The incidence of post-traumatic stress disorder (PTSD) is rising among IDF reservists during their wartime service, according to the findings of a study carried out by Tel Aviv University.
Some of the reservists have served in multiple combat rounds for extended periods.
Although reserve enlistment at the start of the war exceeded 100 percent, currently that figure has declined, and now stands between 75 to 85 percent, the study found.
Among the many reasons for the decline is one of particular significance: deterioration in the mental resilience of soldiers exposed to traumatic combat experience.
The findings of the study, which surveyed the prevalence of post-traumatic symptoms among combat soldiers for several years, were presented at TAU’s ‘Future of Israel Conference’ sponsored by the Kadar Foundation.
The study was led by Professor Yair Bar-Haim, head of TAU’s National Center for Traumatic Stress and Resilience.
The researchers used a Hebrew version of a questionnaire considered the gold standard for self-reporting PTSD symptoms, with respondents self-rating the severity of their symptoms.
The researchers tracked 579 soldiers drafted into one of the IDF’s infantry brigades in March 2019. Participants filled out the PTSD symptom questionnaire at five points in time: enlistment, after 15 months of service, after 27 months of service, six months after honorary discharge, and 18 months post-discharge (several months into the Iron Swords War). Findings indicate that as service progressed, the percentage of soldiers reporting multiple PTSD symptoms at clinically significant levels (according to the DSM-5) increased accordingly.
At the first data collection point, at the time of enlistment, less than 0.5 percent of recruits suffered from pre-existing PTSD. After approximately 18 months in the army – six months of combat training plus nine months of active deployment, the figure rose to 2.6 percent. Toward the end of the regular military service, after several additional combat deployments, it reached 4.4 percent.
Six months post-discharge, contrary to the hope that the severity of symptoms would diminish after leaving the army, the rate rose again, with nearly eight reporting clinical levels of PTSD symptoms. It should be noted that these data reflect a relatively quiet period, with no war or substantial military operation in Israel.
The fifth data collection point occurred several months into the Iron Swords War. About 85 percent of the study’s participants had been called up for reserve duty and took part in the war.
Unsurprisingly, the war exacerbated psychological difficulties, and the number of respondents reporting significant post-traumatic stress symptoms rose to about 12 percent.
“These data reflect one draft round of one IDF infantry brigade — such as Paratroopers, Golani, or Givati — recruited in 2019 and discharged in 2022,” Prof. Bar-Haim said.
“During these soldiers’ regular service, Israel was not involved in a war or special military operation, so these figures reflect PTSD symptoms severity among IDF combat soldiers during routine activity … the study points to a shar rise in self-reported clinical PTSD symptoms after discharge,” he said.
It is important to note that the results of the questionnaire provide only an estimation of the respondent’s condition and cannot replace a formal diagnosis of PTSD, made through a structured clinical interview. Nevertheless, numerous studies both in Israel and abroad indicate a strong correlation of 0.70 to 0.85 between the results of self-report screening tools and clinical interview outcomes. This means that individuals reporting severe symptoms in the questionnaire tend to receive high scores in structured clinical interviews as well.
“The Iron Swords War generated an additional rise, with about 12 percent of the original sample reporting clinically significant PTSD symptoms. Far from surprising, these figures are consistent with what is known about post-traumatic symptoms following high-intensity warfare, in both the IDF and other armies,” the professor noted.
“The data also contribute to the understanding that Israel’s mental health system is in a state of emergency,” he emphasized.
The professor urged decision-makers to “urgently” to devise long-term solutions for treating a large number of veterans with PTSD.
“These solutions must look beyond the horizon, at least two or three decades ahead. They should include accelerated and high-quality training of therapists, along with the establishment of strong regional clinics specializing in trauma therapy for veterans,” he recommended.
The researchers noted the IDF is “taking many steps to prevent and treat PTSD” despite the immense burden on the military, the Ministry of Defense, the Rehabilitation Department, and Israeli society.
“The greatest pressure of all falls on the veterans and their families,” the professor added.
