Prolonged grief and psychological distress among the public amidst the ongoing hostage crisis following the october 7 attack

Background: The 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 public concern for the hostages relates to psychological distress and functional impairment, focusing on prolonged grief–like responses in the context of unresolved national uncertainty. Methods: A nationally representative sample of 515 Israeli adults completed self-report questionnaires at two time points: August 2023 (pre-attack) and May 2025. Measures included anxiety, depression, PTSD symptoms, cumulative stress, emotional burnout, and daily functioning. Concern for the hostages was rated on a 4-point scale. Symptoms associated with Prolonged Grief Disorder (PGD) were measured using an adapted PG-13 scale. Multivariate analyses controlled for baseline distress and trauma exposure. Results: Higher concern levels were significantly associated with elevated distress across all symptom domains. Approximately half of the participants (48.7%) reported elevated levels of PGD-like symptoms in relation to the hostage situation, exhibiting significantly higher psychological symptoms and lower functional well-being, including poorer sleep, reduced concentration, and diminished optimism and hope. Conclusions: Findings 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 may therefore benefit from addressing distress related not only to direct trauma and bereavement, but also to prolonged uncertainty and symbolic loss.