented massive attack threatening all Israeli airspace. Before then, no direct or open attack has ever been launched from Iran towards Israel.
Due to the distance between the countries and the nature of these weapons, Israelis were informed about the attack four hours ahead of time. During this stressful situation, most Israelis were consuming media information through the night to be updated about the forthcoming attack, thereby losing sleep, as there was no clear indication of its exact time or target.
Such war-related traumatic events are well known for their devastating effects. Most of these events are measured months and even years after they occur, and less is known about the first days after the event.
Need to identify traumatic reactions early
The researchers said their findings underscore the need for early identification of traumatic reactions and timely therapeutic intervention to mitigate the risk of long-term psychological harm.
“We wanted to focus on one issue; the reason we chose the Iranian attack was because it was a unique moment during the war,” Ben-David told The Jerusalem Post in an interview.
“We were told the missiles were on their way, and we had time to prepare. Those who had a sleepless night probably were using more media sources, and this caused the most distress. Fortunately, these fears do not necessarily linger. I’m not saying that too much media is bad, but if a friend says he hadn’t slept all night and looked at every possible media source, that is a red flag from a person who needs help.”
The next morning, we sent the kids to school and went to work. It’s crazy! “They were trying to kill us, but we didn’t acknowledge that something had happened. Israelis are incredibly resilient; if residents of London, Copenhagen, or Amsterdam were exposed to missiles like we are, they would fall apart,” said Ben-David. He added that he has met Iranians at scientific conferences. “They have come up to me and shaken my hand after my lectures. The Egyptians and Jordanians haven’t done that.”
THE DATA indicate that a history of exposure to previous traumatic events, whether in the context of previous wars or personal life experiences, was not a significant factor in the levels of distress measured after the April 13 attack. The missiles caused minor damage to the Nevatim Airbase in southern Israel, which remained operational; a seven-year-old Israeli Bedouin girl was struck and injured by part of a missile; and 31 other people either suffered minor injuries while rushing to shelters or were treated immediately for anxiety.
However, a clear link was found between post-traumatic distress in the wake of the events of October 7 and traumatic reactions to the Iranian attack. Thus, it was not the prior exposure to trauma itself that had an impact but rather the way in which the individual had processed and coped with that trauma.
He stressed the need for tailored psychological interventions during times of crisis. “In the State of Israel, the morning after a missile attack, we were all required to continue with our daily routines – getting up, going to work, making sandwiches for our children, and sending them off to school – as if we had not just experienced a significant traumatic event.
“There was almost no attention given to this at the national level, but it is very important to acknowledge and validate these feelings,” he continued.
Ben-David, who heads Reichman’s communication, aging, and neuropsychology lab, added that the findings that emerged from the study “reinforce the need for initiatives like the psychological first-aid project we established at our School of Psychology.”
“This project, developed in collaboration with faculty and students, takes mental health professionals out of traditional treatment rooms and into the field. Instead of waiting for patients to seek help, they provide immediate assistance, for example, at the support centers for the families of the hostages, offering anyone in need to sit down with them for a short conversation. This can serve as an essential first step in emotional recovery.”
The data clearly show “the profound impact of security crises on mental health in the immediate term,” he added. “The fact that people experienced such high levels of distress within just a few days highlights the need for rapid interventions and emotional coping tools in the early stages of a crisis.
“It is also important to recognize that the emotional response to such events is not limited to people with a history of trauma; even those who have never experienced a traumatic event may suffer significant emotional distress. Therefore, we must focus on identifying response patterns, increasing accessibility to mental health support, and raising awareness to ensure that everyone at risk receives the appropriate support at the right time – without making assumptions about who needs help.”
