Dynamics of adolescent anxiety and helplessness in wartime

Adolescents exposed to war face unpredictable, extreme threats and pervasive uncontrollability that elicit profound negative emotions, including anxiety and helplessness. Prior research has often aggregated these emotions into broad negative-affect measures, obscuring potentially distinct temporal dynamics and specific contributions to psychopathology. Using ecological momentary assessment (EMA), we examined the temporal interplay between momentary anxiety and helplessness, and their associations with anxiety symptoms and trauma cognitions, in 116 adolescents (aged 15-18 years) during the Israel-Hamas War (2023). Momentary anxiety and helplessness were concurrently associated at both between-person and within-person levels. Temporal analyses further revealed a primarily unidirectional relationship in which momentary anxiety predicted helplessness. Finally, intensity of anxiety and helplessness was the sole predictor of trauma-related cognitions, while both intensity and lability were associated with higher anxiety-related symptomatology. These findings underscore lability as a distinct risk factor for anxiety and position anxiety as a primary therapeutic target that may disrupt the cascade into helplessness in war-exposed youth.