A prospective study of resilience, stress, and mental and physical health following a large-scale terrorist attack

On October 7, 2023, a terrorist attack in Israel's southern and central areas claimed the lives of about 1,400 civilians and left 251 people abducted. Prior research has shown that exposure to such violent events can lead to negative mental, emotional, and physical health outcomes, with resilience emerging as a potential protective factor.

However, the relationship between resilience and health during prolonged collective trauma has not been fully explored. This study tracks 250 civilians before and several months after the attack to investigate how stress may mediate the connection between resilience and both mental and self-rated physical health. The results indicate that mental and physical health deteriorate significantly following the attack, and resilience is positively correlated with both mental and physical health.

Crucially, the study finds that perceived stress partially explains the relationship between resilience and health outcomes, while no significant effects on health are observed when accounting for time-lagged mediation. These findings reinforce the importance of resilience–stress–health frameworks in understanding the impact of prolonged collective trauma and suggest that perceived stress may play a role in linking resilience to health.

Future research should delve into the various factors—personal, social, and biological—that influence resilience, which could ultimately inform interventions to enhance adaptation and well-being during extended periods of adversity. The study adhered to ethical guidelines set forth by the Declaration of Helsinki and obtained approval from the Institutional Review Board at Max Stern Yezreel Valley College.

All participants provided informed consent. This research is available under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, allowing non-commercial use and sharing of the findings while requiring proper citation and adherence to licensing terms.