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This study investigated the impact of wartime exposure among at-risk mothers and examined the potential role of adverse childhood experiences (ACEs) in shaping their coping capacities during periods of armed conflict. Previous research has shown that exposure to war negatively affects mental health, with higher levels of psychological distress corresponding to increased exposure. Women, who often constitute a vulnerable or marginalized group, are particularly affected by conflict and war.
ACEs are potentially traumatic events occurring before the age of 18, including abuse, neglect, and dysfunctional family environments. Research indicates that such experiences can affect an individual's mental well-being and increase the risk of developing symptoms of depression and anxiety. Furthermore, ACEs may impact parenting capacity, become embodied, and be transmitted intergenerationally, thus perpetuating cycles of risk. Parents serve as mediators in situations involving children's exposure to trauma, especially war-related trauma. When parents report experiencing war-related trauma themselves, their distress has been linked to difficulties in their children. However, research on the role of ACEs in shaping the psychological well-being of mothers exposed to war is scarce.
The first research hypothesis was that higher exposure to war would be associated with an increase in symptoms of anxiety and depression. The second hypothesis proposed that ACEs would moderate this relationship, so that the effect of war exposure on increased symptoms would be stronger among mothers with higher levels of childhood adverse childhood experiences.
The study included 177 mothers who participated in a larger longitudinal study assessing the effectiveness of intervention programs for at-risk parents of children aged 0–3 (Shar-Censor et al., in preparation). The longitudinal study was conducted in 11 different municipalities across Israel, encompassing diverse geographical areas and including mothers from various sectors of Israeli society (Ultra-Orthodox, observant, and secular Jewish mothers and Muslim mothers). Data collection took place at three time points between 2020 and 2022, and at a fourth point in 2024. Data relevant to the current study were drawn from two time points: the first (Time1), conducted prior to the intervention and before the "Iron Swords" war, and the fourth (Time4), conducted starting in April 2024, approximately six months after “October 7th” and the onset of the “Swords of Iron” war.
At Time1, the mothers were interviewed by trained staff using the Adverse Childhood Experiences Questionnaire (Center for Disease Control, 2016; Felitti et al., 1998). At Time4, mothers completed the War Exposure Questionnaire (Shai & Shar-Censor, 2023). At both time points, mothers completed the Depression, Anxiety, and Stress Scale (DASS-21; Lovibond & Lovibond, 1995).
The findings indicated a significant association between exposure to war-related events and increases in depression and anxiety symptoms among at-risk mothers. Additionally, three major risk factors for deterioration in depression and anxiety symptoms during times of crisis were identified: higher baseline symptoms of depression and anxiety, more adverse childhood experiences, and exposure to more war-related events. However, ACEs did not moderate the effect of war exposure on changes in depression and anxiety symptoms. These findings highlight the importance of early identification of women at risk and the need for tailored therapeutic and systemic interventions. Future research may deepen this understanding using additional research tools for assessing other adverse childhood experiences, exploration of resilience factors, and inclusion of broader populations to support the development of effective strategies for identifying and assisting vulnerable populations in wartime.