Escalation during continuous traumatic stress: the psychological impact of wartime flare-up

Background: In June 2025, after nearly two years of fighting on Israel's northern and Gaza borders, direct conflict between Israel and Iran exposed the Israeli homefront to hundreds of rockets and drones targeting urban centres.Objective: This study was designed to assess the continuous traumatic stress response (CTSR) following a period of escalation and acute threat on the homefront and the relationship with unique war variables compared to recognized individual and social factors.Method: An online questionnaire was sent to a longitudinal sample of adults living on the homefront during the Israel-Hamas war, a week following a significant escalation where rocket and missile fire was exchanged between Iran and Israel. The sample included 287 Israeli civilians (87.3% female; age 19-76) who reported psychological distress post-escalation, which was studied in relation to war-related exposures, peritraumatic dissociation during the conflict, and perceived social support and trust.Results: Participants evacuated experienced higher levels of CTSR, depression, and anxiety. Importantly, peritraumatic dissociation was identified as the strongest predictor of psychological distress across outcomes, surpassing the impact of objective war-related experiences. Different forms of social support had varying effects on distress, while trust in government institutions uniquely influenced psychological outcomes.Conclusions: The findings suggest that internal psychological responses during threats might be more indicative of distress than actual exposure and highlight the need for targeted interventions for displaced populations. Interventions that address dissociative experiences may be especially valuable during periods of heightened threat.