Depression, anxiety, and PTSD among Palestinian detention survivors assessed during the ongoing October 2023 war: Prevalence, comorbidity, and the limits of individual risk factors
DOI:
https://doi.org/10.7146/torture.v36i2.170760Keywords:
detention, accommodation, legal status, torture survivors, rehabilitation, post-traumatic stress disorder, depression, anxietyAbstract
Introduction: Palestinian detainees held during the October 2023 war have widely reported torture, but quantitative studies jointly assessing depression, anxiety, and post-traumatic stress disorder (PTSD) remain rare. We aimed to characterise the prevalence, severity, and comorbidity of these conditions and to examine demographic and detention-related predictors.
Methods: In this cross-sectional study, we recruited 383 Palestinian adults detained by Israeli authorities during the October 2023 war, subsequently released, and reporting torture. Participants were recruited through rehabilitation centres, human rights organisations, and community networks in Gaza, and completed Arabic-language PHQ-9, GAD-7, and PCL-5 measures in structured, trauma-informed interviews between late 2025 and early 2026. Multiple linear regression assessed predictors of symptom severity, and regression-based path analysis examined the pathway from cumulative torture exposure to depression through PTSD.
Results: 76.75% scored in the moderate-to-severe range on the PHQ-9, 65.50% on the GAD-7, and 68.50% met the PCL-5 threshold for probable PTSD. The three conditions were strongly intercorrelated (r = 0.59–0.66, p < .0001), with 49.35% meeting thresholds for all three. Education was the only demographic variable significantly associated with depression, anxiety, and PTSD severity, though models explained under 3% of variance; age, gender, detention duration, and cumulative torture exposure were not significant predictors. PTSD severity was strongly associated with depression, whereas cumulative torture exposure was not significantly associated with either outcome. Internal consistency was good (Cronbach's α = 0.80–0.91).
Discussion: Palestinian detention survivors showed an extremely high and highly comorbid burden of depression, anxiety, and PTSD. The near-ceiling torture exposure in this sample may help explain the limited predictive power of individual demographic and exposure variables. These findings support integrated, trauma-informed mental health care and continued human rights documentation for this population.
torture, detention, PTSD, depression, comorbidity
References
Ahmed, S. H., et al. (2024). Prevalence of post-traumatic stress disorder and depressive symptoms among civilians residing in armed conflict-affected regions: A systematic review and metaanalysis. General Psychiatry, 37(3), e101438. doi:10.1136/ gpsych-2023-101438 Aldabbour, B., El-Jamal, M., Abuabada, A., Al-Dardasawi, A., Abusedo, E., Abu Daff, H., Al-Saqqa, H., Abu Helal, D., Abu Radwan, R., El-Hindawi, R., Hamada, M., Abu Khader, W., & Dardas, L. A. (2025). The psychological toll of war and forced displacement in Gaza: A study on anxiety, PTSD, and depression. Chronic Stress, 9. doi:10.1177/24705470251334943 Aldabbour, B., Jaradat, R., Aljbour, O., Abdo, M., Aljbour, J., Abo Dayya, A., Dabbour Asad, M., & Abuabada, A. (2025). Depression, anxiety, stress, sleep quality, and life satisfaction among undergraduate medical students in the Gaza Strip: A cross-sectional survey. Middle East Current Psychiatry, 32, 14. doi:10.1186/s43045-025-00507-z Addameer – Prisoner Support and Human Rights Association. (2016). Induced desperation: The psychological torture of administrative detention. https://www.addameer.org/ publications/induced-desperation-psychological-tortureadministrative-detention American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. University of Pennsylvania Press. Bloom, S. L. (1997). Creating sanctuary: Toward the evolution of sane societies. Routledge. B’Tselem. (2026). Living Hell: The Israeli prison system as a network of torture camps. B’Tselem – The Israeli Information Center for Human Rights in the Occupied Territories. https:// www.btselem.org/publications/202601_living_hellDugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36(2), 215–226. doi:10.1016/S0005-7967(97)00070-3 Einolf, C. J. (2007). The fall and rise of torture: A comparative and historical analysis. Sociological Theory, 25(2), 101–121. doi:10.1111/j.1467-9558.2007.00300.x Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35. doi:10.1037/0033-2909.99.1.20 Goffman, E. (1961). Asylums: Essays on the social situation of mental patients and other inmates. Anchor Books. Hamamra, B., Mahamid, F., Bdier, D., & Mayaleh, A. (2025). Detention and psychological trauma during Gazacide: A qualitative study. European Journal of Trauma & Dissociation, 9(3), Article 100575. doi:10.1016/j.ejtd.2025.100575 Herman, J. L. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. Basic Books. Jabr, S., & Helbich, M. (2025). Torture as a tool of domination: The logic behind the use of torture against Palestinians. A human rights approach. Torture Journal, 35(2–3), 101–111. doi:10.7146/torture.v35i2.156977 Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology of trauma. Free Press. Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. doi:10.1046/ j.1525-1497.2001.016009606.x Lim, I. C. Z. Y., Tam, W. W. S., Chudzicka-Czupała, A., McIntyre, R. S., Teopiz, K. M., Ho, R. C., & Ho, C. S. H. (2022). Prevalence of depression, anxiety and post-traumatic stress in war- and conflict-afflicted areas: A meta-analysis. Frontiers in Psychiatry, 13, 978703. doi:10.3389/fpsyt.2022.978703 Marie, M., Hannigan, B., & Jones, A. (2018). Social ecology of resilience and Sumud of Palestinians. Health, 22(1), 20–35. doi:10.1177/1363459316677624 Palestinian Centre for Human Rights (PCHR). (2025). Systematic torture and ill-treatment of Palestinian detainees: Legal analysis and documentation. PCHR Report. https://pchrgaza.org/pchrsubmits-evidence-of-systematic-torture-of-palestinian-detaineesahead-of-uncat-review-of-israel/ Rizkalla, N., Bakr, O., Alsamman, S., Sbini, S., Masud, H., & Segal, S. P. (2022). The Syrian regime’s apparatus for systemic torture: A qualitative narrative study of testimonies from survivors. BMC Psychiatry, 22, Article 787. doi:10.1186/s12888-02204425-w Sehwail, M., Rasras, K., Sehwail, W., Wichmann Madsen, K., & Aon, M. (2025). The profile and psychological effects of torture of Palestinians detained in Israeli prisons after 7th October 2023. Torture Journal, 35(2–3), 50–60. doi:10.7146/torture. v35i2.156890 Seligman, M. E. P. (1972). Learned helplessness. Annual Review of Medicine, 23, 407–412. doi:10.1146/annurev. me.23.020172.002203 Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. doi:10.1001/archinte.166.10.1092 Sykes, G. M. (1958). The society of captives: A study of a maximumsecurity prison. Princeton University Press. Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD. https://www.ptsd.va.gov World Health Organization. (2019). ICD-11: International classification of diseases for mortality and morbidity statistics (11th ed.). World Health Organization.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Torture Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
We accept that some authors (e.g. government employees in some countries) are unable to transfer copyright. The Creative Commons Licence Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) covers both the Torture Journal and the IRCT web site. The publisher will not put any limitation on the personal freedom of the author to use material contained in the paper in other works which may be published, provided that acknowledgement is made to the original place of publication.
