Psychological Impact of Political Conflict: Prevalence and Severity of PTSD Among Children and Adolescents in the North and Middle West Bank Following the October 7, 2023, Events

<b>Background:</b> The political conflict in the West Bank was escalated on October 7, 2023, further increasing exposure to traumatic events among children and adolescents, with potential implications for their mental health. This study estimates the prevalence and severity of posttraumatic stress disorder (PTSD), its sociodemographic correlates, and functional impacts on affected youth. <b>Methods:</b> This cross-sectional study was conducted from February 5 to March 5, 2024, among 1148 Palestinian children and adolescents aged 8-15 years from the North and Middle West Bank, selected by stratified random sampling. The Child PTSD Symptom Scale was used to assess symptoms of PTSD, while trauma exposure was measured using the War-Trauma Exposure Checklist. SPSS was used for data analysis. <b>Results:</b> Symptoms of PTSD were moderate to very severe in 70.0% of participants. The most prevalent traumatic experiences were witnessing bombings on television (93.4%) and witnessing dismembered bodies on television (92.8%). Intrusion symptoms predominated, with frequent reports of nightmares and intrusive thoughts. Age showed a significant positive correlation with PTSD severity (<i>r</i> = 0.12, <i>p</i>=0.034), indicating more severe symptoms in older children. PTSD significantly impaired academic performance (55.0%), emotional relationships (41.5%), and recreational activities (32.7%). Children experiencing > 5 traumatic events had substantially higher rates of severe PTSD symptoms (73.6% of this group; <i>p</i>=0.003). <b>Conclusions:</b> These findings indicate a severe mental health crisis among conflict-exposed children in the West Bank. Immediate interventions are needed, including trauma-focused cognitive behavioral therapy delivered with substantial modifications for ongoing conflict settings and school-based mental health programs. Respite for children and parents may be an important first step to engaging children and families in therapy. Systemic barriers to mental health care need to be tackled if better outcomes are achieved in this vulnerable population.