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For many Israelis, the Oct. 7 terrorist attack marked the beginning of months of uncertainty, fear and repeated exposure to trauma. Yet while emotional strain was common, people did not all respond in the same way.

A new longitudinal study led by Dr. Dana Katsoty and professor Ariel Knafo-Noam of the Hebrew University of Jerusalem and Columbia University, together with professor Anthony D. Mancini of Pace University, reveals that psychological adaptation after large-scale trauma follows several distinct patterns. The findings suggest that how distress changes over time, not simply how severe it appears at one moment, can provide insight into who is most likely to develop long-term post-traumatic stress symptoms. The findings are published in the journal Clinical Psychological Science.

The researchers also identified several factors associated with these different recovery paths. Participants who were older, were male, experienced more positive emotions in the weeks following the attack, perceived the world as generally safe and regularly volunteered before the war were more likely to demonstrate resilience. In contrast, greater exposure to traumatic events and higher levels of emotional empathy—emotional resonance with others' suffering—were associated with persistent psychological distress.

The findings offer both reassurance and caution. More than half of participants demonstrated resilience, while another quarter recovered despite experiencing severe distress immediately after the attack. At the same time, nearly one in five participants continued to experience persistent psychological distress six months into the war, highlighting the lasting mental health consequences of prolonged conflict.

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