Childhood and adolescence represent an essential stage in developing mental health. More than half of mental health issues begin in these age groups, and many of these issues continue throughout adult life [32]. The psychological impact of watching war news, especially Middle East conflicts, has evolved between the past and the present. In the past, the traditional media and news were presented in a more controlled and organized manner, as not every home could watch what happened worldwide. Today, with increased access to online and social media news sources, individuals may feel a greater volume and diversity of information and gruesome images of frightening events [33, 34].
The present study aimed to assess the adverse effects of watching the ongoing war scenes of the Palestine-Israeli conflict in the Gaza Strip on adolescent’s mental health. The findings of the DASS-21 scales revealed that 29.9%, 61.5%, and 57% of respondents had variant degrees of stress, depression, and anxiety, respectively.
The current study found that the overall prevalence rates of stress, depression, and anxiety in our study were high, comparable to other studies conducted in different countries assessing the effect of the Russo-Ukrainian war on the same age group; in Poland (Stress 17.4%, Depression 29%, Anxiety 36.5%) and Taiwan (Stress 3.7%, Depression 11.2%, Anxiety 14.9%) [35].
There is evidence that neighbors who share the same language, beliefs, and religion as the inflicted people might have exacerbated reactive responses and become more sympathetic toward them [35, 36]. This might be the explanation for the observed high levels of psychological issues among our participants. Also, the geographical location can’t be ignored since Egypt borders Gaza in the northeast.
Interestingly, female adolescents experienced a statistically significant higher level of stress, depression, and anxiety than males. These results align with other studies, which showed that females had higher DASS-21 and IES-R (The Impact of Event Scale-Revised) scores [34]. Also, a systematic review included studies conducted between 1994 and 2014 interpreted that females who were not involved in a war zone in 30 countries were associated with a higher prevalence of depression [37]. Similar literaturee elucidated that the higher levels of mental health problems might be due to younger pubertal age, unhealthy ways of coping, including contemplation, and issues with peers and parenting, which make them more prone to emotional distress [38].
Though urban life confers its dwellers’ health facilities, better education, work opportunities, entertainment, and economic developments, it is deleterious to mental health [39]. Consistently, adolescents from urban areas demonstrated statistically significantly increased levels of anxiety than their peers from rural areas. Most evidence pointed out the detrimental effect of urban living on mental wellbeing, which has heightened levels of inequality, vehemence, racial or ethnic marginalization, environmental pollution, and diminished green space [39,40,41].
The present study revealed that adolescents in high schools who were aged between 15 and 18 years old experienced increased rates of stress 35.8%, depression 68.1%, and anxiety 60.3% comparable to their younger peers whose rates of stress, depression, and anxiety were 19.3%, 49.7%, and 47.6%. Studies suggest that when children get older, they might not seek social support, although they showed that social support has a mediating role in reducing mental health problems [42].
Social media have become an integral part of adolescents’ lives, with reports showing that 97% of adolescents are active on social media today [43]. Expectedly, most of the studied adolescents (70%) reported following the Gaza scenes across diverse social media platforms using their smartphones or devices, and mostly no parental guide for the watched frightening content. Millions of children and adolescents in the region are indirectly exposed to war, armed conflict, and terrorism through the media, inducing panic, fear, mass anxiety, constant hazard, and learned powerlessness [44].
The advancing, variant, accessible media channels, notorious for their amenability, render adolescents become insatiable users of media covering wars, armed confrontations, and terror attacks [45, 46].
Studies showed that the increased frequency, longer hours or intensity, and methods of media exposure determine the impact of watching conflict scenes on adolescents’ mental health, where highly gruesome images have exacerbated distress symptoms [47]. Consistently, our findings showed a significant prevalence of mental disorder symptoms among participants who reported watching the events for 5–7 days per week and more than 3 h per day compared to those who watched for less frequency and shorter duration. Additionally, previous literature demonstrated that actual violence has a more significant impact on children and adolescents than fictional ones, as the scenes could profoundly influence adolescents watched through different media channels portraying armed confrontations and incidents of terrorism [48]. Similarly, a study of the Polish population in the context of the war in Ukraine, covering about 72 participants, showed increased symptoms of depression and anxiety (64.7%,65%) among participants spending longer time watching the events. The authors explained fear for their future, the possible inclusion of their country in such war, and living in the same hostility and suffering [49].
Likely, another study finding about the National Survey of Stress Reactions after the September 11 terroristic attack on the United States showed that 35% of children had one or more stress symptoms, and 44% of adults reported one or more substantial symptoms of stress and were significantly associated with increased exposure time [50].
Our findings revealed that 70.2% of adolescents watching the scenes of the conflict were following the events through the different platforms on the Internet, while 29.8% were following the events on TV. Since the Internet provides quick access to real-time updates, it was no surprise that many students relied on it as their primary news source. Therefore, meticulous and supervised use of displayed materials on media could mitigate the risks of psychological distress among children and adolescents.
This observation is supported by a related study that detected that almost all of its participants (94.1%) reported looking at news online regularly. In comparison, 61% of participants watched news on TV but not frequently. Also, it referred to students’ tendency to get the news from the Iinternet as it allows them to check news between classes, while walking, and even during classes. Ffollowing multiple online news sources on social media such as CNN, The New York Times, USA Today, and the Huffington Post, with the convenience of their smartphones, they can look at their phones for news at any time [51].
About 21.8% of participants reported that they abruptly followed any scenes related to the Gaza conflict for multiple reasons. It was noted that the DASS-21 scale results were better among this group. The stress level doubled in adolescents still watching conflict scenes regularly (33.7%), comparable to 15.9% in adolescents who stopped watching the events (p-value = 0.001). Likely were depression and anxiety rates: 47.8% and 44.2% among students who stopped watching the events, while higher rates were observed among their counterparts who were still following the events regularly (65.3% and 60.6%, respectively).
Correspondingly, Slone et al.2013 concluded that intervention enhancement of self-mastery and refraining from direct exposure to war scenes were beneficial to decline the incidence of emotional distress symptoms among adolescents, compared to the control group who reported higher rates of psychological indices [52].
However, according to the theory of emotional desensitization, with repeated exposure to violence, people become “numb” to the violence, i.e., they experience less anxiety with each new exposure. However, this hypothesis might not apply to adolescence phases of life [53].
The present study investigated reasons explaining why adolescents stopped viewing conflict events; the results showed that more than one-third (37.2%) of participants stopped watching the events of conflict because they got busy with their studying chores, about one-third (34.5%) felt helpless to change the situation, 19.5% of them got bored with following the news and 8.8% were prohibited by their parents from watching these events.
Likely, a related study showed that people might take a break from the bad news because they might feel disempowered, helpless, apathetic, and even insensitive [52]. Another study showed that they might feel guilty as it suggested that individuals who follow situations in which people have died may develop “surveillance guilt” [54].