War-Related Posttraumatic Stress Symptoms During the First Two Postpartum Years: The Moderating Role of Childhood Adversity.

Abstract

Early motherhood is a sensitive period marked by increased psychological vulnerability, potentially impacting child developmental trajectories. While childhood adversity and war-related trauma are known as risk factors for psychopathology, little is known about their combined impact on posttraumatic stress symptoms (PTSS) during the first 2 years of motherhood. Grounded in stress sensitisation, this two-wave study examined how childhood adverse experiences (ACEs) and childhood war-related insecurity moderate the prospective association between contemporary cumulative war exposure and maternal PTSS. A sample of 394 Israeli mothers was assessed at two time points during the Israel-Hamas war: T1 (5 months post-outbreak) and T2 (14 months later). Participants were categorised into a four-group typology based on developmental history: No adversity, ACEs only, Childhood war-related insecurity only, and Combined (ACEs + Childhood war-related insecurity). High symptom stability was observed, yet mothers in the Combined group exhibited the highest clinical risk, with 41.7% meeting the PTSD threshold at T2. Additionally, childhood adversity moderated the link between contemporary cumulative war exposure and PTSS at T2. Contemporary cumulative war exposure was associated with a steeper increase in PTSS primarily among mothers in the Combined group, supporting the stress sensitisation model. Mothers with a dual history of interpersonal adversity and childhood war-related insecurity appeared particularly sensitised to renewed threats. These results highlight the necessity of trauma-informed care and screening to support maternal and infant well-being in conflict zones.