The role of social support in moderating anxiety, depression, and PTSD symptoms during the ‘swords of iron’ war in Israel

Abstract Emotion-focused coping strategies, which aim to manage emotions rather than address stressors directly, are consistently linked to heightened psychological distress, including depression, anxiety, and post-traumatic symptoms. In contrast, perceived social support acts as a protective factor, buffering individuals from these adverse effects by enhancing coping efficacy and psychological resilience. This study investigated whether perceived social support serves as a moderator in the link between emotion-focused coping styles psychological distress during the 2023 Israel-Gaza war. Using a cross-sectional design, 589 participants completed digital questionnaires measuring depression (PHQ), anxiety (GAD), PTSD symptoms (PCL-5), perceived social support (MSPSS), and coping styles (COPE). Multiple regression analyses assessed the association between emotion-focused coping and psychological distress, as well as the moderating effect of social support. A significant interaction emerged between emotion-focused coping strategies and perceived social support in predicting psychological distress ( p < .001). Simple slope analysis demonstrated that social support mitigated distress across low ( p < .0001), moderate ( p < .0001), and high ( p < .0001) levels of emotion-focused coping. These findings remained consistent after adjusting for confounding variables, including age, gender, and prior diagnoses of depression, anxiety, and PTSD. Perceived social support moderates the negative psychological impact of emotion-focused coping during high-stress events, such as the October 7 war in Israel. These findings underscore the critical role of social support networks in fostering resilience during conflict, emphasizing the need for interventions that strengthen these networks in high-risk environments.