War-Related Mental Health and Resilience: Understanding Potential Cultural Pathways

• Baseline resilience is negatively associated with war related depression, anxiety, and stress. • Arabs compared to Jews exhibit higher levels of anxiety. • During war, resilience shows a protective effect against anxiety among Arabs and not Jews. • Cultural factors play a role in the relationship between resilience and anxiety. Resilience can serve as a protective factor, mitigating the risk of mental health issues following experiences of war. Individuals with higher levels of resilience typically exhibit better emotional adjustment and engage in more positive social behaviors, whereas those with lower resilience are more vulnerable to emotional difficulties and trauma-related symptoms. The primary objective of the study was to investigate levels of resilience and war-related psychopathology among Jewish and Arab populations in Israel during a time of ongoing conflict. We used a cohort design, with participants followed over an eight-month period at two points of time. Before the events of October 2023 (in July 2023), 512 participants completed an online questionnaire. Following the October events (in March 2024), 250 (48%) of these same participants (126 females; mean age 42.12, SD = 10.58; 156 Jews) again filled out the questionnaires. Respondents completed standardized online measures assessing resilience, depression, anxiety, and stress. Baseline resilience was found to be negatively associated with depression (r=-.35, p < .001), anxiety (r=-.34, p < .001) and stress (r=-.29, p < .001) following the attack. Notably, Arabs exhibited higher levels of anxiety ( p < .001), consistent with previous research indicating elevated psychological distress among Arabs as a minority in Israel. Furthermore, culture moderated the relationship between resilience and anxiety among Arabs ( p < .001). Specifically, resilience had a protective effect against anxiety only within this ethnic group. The observed cultural moderation of the association between resilience and anxiety highlights the importance of considering the cultural context when designing support interventions.