Psychological Distress, Resources, and Coping Strategies Among Evacuees and Non-Evacuees From an Armed Conflict Zone: A Network Analysis.

Abstract

This study focuses on two groups: evacuees from Israel's southern and northern frontline communities following the October 7th Hamas attack, and individuals from regions not directly threatened. Using network analysis, we identified key associations and central nodes related to stress indicators (i.e., exposure to traumatic life events, physical health-related quality of life, anxiety, and depression) as well as personal resources (i.e., self-mastery and meaning in life), and coping strategies. The study included 221 evacuees and 145 non-evacuees (controls), recruited via iPanel, Israel's leading online research panel. Participants completed standardised self-report questionnaires. Evacuees exhibited higher levels of anxiety, depression, and traumatic life events, than did controls. Additionally, evacuees showed higher levels of problem-focused coping and a greater sense of meaning in life, along with lower physical health-related quality of life. Network analysis revealed that both groups had four sub-networks: 'personal state', 'psychological distress', 'resources', and 'coping'. However, the sub-networks' composition varied. Both groups shared similar sub-networks for 'coping' and 'personal state', but differed in 'psychological distress' and 'resources'. For the controls, dysfunctional coping strategies were part of 'psychological distress', whereas for evacuees, they were included in 'resources'. Additionally, meaning in life was more central among the controls, influencing the interaction between coping mechanisms, personal states, and psychological distress. For evacuees, physical health-related quality of life was more closely associated with the absence of negative factors-(i.e., anxiety, depression, traumatic experiences, and lower self-mastery)-rather than the presence of adaptive coping strategies and meaning in life. These differences highlight the vulnerability of evacuees and the central role of personal resources. Targeted interventions that foster resources such as self-mastery and meaning in life are vital for coping with the psychological distress associated with forced displacement.