Psychological Impact of the Gaza Blockade: A Mental Health Analysis 2007–2024
DOI:
https://doi.org/10.57214/jasira.v4i1.302Keywords:
Depression, Gaza Blockade, Intergenerational Trauma, Mental Health, PTSDAbstract
This meta-analysis systematically examines the psychological effects of the Gaza blockade on the mental health of affected populations, synthesizing data from 47 studies with 31,842 participants published between 2007 and 2024. The results show a significant increase in mental health disorders, with a pooled effect size of r = 0.73 (95% CI [0.68, 0.78]). PTSD was the most prevalent at 73.2%, followed by depression at 68.7%, and anxiety at 65.4%, highlighting the severe psychological impact. Hierarchical regression analysis revealed a strong correlation between the duration of the blockade and the severity of psychological symptoms (β = 0.68, p < .001). Children and adolescents were particularly vulnerable, with an odds ratio of 2.84 for developing complex trauma. Structural equation modeling indicated that limited access to mental health services significantly worsened psychological conditions, with model fit indices (χ2/df = 2.34, CFI = 0.96, RMSEA = 0.058). This study also identified a higher prevalence of disorders compared to previous studies and uncovered a new pattern of intergenerational trauma (d = 0.82). This meta-analysis enhances the understanding of how prolonged blockades affect mental health and provides a foundation for evidence-based psychosocial interventions.
References
Agbaria, N., Petzold, S., Deckert, A., Henschke, N., Veronese, G., Dambach, P., ... & Winkler, V. (2021). Prevalence of post-traumatic stress disorder among Palestinian children and adolescents exposed to political violence: A systematic review and meta-analysis. PLoS One, 16(8), e0256426. https://doi.org/10.1371/journal.pone.0256426
Aldabbour, B., Abuabada, A., Lahlouh, A., Halimy, M., Elamassie, S., Sammour, A. A. K., ... & Nadarajah, S. (2024). Psychological impacts of the Gaza war on Palestinian young adults: A cross-sectional study of depression, anxiety, stress, and PTSD symptoms. BMC Psychology, 12(1), 696. https://doi.org/10.1186/s40359-024-02188-5
Al-Krenawi, A., & Graham, J. R. (2011). Mental health help-seeking among Arab university students in Israel, differentiated by religion. Mental Health, Religion & Culture, 14(2), 157-167. https://doi.org/10.1080/13674670903454229
Al‐Krenawi, A., & Graham, J. R. (2012). The impact of political violence on psychosocial functioning of individuals and families: The case of Palestinian adolescents. Child and Adolescent Mental Health, 17(1), 14-22. https://doi.org/10.1111/j.1475-3588.2011.00600.x
Altawil, M., Nel, P. W., Asker, A., Samara, M., & Harrold, D. (2008). The effects of chronic war trauma among Palestinian children. Children: The invisible victims of war-An interdisciplinary study. Peterborough: DSM Technical Publications Ltd.
Barber, B. K., McNeely, C., & Spellings, C. (2012). Role of political factors in wellbeing and quality of life during long-term constraints and conflict: An initial study. The Lancet, 380, S17. https://doi.org/10.1016/S0140-6736(13)60199-3
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. Wiley. https://doi.org/10.1002/9780470743386
Buheji, M., & Buheji, B. (2024). Mitigating risks of slow children development due to war on Gaza 2023. International Journal of Psychology and Behavioral Sciences, 14(1), 11-21.
Daud, A., af Klinteberg, B., & Rydelius, P. A. (2008). Resilience and vulnerability among refugee children of traumatized and non-traumatized parents. Child and Adolescent Psychiatry and Mental Health, 2(1), 7. https://doi.org/10.1186/1753-2000-2-7
Dissanayake, L., Jabir, S., Shepherd, T., Helliwell, T., Selvaratnam, L., Jayaweera, K., ... & Sumathipala, A. (2023). The aftermath of war; mental health, substance use and their correlates with social support and resilience among adolescents in a post-conflict region of Sri Lanka. Child and Adolescent Psychiatry and Mental Health, 17(1), 101. https://doi.org/10.1186/s13034-023-00648-1
Dubow, E. F., Boxer, P., Huesmann, L. R., Shikaki, K., Landau, S., Gvirsman, S. D., & Ginges, J. (2009). Exposure to conflict and violence across contexts: Relations to adjustment among Palestinian children. Journal of Clinical Child & Adolescent Psychology, 39(1), 103-116. https://doi.org/10.1080/15374410903401153
Duval, S., & Tweedie, R. (2000). Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56(2), 455-463. https://doi.org/10.1111/j.0006-341X.2000.00455.x
El-Khodary, B., & Samara, M. (2020). The relationship between multiple exposures to violence and war trauma, and mental health and behavioural problems among Palestinian children and adolescents. European Child & Adolescent Psychiatry, 29(5), 719-731. https://doi.org/10.1007/s00787-019-01376-8
El-Khodary, B., Samara, M., & Askew, C. (2020). Traumatic events and PTSD among Palestinian children and adolescents: The effect of demographic and socioeconomic factors. Frontiers in Psychiatry, 11, 4. https://doi.org/10.3389/fpsyt.2020.00004
Fazel, M., Reed, R. V., Panter-Brick, C., & Stein, A. (2012). Mental health of displaced and refugee children resettled in high-income countries: Risk and protective factors. The Lancet, 379(9812), 266-282. https://doi.org/10.1016/S0140-6736(11)60051-2
Foverskov, E., White, J. S., Frøslev, T., Sørensen, H. T., & Hamad, R. (2022). Risk of psychiatric disorders among refugee children and adolescents living in disadvantaged neighborhoods. JAMA Pediatrics, 176(11), 1107-1114. https://doi.org/10.1001/jamapediatrics.2022.3235
Giacaman, R., Rabaia, Y., Nguyen-Gillham, V., Batniji, R., Punamäki, R. L., & Summerfield, D. (2011). Mental health, social distress and political oppression: The case of the occupied Palestinian territory. Global Public Health, 6(5), 547-559. https://doi.org/10.1080/17441692.2010.528443
Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (Eds.). (2022). Cochrane handbook for systematic reviews of interventions (2nd ed.). Wiley. https://doi.org/10.1002/9781119536604
Kassam-Adams, N. (2014). Design, delivery, and evaluation of early interventions for children exposed to acute trauma. European Journal of Psychotraumatology, 5(1), 22757. https://doi.org/10.3402/ejpt.v5.22757
Leak, W. N. (1946). Population statistics in Palestine. British Medical Journal, 2(4463), 98. https://doi.org/10.1136/bmj.2.4463.98-a
Marie, M., Hannigan, B., & Jones, A. (2016). Mental health needs and services in the West Bank, Palestine. International Journal of Mental Health Systems, 10(1), 23. https://doi.org/10.1186/s13033-016-0056-8
Masten, A. S., & Narayan, A. J. (2012). Child development in the context of disaster, war, and terrorism: Pathways of risk and resilience. Annual Review of Psychology, 63(1), 227-257. https://doi.org/10.1146/annurev-psych-120710-100356
Miller, K. E., & Rasmussen, A. (2017). The mental health of civilians displaced by armed conflict: An ecological model of refugee distress. Epidemiology and Psychiatric Sciences, 26(2), 129-138. https://doi.org/10.1017/S2045796016000172
Moss, W. J., Ramakrishnan, M., Storms, D., Henderson Siegle, A., Weiss, W. M., Lejnev, I., & Muhe, L. (2006). Child health in complex emergencies. Bulletin of the World Health Organization, 84, 58-64. https://doi.org/10.2471/BLT.04.019570
Nasir, L. S., & Al-Qutob, R. (2005). Barriers to the diagnosis and treatment of depression in Jordan: A nationwide qualitative study. The Journal of the American Board of Family Practice, 18(2), 125-131. https://doi.org/10.3122/jabfm.18.2.125
Nguyen‐Gillham, V., Giacaman, R., Naser, G., & Boyce, W. (2008). Normalising the abnormal: Palestinian youth and the contradictions of resilience in protracted conflict. Health & Social Care in the Community, 16(3), 291-298. https://doi.org/10.1111/j.1365-2524.2008.00767.x
Nocon, A., Eberle-Sejari, R., Unterhitzenberger, J., & Rosner, R. (2017). The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: Systematic review and meta-analysis. European Journal of Psychotraumatology, 8(sup2), 1388709. https://doi.org/10.1080/20008198.2017.1388709
Nouri, S. (2019). Effects of conflict, displacement, and migration on the health of refugee and conflict-stricken populations in the Middle East. Institute of Advanced Engineering and Science. https://doi.org/10.11591/ijphs.v8i3.18590
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Palosaari, E., Punamäki, R. L., Qouta, S., & Diab, M. (2013). Intergenerational effects of war trauma among Palestinian families mediated via psychological maltreatment. Child Abuse & Neglect, 37(11), 955-968. https://doi.org/10.1016/j.chiabu.2013.04.006
Peltonen, K., & Punamäki, R. L. (2010). Preventive interventions among children exposed to trauma of armed conflict: A literature review. Aggressive Behavior: Official Journal of the International Society for Research on Aggression, 36(2), 95-116. https://doi.org/10.1002/ab.20334
Peltonen, K., Qouta, S., El Sarraj, E., & Punamäki, R. L. (2010). Military trauma and social development: The moderating and mediating roles of peer and sibling relations in mental health. International Journal of Behavioral Development, 34(6), 554-563. https://doi.org/10.1177/0165025410368943
Punamäki, R. L., Isosävi, S., Qouta, S. R., Kuittinen, S., & Diab, S. Y. (2017). War trauma and maternal-fetal attachment predicting maternal mental health, infant development, and dyadic interaction in Palestinian families. Attachment & Human Development, 19(5), 463-486. https://doi.org/10.1080/14616734.2017.1330833
Qouta, S., Punamäki, R. L., & El Sarraj, E. (2008). Child development and family mental health in war and military violence: The Palestinian experience. International Journal of Behavioral Development, 32(4), 310-321. https://doi.org/10.1177/0165025408090973
Qutishat, M. (2025). Mental health in Gaza: Addressing sustainability challenges of ongoing war conflict. Middle East Current Psychiatry, 32(1), 27. https://doi.org/10.1186/s43045-025-00520-2
Reed, R. V., Fazel, M., Jones, L., Panter-Brick, C., & Stein, A. (2012). Mental health of displaced and refugee children resettled in low-income and middle-income countries: Risk and protective factors. The Lancet, 379(9812), 250-265. https://doi.org/10.1016/S0140-6736(11)60050-0
Schouler-Ocak, M., & Kastrup, M. C. (2021). Mental health in refugees and asylum seekers. In Mental Health, Mental Illness and Migration (pp. 237-246). Singapore: Springer Singapore. https://doi.org/10.1007/978-981-10-2366-8_8
Schwartz, D., & Proctor, L. J. (2000). Community violence exposure and children's social adjustment in the school peer group: The mediating roles of emotion regulation and social cognition. Journal of Consulting and Clinical Psychology, 68(4), 670. https://doi.org/10.1037/0022-006X.68.4.670
Sim, A. (2018). Developing an empirically-based conceptual model of the intergenerational impact of war: A mixed methods study with Syrian refugees in Lebanon (Doctoral dissertation, University of Oxford).
Slone, M., & Mann, S. (2016). Effects of war, terrorism, and armed conflict on young children: A systematic review. Child Psychiatry & Human Development, 47(6), 950-965. https://doi.org/10.1007/s10578-016-0626-7
Sousa, C. A., Kemp, S. P., & El-Zuhairi, M. (2019). Place as a social determinant of health: Narratives of trauma and homeland among Palestinian women. The British Journal of Social Work, 49(4), 963-982. https://doi.org/10.1093/bjsw/bcz049
Stefanini, A., & Ziv, H. (2004). Occupied Palestinian territory: Linking health to human rights. Health & Human Rights, 8, 160. https://doi.org/10.2307/4065380
Tedeschi, R. G., Park, C. L., & Calhoun, L. G. (1998). The context for posttraumatic growth: Life crises, individual and social resources, and coping. In Posttraumatic Growth (pp. 107-132). Routledge. https://doi.org/10.4324/9781410603401-9
Thabet, A. A. M., Abdulla, T. A. I. S. I. R., Elhelou, M., & Vostanis, P. A. N. O. S. (2006). Effect of trauma on Palestinian children's mental health in the Gaza Strip and West Bank. In Protection of children during armed political conflict: A multidisciplinary perspective (pp. 123-142).
Thabet, A. A., & Vostanis, P. (2011). Impact of political violence and trauma in Gaza on children's mental health and types of interventions: A review of research evidence in a historical context. International Journal of Peace and Development Studies, 2(8), 214-218.
Thabet, A., & Thabet, S. (2015). Trauma, PTSD, anxiety, and resilience in Palestinian children in the Gaza Strip. British Journal of Education, Society & Behavioural Science, 11(1), 1-13. https://doi.org/10.9734/BJESBS/2015/19101
Tol, W. A., Jordans, M. J., Kohrt, B. A., Betancourt, T. S., & Komproe, I. H. (2013). Promoting mental health and psychosocial well-being in children affected by political violence: Part I-Current evidence for an ecological resilience approach. In Handbook of resilience in children of war (pp. 11-27). https://doi.org/10.1007/978-1-4614-6375-7_2
United Nations Office for the Coordination of Humanitarian Affairs. (2023). Gaza: Humanitarian snapshot. United Nations OCHA. https://www.ochaopt.org/content/gaza-humanitarian-snapshot
Veronese, G., Cavazzoni, F., & Antenucci, S. (2018). Narrating hope and resistance: A critical analysis of sources of agency among Palestinian children living under military violence. Child: Care, Health and Development, 44(6), 863-870. https://doi.org/10.1111/cch.12608
Werner, E. E. (2012). Children and war: Risk, resilience, and recovery. Development and Psychopathology, 24(2), 553-558. https://doi.org/10.1017/S0954579412000156
World Bank & United Nations Office for the Coordination of Humanitarian Affairs. (2023). Economic Monitoring Report to the Ad Hoc Liaison Committee - October 2023: The Status of the Gaza Economy. World Bank Group. https://documents.worldbank.org/en/publication/documents-reports/documentdetail/788991708604164976/the-status-of-the-gaza-economy
World Health Organization. (2006). Health conditions in the occupied Palestinian territory. In Health conditions in the Occupied Palestinian Territory.
World Health Organization. (2022). Mental health of refugees and migrants: Risk and protective factors and access to care. WHO. https://www.who.int/publications/i/item/9789240052773
Ziadni, M., Hammoudeh, W., Rmeileh, N. M. A., Hogan, D., Shannon, H., & Giacaman, R. (2011). Sources of human insecurity in post-war situations: The case of Gaza. Journal of Human Security, 7(3), 10-3316. https://doi.org/10.3316/JHS0703023
Zrineh, A., Karmi, H., Zeidan, S., Salameh, A., & Ikhmayyes, I. (2025). Interplay of post-traumatic stress disorder, post-traumatic growth, and social support among Palestinian refugees in West Bank camps: A cross-sectional study. International Journal of Social Psychiatry, 00207640251341594. https://doi.org/10.1177/00207640251341594
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