A Nation in Mourning: Prolonged Grief and Psychological Distress in the Israeli Public Amidst the Ongoing Hostage Crisis Following the October 7th Attack

BackgroundThe October 7, 2023, terrorist attack in Israel led to over 1,200 civilian deaths and the abduction of 251 individuals to Gaza. While prior studies have documented the psychological toll on directly affected populations, the broader emotional impact of the ongoing hostage crisis on the general public remains unclear. This study explored how concern for the hostages relates to psychological distress and functional impairment, conceptualizing this reaction as a form of collective prolonged grief. MethodsA nationally representative sample of 515 Israeli adults completed self-report questionnaires at two timepoints: August 2023 (pre-attack) and May 2025. Measures assessed anxiety, depression, PTSD symptoms, cumulative stress, emotional burnout, and daily functioning. Concern for the hostages was rated on a 4-point scale. Prolonged Grief Disorder (PGD) symptoms were measured using an adapted PG-13 scale to reflect ambiguous loss. Multivariate analyses controlled for baseline distress and trauma exposure. ResultsHigher concern levels were significantly associated with elevated distress across all symptom domains. Nearly half (48.7%) of participants met criteria for probable PGD in relation to the hostage situation. These individuals exhibited significantly higher psychological symptoms and lower functional well-being--including poorer sleep, reduced concentration, and diminished optimism and hope. ConclusionsFindings indicate that the prolonged hostage crisis constitutes a collective psychological burden marked by ambiguous loss and unresolved national trauma. This form of distress affects even those without direct exposure. Mental health efforts must extend beyond trauma-specific care to include interventions for symbolic and collective grief. National leadership plays a critical role in recognizing this suffering and restoring societal trust.