The attack is not over yet: The impact of direct exposure to the October 7, 2023, attack on trajectories of PTSD and depression among the Israeli population.

Objective: The magnitude of the October 7, 2023, attack in southern Israel was without precedent. In this national cohort study, we aimed to prospectively assess the trajectories of posttraumatic stress disorder (PTSD) and depression in order to ascertain the psychological ramifications of direct exposure to the attack.

Method: A representative sample of 634 Israeli adults (320 female, 50.5%), aged 18-85 (M_age = 40.89, SD = 14.06) completed the study at three time points: T1, on August 20-30, 2023; T2, on November 9-19, 2023; and T3, on February 10-20, 2023. Of the sample, 62 citizens (9.8%) were directly exposed to the attack.

Results: At T3, participants who were directly exposed presented with higher levels of probable diagnoses of PTSD (40.3%; n = 25) and depression (45.2%; n = 28) compared with participants that were not directly exposed (PTSD: 26.2%; n = 151); depression: 29% (n = 162). Notably, whereas PTSD and depressive symptoms declined significantly from T2 to T3 among participants with no direct exposure, no such declines were found among people with direct exposure to the attack.

Conclusions: Our study accentuates the long-term impact of the October 7, 2023, attack on the mental health of the Israeli population, particularly among citizens who were directly exposed to the attack. The findings highlight the need to provide rapid, nationwide assessments and triage for interventions for those who were at the first line of confronting the terrorists on one of the grimmest days in Israel's history. (PsycInfo Database Record (c) 2025 APA, all rights reserved).