Mental health of adolescents during times of war.

A substantial proportion of adolescents showed abnormal mental health symptoms during wartime, far exceeding normative expectations.

• 40.2% of adolescents scored within the abnormal range for mental health symptoms
• This exceeded the expected normative rate of 10%
• Data were collected from 973 Israeli adolescents (ages 13-18, 65.8% female)
• Data collection occurred remotely eight months after the October 7th, 2023 attack and subsequent war

Female and older adolescents reported worse emotional status during the wartime period.

• Sex and age were associated with emotional status outcomes
• Female participants reported worse emotional status than male participants
• Older adolescents within the 13-18 age range reported worse emotional status
• This was identified through cross-sectional self-report data

Adolescents reported reduced participation across all occupational domains during wartime.

• War-related changes in daily-life participation were assessed across multiple occupational domains
• Reductions in participation were noted across all domains
• Notable individual variability was observed in participation changes
• Participation changes were measured using validated self-report questionnaires

Executive dysfunction and lower resilience showed the strongest associations with poorer mental health during wartime.

• A regression model explained over 50% of the variance in mental health scores
• Greater executive dysfunction was among the strongest predictors of poorer mental health
• Lower resilience was among the strongest predictors of poorer mental health
• Variables assessed included dispositional resilience, subjective executive functions (EFs), sense of coherence, and war-related changes in daily-life participation

Decision tree analysis identified inhibitory control and participation stability as key factors associated with better mental health outcomes.

• Adolescents with better inhibitory control were more likely to report better mental health
• Adolescents with more stable participation were more likely to report better mental health
• Among adolescents with EF difficulties, lower arousal symptoms were associated with better mental health
• Decision tree analysis was used as a complementary analytical method alongside regression modeling

Executive functions, patterns of daily-life participation, and arousal symptoms were identified as potential intervention targets for adolescents under prolonged war-related stress.

• EFs, participation patterns, and arousal symptoms were associated with adolescents' capacity to cope with war-related stress
• The authors suggest addressing these factors as potential intervention targets
• The goal of targeting these factors would be to mitigate long-term negative consequences of prolonged conflict-related stress
• Findings highlight individual differences linked to internal resources and participation