Coping with stress among parents of combatants: The Swords of Iron War

ABSTRACT

This study explores how Israeli parents of combatants coped with stress during the Swords of Iron War and how their coping strategies related to their mental health. The sample included 187 Israeli parents (94 mothers and 93 fathers) of combatants serving in either compulsory service or reserve duty during the war. Data were collected in November 2024 via an online survey, ensuring geographic representation across Israel, during a period of intense combat on three fronts: south, north, and the West Bank. The findings indicated that as perceived stress increased, the tendency to rely on active coping strategies such as active distraction and seeking emotional support, as well as passive coping strategies, also increased. None of these strategies correlated with improved mental health. In contradistinction, positive reframing and engaging in spiritual practices were linked to better mental health outcomes. Substance use was found to mediate the relationship between stress and mental health. No significant gender differences emerged in the relationship between perceived stress and mental health. The findings suggest that commonly used coping strategies may not protect the mental health of combatants’ parents. It is recommended to guide parents toward adaptive, resilience-promoting strategies.

What is the public significance of this article?—This study highlights the psychological toll experienced by Israeli parents of combat soldiers during the Swords of Iron War. Despite using various coping strategies, many parents reported diminished mental health, especially under heightened stress. The findings emphasize the need for targeted support systems that promote resilience and offer more effective, adaptive coping methods for families of combatants during wartime. By identifying which coping strategies are most beneficial, this research can guide mental health professionals and policymakers in providing timely interventions to protect civilian well-being on the home front

Introduction

This study examined the contribution of perceived stress and coping strategies to explaining the mental health of Israeli parents of combat soldiers (hereafter: “combatants”) during the Swords of Iron War (hereafter: “the war”). The war began on October 7, 2023, and was characterized by wide-scale military activity that extended beyond Israel’s borders. Many Israeli reserve soldiers were mobilized alongside soldiers in compulsory military service. This mobilization posed substantial coping challenges for the combatants’ families.

Studies conducted in various war-affected countries during the past decades examined the impact of stress related to having a family member in combat, but only a small number focused specifically on combatants’ parents. These studies reported various emotional responses by parents, including concern, sadness, and longing, alongside feelings of pride and appreciation for their children’s military service and commitment (Basinger & Knobloch, 2018; Palmer, 2008; Riggs & Riggs, 2011). To date, however, few studies have specifically addressed how combatants’ parents cope with the psychological burden associated with their children’s military service (e.g., Lipman et al., 2021; Savitsky & Shvartsur, 2024). The present study addresses this gap by focusing on combatants’ parents and examining the relationship between their perceived stress, the coping strategies they adopt, and their mental health.

Conceptual and theoretical framework

The theoretical foundation of this study is grounded in the Conservation of Resources (COR) theory (Hobfoll, 1989), which posits that individuals are motivated to preserve, protect, and accumulate valued resources. Hobfoll defines resources broadly to include personal traits, material possessions, energies, and beliefs that support adaptation and resilience. According to the COR theory, when individuals are unable to maintain their resources, the resulting resource loss generates stress, which can undermine mental health (Hobfoll et al., 2018).

To counteract this stress, individuals turn to coping strategies. There is general agreement in the literature that coping mechanisms serve to manage stress and buffer against its psychological and physical consequences (see Penley et al., 2002, for a meta-analysis). However, theoretical models conceptualize coping differently. According to the COR framework, coping is guided by three key goals: avoiding additional resource depletion, replenishing previously lost resources, and cultivating new resources (personal, social, emotional). Each coping strategy reflects a form of psychological defense aimed at mitigating perceived threats (Hobfoll et al., 2018) However, Hobfoll indicated that coping itself may also require significant effort and can become an additional source of stress.

The cognitive appraisal model developed by Lazarus and Folkman (1984) offers a complementary conceptualization of coping. According to this model, coping refers to the constantly changing efforts to manage external or internal demands appraised as taxing or exceeding the individual’s resources. This framework distinguishes between problem-focused coping strategies which aim to eliminate or reduce the source of stress (such as seeking practical solutions or changing the stressful situation), and emotion-focused coping strategies which aim to regulate the emotional response to stress (such as avoidance, denial, or seeking emotional support) in order to alleviate the individual’s distress. When individuals perceive some degree of control over the situation, they tend to opt for problem-focused coping. However, when such control is lacking and problem-focused coping is not feasible, individuals are more likely to resort to emotion-focused coping in its various forms in order to preserve their mental health

It is important to note that mental health is currently defined as a positive state of psychological well-being marked by personal growth, effective stress management, productive functioning, and meaningful contribution to the community (World Health Organization, 2022). Nonetheless, coping strategies do not always ensure effective adaptation under stress. A key distinction supported by Thompson et al. (2010) is between adaptive and maladaptive coping strategies. Adaptive strategies such as seeking emotional support, problem-solving, maintaining positive thinking, or engaging in spiritual or religious practices enhance adjustment to challenging circumstances and promote mental health (Folkman & Moskowitz, 2004; Javed & Parveen, 2021; Park, 2005). In contradistinction, maladaptive strategies, such as denial (Schneider et al., 2018), expression of helplessness (Zucca et al., 2010), or substance abuse (Tartaglia & Bergagna, 2020), may provide short-term relief but can worsen psychological distress over time.

Stressors among combatants’ parents

Parental concerns for combatants differ from typical wartime communal worries, as they stem from the soldiers’ ongoing exposure to potentially life-threatening situations. This ongoing risk leads to existential anxiety that may persist even after the war ends (Riggs & Riggs, 2011). In Israel, prolonged and unpredictable conflicts, such as the ongoing Swords of Iron War, whose end remains unknown at the time of writing this paper, significantly heighten parental distress, creating a sustained burden of uncertainty with no real reprieve. Research shows that combatants’ parents frequently report feelings of longing, sadness, and deep fear that they may never embrace their children again (Duarte et al., 2020), feelings that intensify when their combatant children are deployed in particularly dangerous areas (Andres & Moelker, 2009). Recent data show that 22.8% of parents of soldiers report ongoing psychological distress, including symptoms of depression, anxiety, and stress. The likelihood of such distress is markedly higher among parents of combatants (Savitsky & Shvartsur, 2024).

Another challenge faced by parents is the limited information they receive. Due to military discipline and combatants’ desire not to worry their families, they often avoid sharing details of their experiences (Lipman et al., 2021). Unlike spouses or children of soldiers, who are commonly acknowledged by military and civilian support systems as requiring emotional assistance, parents often receive limited recognition. This partial acknowledgment may result in feelings of social isolation and a sense of insufficient support from both the community and institutional systems (Andres & Moelker, 2009).

A deeper, more complex stressor involves the internal conflict between parental and national identity. Many parents feel pride in their children’s service, but also experience anger, injustice, and even regret due to the danger their children face (Tuval-Mashiach & Corb, 2018). Nevertheless, combatants’ parents are expected to maintain daily functioning, care for other family members, and fulfill their professional responsibilities, while coping with deep and ongoing concern (Wadsworth & Southwell, 2011). This further depletes their emotional and psychological resources. Moreover, the limited availability of effective coping strategies in this situation adds another layer of difficulty. Problem-focused coping strategies, which aim to resolve the source of stress (Lazarus & Folkman, 1984), are largely inapplicable in this context, as parents cannot stop the war or remove their children from combat zones. The available coping avenues are thus significantly narrowed, leaving emotion-focused strategies as the only remaining option for parents facing this ongoing uncertainty.

Based on the above-mentioned theorical frameworks and recognizing the multiple sources of stress experienced by combatants’ parents, this study employed an integrative, multi-variable model to examine how perceived stress and coping strategies relate to the mental health of mothers and fathers of combatants during the Swords of Iron War.

The hypothesized research model

The hypothesized research model positions combatants’ parents’ mental health as a dependent variable, with stress levels and coping strategies as independent variables. Both direct and indirect relationships among these variables are proposed (Figure 1).

Figure 1.

The hypothetical research model.

Direct relationships

Stress and mental health. Beyond the general societal stress stemming from the substantial losses sustained by Israeli society since October 7, combatants’ parents experience additional significant stress, primarily due to ongoing concerns for their children’s safety. According to the COR theory (Hobfoll, 1989), stress arises when individuals experience actual or threatened loss of valuable resources. In the case of combatants’ parents soldiers, such resource loss is strongly associated with diminished mental health. These losses often include a reduced sense of security, loss of emotional calm, depletion of mental energy, and disruptions in sleep quality – all of which are critical for psychological resilience during prolonged periods of uncertainty and fear. Previous Israeli studies conducted during military operations support this, demonstrating elevated post-traumatic symptoms and psychological distress among combatants’ parents (Bitton et al. 2017; Tuval-Mashiach & Corb, 2018; Zerach & Gordon-Shalev, 2022). It is therefore hypothesized:

Hypothesis 1:

Higher stress levels among combatants’ parents will correlate with lower levels of mental health.

Stress and coping strategies. According to Lazarus and Folkman (1984), when individuals face situations characterized by limited control or high uncertainty, where problem-focused coping is not feasible, they tend to adopt emotion-focused coping strategies aimed at alleviating emotional distress. Given the ongoing uncertainty and lack of control experienced by combatants’ parents, it is likely that they rely predominantly on such emotional coping strategies. This hypothesis is supported by a comprehensive review conducted by Compas et al. (2001), which found that increased stress levels are associated with greater activation of coping mechanisms. Prior research has demonstrated a similar pattern of coping behavior among civilians during wartime threats (Zeidner & Ben-Zur, 1993). It is thus hypothesized:

Hypothesis 2:

Higher stress levels among combatants’ parents will correlate with greater use of coping strategies.

Coping strategies and mental health. While the primary objective of coping strategies is to mitigate stress and reduce psychological distress, studies show that their effectiveness varies by strategy type (Holton et al., 2016). Maladaptive coping strategies, including denial, substance abuse, avoidance, and expressing negative emotions such as helplessness, correlate negatively with mental health (Owen et al., 2023). Adaptive coping strategies, such as seeking social support and fostering self-efficacy and self-worth, correlate positively with psychological well-being (Taylor & Stanton, 2007). Hence, it is hypothesized:

Hypothesis 3:

Adaptive coping strategies will positively correlate with mental health, whereas maladaptive coping strategies will negatively correlate with mental health.

Indirect relationships – coping strategies as mediators

Coping strategies may mediate the relationship between stress and mental health, potentially clarifying variations in psychological outcomes (Taylor & Stanton, 2007). However, mediating effects differ depending on whether coping strategies are adaptive or maladaptive. Adaptive strategies may buffer stress and enhance mental health, whereas maladaptive strategies may exacerbate psychological distress (Compas et al., 2001; Holahan et al., 2005). Thus, distinguishing between these types of coping strategies is essential:

Hypothesis 4:

Adaptive coping strategies will mediate the relationship between stress and mental health among combatants’ parents, such that in cases where stress is associated with greater use of adaptive strategies, these strategies will be positively associated with mental health.

Hypothesis 5:

Maladaptive coping strategies will mediate the relationship between stress and mental health among combatants’ parents, such that in cases where stress is associated with greater use of maladaptive strategies, these strategies will be negatively associated with mental health.

Considering established gender differences in both stress experiences and preferred coping strategies (Matud, 2004), a gender-specific analysis is essential, as these differences may impact relationships between stress, coping strategies, and mental health.

Explanatory variables and mental health: mothers and fathers of combat soldiers

This study focused on the impact of parental gender on the experience of stress and worry related to children serving in combat. Differences between mothers and fathers are best understood as the product of gendered parental roles, shaped by both gender role socialization and the cultural meanings assigned to motherhood and fatherhood within Israeli society, particularly in the context of military service.

According to Gender Role Theory (Wood & Eagly, 2002), stress experiences and coping responses differ based on socially constructed expectations of femininity and masculinity (Koenig & Eagly, 2014). In this study, such gendered expectations are examined through the lens of parenthood. The roles of the “mother of a combat soldier” and the “father of a combat soldier” are not neutral. Rather, they are socially constructed and imbued with symbolic, institutional, and emotional meanings unique to the Israeli cultural and military context. Mothers are often portrayed as emotionally fragile, deeply involved, and in need of protection from distressing realities, while fathers are expected to exhibit emotional restraint, rationality, and strength (Ben Meir & Litvak-Hirsh, 2020; Tuval-Mashiach & Corb, 2018).

For mothers, limited access to information and military secrecy contribute to a perceived loss of control and reinforce their positioning within a gendered knowledge field, symbolically excluding them from military authority. As a result, many mothers report experiences of helplessness and emotional isolation (Gardiner & Garner, 2010). These cultural constructions justify expectations of emotional and behavioral differences between mothers and fathers, particularly in relation to their stress responses and coping strategies.

Empirical research supports these distinctions. Women are more likely to use emotion-focused coping strategies, such as seeking emotional support (Ptacek et al., 1994) or denial (Oppegaard et al., 2020), whereas men tend to prefer problem-focused coping strategies (Tamres et al., 2002). These differences are reinforced by societal norms that afford women greater legitimacy in expressing emotions such as fear and sadness, while encouraging men to suppress such expressions (Caponnetto et al., 2024).

Mothers thus tend to report more symptoms of secondary traumatization during wartime, including sleep disturbances, depression, and somatic complaints (Dirkzwager et al., 2005). Fathers may experience similar levels of psychological distress but are less likely to acknowledge or express it, in part due to internalized masculine norms that associate emotional vulnerability with weakness (Addis & Mahalik, 2003; Brody & Hall, 2008). This emotional suppression helps maintain a culturally sanctioned masculine self-image and fulfills prevailing social expectations (Ben Meir & Litvak-Hirsh, 2020).

Importantly, these observed differences are not definitively rooted in essential or biological distinctions between men and women. Rather, they reflect socially constructed expectations regarding how mothers and fathers are expected to experience and manage stress. The stronger correlation between stress and adverse mental health outcomes among mothers, as consistently demonstrated in prior studies (Matud, 2004; Rudolph et al., 2001), may stem from the broader social legitimacy granted to women to express psychological distress, contrary to the emotional restraint typically expected of men.

Hypothesis 6:

The relationship between stress and mental health will be stronger among mothers than among fathers

Regarding potential gender differences in the association between coping strategy use and mental health outcomes, the current study adopted an exploratory approach due to the limited empirical evidence available. Thus, no prior hypotheses were formulated for this issue, allowing for an open investigation into whether such differences exist.

Method

Procedure and sample

The study included 187 parents of combat soldiers (93 fathers and 94 mothers). The mothers and fathers were not sampled as couples, meaning each parent participated independently and was not paired with the other parent of the same soldier.

Data were collected via the online panel, Panel4All, which includes tens of thousands of participants from all sectors of Israeli society. A total of 2,710 invitations were sent to panel members via e-mail. In the initial stage, 1,181 respondents completed screening questions to determine eligibility. Only parents of a son or daughter serving in a combat role (mandatory or reserve) could proceed to the full questionnaire. Quota sampling was used, with predefined quotas for gender, region of residence, age, and level of religiosity. The panel’s distribution system ensures that invitations are sent in accordance with these quotas, thereby guaranteeing a representative sample of the target population.

Each participant received a symbolic payment, awarded as points redeemable for digital vouchers or gift cards. The invitation e-mail specified the expected survey duration as well as the number of points to be awarded upon completion. Further methodological details regarding the internet panel used for data collection are available on the Panel4All website (2024). The survey itself took approximately 20 minutes to complete. If participating parents had more than one child serving in combat, they were instructed to refer to the child who had been deployed for the longest period since the start of the war.

The study received approval from the academic institutional ethics committee. The sample’s distribution according to background variables is presented in Table 1. Most participants had one child in combat, while some had two or more. Of these parents, 81.8% had sons in combat, 7.2% had daughters, and 11% had both sons and daughters.

Table 1.

Distribution by background variables: fathers vs. Mothers (N = 187).

Variable	Values	M(SD)	Fathers (n = 93)	Mothers (n = 94)	t/χ2
Age		M(SD)	51.65 (5.60)	51.90(6.09)	t = −0.29
Number of children		M(SD)	2.99 (1.07)	3.12 (1.04)	t = −0.82
Number of combatants		M(SD)	1.19 (0.49)	1.18 (0.48)	t = 0.15
Physical health		M(SD)	3.96 (0.69)	3.93 (0.87)	t = 0.27
Relationship status	Partnered	n	83	75
		%	89.2%	79.8%	χ2 = 3.19
	Unpartnered	n	10	19
		%	10.8%	10.2%
Education	High school	n	14	18
		%	15.1%	19.1%
	Postsecondary	n	20	18
		%	21.5%	19.1%	χ2 = 1.39
	B. A	n	35	39
		%	37.6%	41.5%
	Above B. A	n	24	19
		%	25.8%	20.2%
Religiosity	Secular	n	54	43	χ2 = 3.06
		%	58.1%	46.2%
	Traditional	n	23	33
		%	24.7%	35.5%
	Religious	n	16	17
		%	17.2%	18.3%
Economic status during the war	Deteriorated greatly	n	8	5	χ2 = 4.18
		%	8.6%	5.3%
	Deteriorated	n	26	36
		%	28.0%	38.3%
	No change	n	55	52
		%	59.1%	55.3%
	Improved	n	4	1
		%	4.3%	1.1%
Past military service	Served	n	92	67	χ2 = 28.6***
		%	98.9%	71.3%
	Did not serve	n	1	27
		%	1.1%	28.7%

*p < .05, **p < .01, ***p < .001.

Combatants’ characteristics

Enlistment status: 61.2% (115) were in regular service; 38.8% (73) in the reserves. Duration of service: 4.2% (8) served up to 2 months; 16% (30) for 3–6 months; 34% (64) for 7–12 months; 45.7% (86) since the beginning of the war until November 2024. Combat zone: 46.3% (87) served in the north; 61.7% (116) in the south; 13.8% (26) in the West Bank. Since combatants may have served in more than one zone during the war, the total number of responses based on deployment regions exceeded the total sample size. Home leave frequency: 13.6% (25) weekly; 30.9% (58) biweekly; 34.6% (65) every three weeks; 5.8% (11) monthly or less.

Instruments

The research instruments included several questionnaires:

Mental Health Continuum Questionnaire – Short Form (MHC-SF; Lamers et al., 2011)

This instrument includes 14 items designed to assess mental health. Participants were asked to indicate the frequency with which they experienced each described feeling during the past month, using a 6-point Likert scale ranging from 1 (not at all) to 6 (every day). A sample item is: “During the past month, how often did you feel that you had experiences that challenged you to grow and become a better person?” The total score was calculated by averaging all item responses. A higher score indicates a higher level of mental health. The scale demonstrated good internal consistency (Cronbach’s α = .84).

Perceived Stress Scale – Stress Subscale of the DASS (Lovibond & Lovibond, 1995)

This scale consists of seven items taken from the stress subscale of the Depression Anxiety Stress Scales (DASS). The scale was employed to assess the level of psychological stress experienced by participants. Respondents were asked to indicate the extent to which they had experienced symptoms such as nervousness, difficulty relaxing, irritability, and mental tension since their child’s enlistment. A sample item is: “I found it hard to wind down.” Responses were rated on a 4-point scale ranging from 0 (“did not describe me at all”) to 3 (“described me very much”). The overall stress score was calculated by summing participants’ responses to these seven items, with higher scores indicating higher levels of perceived stress. The stress scale showed high internal reliability (Cronbach’s α = .90).

Coping Strategies Questionnaire (Brief COPE; Carver et al., 1989)

This 28-item questionnaire assessed a range of coping strategies used in response to stress. Parents were asked to indicate the extent to which they used each strategy when dealing with the distress caused by concern for their combat-serving child during the Swords of Iron War. Responses were given on a 4-point scale ranging from 0 (not at all) to 3 (very much). A Principal Axis Factoring analysis with Promax rotation identified six factors explaining 57.7% of the total variance.¹

Based on theoretical and empirical frameworks (e.g., Carver et al., 1989; Connor-Smith & Flachsbart, 2007; Meyer, 2001), the factors were grouped into adaptive and maladaptive coping strategies.

Adaptive coping strategies: emotional support seeking (4 items, e.g., “I seek emotional support from others”; α = .90); active distraction (7 items, e.g., “I do various activities to take my mind off things”; α = .84); positive reframing (4 items, e.g., “I try to see something good in what’s happening”; α = .90); spiritual practices (2 items, e.g., “I try to find comfort in my faith or spiritual beliefs”; r = .80)

Maladaptive coping strategies: Substance use (2 items, e.g., “I use alcohol or drugs to get through it”; α = .87); passive emotional strategies (3 items, e.g., “I refuse to believe that what’s happening is real”; α = .70).

A mean score was calculated for each factor. Higher scores reflect more frequent use of the coping strategy.

Background variables

The parental background questionnaire included gender, age, relationship status, religiosity, economic status, physical health status, and number of combatant children.

The combatant background questionnaire included items regarding type of service (regular or reserve) and affiliation with security forces.

Data analysis

We used Repeated Measures ANOVA and Pearson correlations to present basic statistical descriptions of the data. Path analysis was then conducted to test the research hypotheses.

Results

Descriptive statistics for the main study variables are provided before the findings related to the research hypotheses. As gender differences in perceived stress, coping strategies, and mental health constitute a central focus of this study, the results section begins with an analysis of gender-based differences in these variables.

Gender differences in explanatory variables and mental health

Independent samples t-tests were conducted to examine gender differences in the study variables (N = 182, df = 180). Mothers reported higher levels of stress (M = 1.05, SD = 0.72) compared to fathers (M = 0.82, SD = 0.76), t(180) = −2.13, p < .01. Significant gender differences were also found in some coping strategies. Compared to fathers, mothers were more likely to use active distraction, t(180) = −4.95, p < .001; emotional support seeking, t(180) = −2.74, p < .01; and spiritual practices, t(180) = −2.84, p < .01 (Figure 2).

Figure 2.

Levels of coping strategies use by mothers and fathers.

Hierarchy of coping strategy use: gender differences

A repeated measures ANOVA (within: Multiple Strategies; between: Gender) was conducted to examine whether differences exist in the ranking of coping strategies used by fathers compared to mothers. Coping strategies were considered related to each other within the same individual. This approach accounts for the correlation among the different coping strategies and controls for Type I error inflation that would occur if multiple separate ANOVAs were conducted. The analysis yielded three main findings.

Main effect of coping strategy type

A significant within-subjects effect was found for coping strategy type, indicating that the frequency of use differed significantly between the various strategies: Wilks’ Lambda = .261, F(5,181) = 102.55, p < .001, η² = .739. Pairwise comparisons with Bonferroni correction showed that active distraction was used significantly more than any other strategy across the total sample (fathers and mothers). This was followed by spiritual practices and positive reframing. Emotional support seeking and emotional passive strategies were used with moderate frequency, while substance use was ranked significantly lower than all other strategies.

Main effect of gender

A significant between-subjects main effect of gender was found, indicating that mothers reported using coping strategies more frequently overall than fathers, F(1, 184) = 6.617, p = .011, η² = .035. The overall mean coping score across all strategies was 0.99 for mothers and 0.82 for fathers.

Interaction between gender and coping strategy

A significant interaction was found between gender and strategy type (Gender × Strategy), indicating that the preferred hierarchy of coping strategies differed between fathers and mothers: F(5,180) = 11.42, p < .001, η² = .241. For fathers, the three leading strategies were positive reframing and active distraction (with no significant difference between them), followed by spiritual practices. Emotional support seeking and emotional passive strategies were used moderately and similarly, while substance use was used the least often. Among mothers, active distraction was the most frequently used strategy, followed by spiritual practices, emotional support seeking, and positive reframing. Emotional passive strategies were used significantly less, and substance use was the least used coping method.

Correlations between main study variables

As a preliminary step to testing the hypothesized path model, Pearson correlations were calculated among the key study variables (Table 2). The results showed a significant negative correlation between perceived stress and mental health. Perceived stress was positively correlated with several coping strategies. Positive reframing and spiritual practices were positively correlated with mental health, while emotional passive strategies were negatively correlated with mental health.

Table 2.

Means, standard deviations, and Pearson Correlations.

Variable	1	2	3	4		5	6	7	8	9	10	M	SD
1.Gender	–											0.50	0.50
2.Age	.02	–										51.78	5.87
3.Physical Health	−.02	−.08	–									3.94	0.78
4. Mental health	.004	.03	.35***		–							4.04	1.01
5.Perceived stress	.16*	−.14	−.31***		−.48***	–						6.60	5.27
6.Active distraction	.34***	−.09	−.03		.02	.34***	–					1.53	0.70
7.Emotional support seeking	.20**	−.24***	−.14		−.05	.40***	.52***	–				0.82	0.77
8.Positive reframing	−.13	−.18*	.07		.24***	−.05	.27***	.17*	–			1.05	0.71
9.Passive emotional strategies	.10	−.20**	−.13		−.26***	.51***	.32***	.31***	08.	–		0.70	0.69
10.Substance use	−.14	−.07	.01		−.12	.11	.19**	.35***	.05	.31***	–	0.19	0.55
11.Spiritual practices	.21**	−.17*	.04		.21**	.11	−.29***	.38***	.25***	12.	.21**	1.11	1.05

*p < .05, **p < .01, ***p < .001.

Path model: explaining mental health

In the first level of the path model, background variables were entered, including gender, religiosity (entered as a dummy variable with secular as the reference group compared to religious and traditional) and self-rated physical health, assessed on a 5-point scale ranging from 1 (very poor) to 5 (very good). Preliminary analyses showed that background variables, such as the number of combatant children, were not significantly related to mental health or other endogenous variables and were therefore excluded for reasons of empirical parsimony. Perceived stress was entered at the second level, followed by the six coping strategies at the third level. This structure aimed to assess whether coping strategies mediated the relation between stress and mental health, which was entered at the fourth level.

The model fit indices indicate a good fit to the data, as evidenced by the following values: CFI = .989, TLI = .938, χ² (12) = 17.01, p = .15, RMSEA = .047, and SRMR = .028. These values meet the commonly accepted criteria in the literature for this type of analysis. It revealed both direct and indirect paths from the explanatory variables (perceived stress and coping strategies) to the outcome variable, mental health (Tables 3 and 4 and Figure 3).

Table 3.

Structural path coefficients (standardized estimates).

	Perceived stress	Active distraction	Emotional support seeking	Positive reframing	Passive emotional strategies	Substance use	Spiritual practices	Mental health
Age	−.17* (.07)	−.04 (.07)	−.20** (.07)	−.18* (.08)	−.12* (.06)	−.04 (.09)	−.19** (.07)	.05 (.07)
Gender	.15* (.07)	.30*** (.07)	.15* (.07)	−.12 (.07)	.04 (.07)	−.16* (.07)	.16** (.06)	−.001 (.07)
Physical health	−.32*** (.06)	.07 (.07)	−.05 (.07)	.04 (.08)	.02 (.06)	.05 (.05)	.01 (.07)	.21** (.07)
Traditional vs. secular					−.13* (.06)		.29*** (.07)
Religious vs. secular					−.12* (.06)		.45*** (.06)
Perceived stress		.31*** (.07)	.33*** (.08)	−.05 (.08)	.48*** (.07)	.15 (.08)	.11 (.07)	−.45*** (.07)
Active distraction								.08 (.09)
Emotional support seeking		.43*** (.06)						.10 (.06)
Positive reframing		.35*** (.08)	.20** (.08)					.14* (.06)
Passive emotional strategies		.16* (.07)	.10 (.07)	.13 (.08)				−.05 (.07)
Substance use		.22* (.09)	.37*** (.09)	.03 (.08)	.29*** (.08)			−.13 (.07)
Spiritual practices		.34*** (.07)	.40*** (.07)	.23** (.07)	.15* (.08)	.08 (.08)		.18** (.07)
R2	.15** (.05)	.21*** (.05)	.22*** (.06)	.05 (.03)	.29*** (.06)	.04 (.04)	.29*** (.05)	.38*** (.05)

***p < .001, **p < .01, *p < .05. Standard errors in parentheses; Correlations in shaded cells.

Model Goodness-of-Fit: CFI = .989, TLI = .938, X² = 17.01, df = 12, p = .15, RMSEA = .047, SRMR = .028.

Table 4.

Indirect effects of explanatory variables on mental health.

IV	MV	DV	IV → MV	MV → DV	Direct	Indirect	95% CI Indirect	Total
Perceived stress	Substance use	Mental health	.15~ (.08)	−.13~ (.07)	−.45*** (.07)	−.02* (.01)	[−.06, −.002]	−.42*** (.06)
Physical health	Perceived stress	Mental health	−.32*** (.06)	−.45*** (.07)	.21** (.07)	.14*** (.04)	[.08, .22]	.34*** (.07)
Gender	Substance use	Mental health	−.16* (.07)	−.13~ (.07)	−.001 (.07)	.02* (.01)	[.00, .07]	.01 (.07)
Age	Perceived stress	Mental health	−.17* (.07)	−.45*** (.07)	.05 (.07)	.08* (.03)	[.02, .15]	.04 (.07)
Age	Positive reframing	Mental health	−.18* (.08)	.14* (.06)	.05 (.07)	−.03* (.02)	[−.06, −.003]	.04 (.07)
Age	Spiritual practices	Mental health	−.19** (.07)	.18** (.07)	.05 (.07)	−.04* (.02)	[−.08, −.01]	.04 (.07)

***p < .001, **p < .01, *p < .05, ~p < .10.

Figure 3.

The empirical research Model.

Direct relations (examination of hypotheses 1–4)

Relations between background variables and endogenous variables

Among the background variables, age showed the greatest number of significant associations with the study’s endogenous variables, including perceived stress and coping strategies. Higher parental age was associated with lower levels of perceived stress and less frequent use of certain coping strategies (Table 3).

Relations between perceived stress, coping strategies, and mental health

A significant positive relation was found between perceived stress and several coping strategies, including active distraction, emotional support seeking, and emotional passive strategies. Higher stress levels were associated with greater use of these strategies. A significant negative relation was found between stress and mental health: the higher the stress level, the lower the reported mental health.

Relations between coping strategies and mental health

Positive reframing and spiritual practices were positively associated with mental health.

Indirect relations (examination of hypothesis 5)

For the significance level of the indirect effects, we present the 95% confidence interval based on the bootstrapping results rather than the standard error calculation.

Stress and mental health: Mediated by coping strategies

Only substance use strategy partially mediated the relationship between perceived stress and mental health. Higher levels of perceived stress were associated with greater use of substances, which in turn was linked to lower mental health. No other coping strategy showed a significant mediating effect.

Background variables and mental health: Mediated by perceived stress and coping strategies

Several mediating relationships through endogenous variables were identified between background variables and mental health (see Table 4).

Physical health

The relation between physical health and mental health was mediated by perceived stress. Better physical health was associated with lower stress, which in turn was related to better mental health.

Parental age

Parental age was indirectly related to mental health through multiple pathways. A positive indirect effect emerged through perceived stress: older parents reported lower levels of perceived stress, which in turn was linked to better mental health. Two negative indirect paths were also found: one through positive reframing and the other through spiritual practices. As age increased, use of these two coping strategies declined, and lower use of these strategies was associated with poorer mental health.

Gender

An indirect relation between gender and mental health emerged through substance use: mothers reported lower substance use than fathers, and lower substance use was associated with better mental health.

Moderation analysis by gender (examination of hypothesis 6)

Following the identification of significant relationships in the empirical path model, a moderation analysis was conducted using PROCESS v4.2 for SPSS (Hayes, 2022) to examine whether gender moderated the association between perceived stress and mental health, as well as the associations between coping strategies and mental health.

The results indicated that most of the tested interactions were not significant. Gender did not moderate the relation between stress and mental health, between stress and coping strategies, or most of the relations between coping strategies and mental health. The only exception was a significant interaction between gender and use of active distraction strategy in explaining mental health, F(1, 183) = 7.45, p < .001 (Figure 4). Among fathers, greater use of active distraction was associated with lower mental health. Among mothers, greater use of this strategy was related to higher mental health, indicating a gender-specific pattern in the direction of association.

Figure 4.

Interaction between active distraction strategy and parental gender on mental health.

Discussion

One of the key conclusions of this study is that the coping strategies most commonly used by combatants’ parents during periods of acute stress were not linked to better mental health. However, strategies such as positive reframing and spiritual practices, although not used more frequently as stress increased, were nonetheless associated with more favorable mental health outcomes.

Another important finding relates to gender differences in the experiences of combatants’ mothers and fathers. While significant differences were observed in the levels of perceived stress and in some of the coping strategies used, no gender differences were found in the relation between perceived stress and mental health. This suggests that in situations of prolonged threat and acute concern for the safety of their children, the emotional-cognitive mechanisms linking stress to mental health operate similarly among mothers and fathers.

It is noteworthy that, despite the considerable challenges faced by parents of combat soldiers, their reported level of mental health (M = 4.01, SD = 1.01) was not lower (and was even slightly higher), than that observed in the original Dutch normative sample in which the MHC-SF was developed (M = 3.94, SD = 0.86; Lamers et al., 2011). In contrast, the mean DASS stress score in the current sample was 6.60 (SD = 5.27), which exceeds the international standard (mean = 4.73, SD = 4.0; Henry & Crawford, 2005). Thus, it may be concluded that a comparison of these findings with international benchmarks reveals a multifaceted reality. On one hand, participants demonstrated mental health levels comparable to those found in the general population, despite the challenging circumstances associated with being parents to soldiers in active combat. On the other hand, their reported stress levels were relatively higher than the international norm. As demonstrated in earlier studies, this complexity highlights the possibility of experiencing both positive and negative emotions simultaneously (Tugade & Fredrickson, 2004).

These findings suggest that parents of combat soldiers may exhibit relatively high mental health likely stemming from resilience, a sense of growth through crisis, and a strengthened sense of belonging to their community, which are core components of mental health, while simultaneously experiencing elevated stress due to concern for their children in dangerous situations. This pattern illustrates the emotional complexity that can arise in challenging life circumstances. With these insights and conclusions in mind, the research hypotheses will now be discussed.

Perceived stress, mental health and coping strategies

As expected, a significant negative association was found between perceived stress and mental health, such that higher levels of stress were associated with lower levels of mental health (support for Hypothesis 1). This finding aligns with previous research showing that during times of emotional stress stemming from concern for their children, combatants’ parents experience elevated levels of anxiety and depression (Duarte et al., 2020; Savitsky & Shvartsur, 2024). Moreover, the findings indicate that as stress levels increase, parents tend to rely more on strategies that offer immediate emotional relief, such as seeking emotional support, active distraction, and emotional passive strategies. However, no significant relationship was found between stress levels and the use of adaptive strategies such as positive reframing and spiritual practices, possibly because these strategies require greater psychological investment and internal resources. This pattern suggests that under high stress, parents use coping strategies selectively, often avoiding the more effortful strategies that might actually benefit their mental health (partial support for Hypothesis 2).

As expected, some coping strategies considered adaptive, such as spiritual practices and positive thinking, were positively associated with mental health. However, other strategies also classified in the literature as adaptive, such as seeking emotional support and active distraction, were not positively associated with mental health, despite their potential to offer emotional relief. It is possible that under conditions of extreme stress stemming from deep concern for their combatant children, the beneficial effects of these strategies are not realized due to the circumstances in which they are used. For example, seeking emotional support may lose its effectiveness when parents turn to others in similar situations, namely other parents of combatants who are also experiencing high levels of emotional distress and lack the resources to provide the needed support. Such interactions, instead of alleviating distress, may actually intensify worry and further impair mental health. Similarly, active distraction may not be effective when the source of concern is one’s own child. In such cases, attempts to divert attention or engage in purposeful activity may fail to provide meaningful emotional relief and therefore do not contribute to improved mental health.

Regarding maladaptive strategies, only substance use was found to be negatively associated with mental health, and this association approached statistical significance, offering partial support for the research hypothesis. However, contrary to expectations, the emotional passive strategy reflected in expressions of helplessness was not significantly associated with poorer mental health. One possible explanation is that this strategy may have a dual effect: on the one hand it can function as a form of emotional release, enabling individuals to express and vent stress; on the other hand, it may intensify feelings of helplessness, loss of control, and emotional distress. These opposing effects may offset one another, thereby obscuring a clear association with mental health. Overall, the findings concerning the relationship between coping strategies and mental health provide only partial support for Hypothesis 3.

Coping as a mediator between stress and mental health

Positive reframing and spiritual practices did not mediate the relationship between stress and mental health (contrary to Hypothesis 4). However, these two strategies were directly and positively associated with mental health. This suggests that their contribution to mental health may not stem from being activated in response to stress, but rather from their inherent psychological benefits, such as fostering meaning, hope, or faith, which have been found to be independently linked to mental health (Pargament et al., 1998; Steger et al., 2006). Conversely, the maladaptive strategy of substance use was found to mediate the relation between stress and mental health. Higher stress levels were accompanied by greater use of this strategy, which was also associated with lower levels of mental health. These findings provide partial support for Hypothesis 5 and highlight a significant point: when loved ones are under threat, individuals often resort to less effective or even harmful coping strategies. While these strategies may offer immediate relief, they can have negative long-term consequences and may serve as mediators in a detrimental direction. It is important to highlight that the number of children serving in combat roles was not associated with parents’ perceived stress or mental health. This suggests that parental distress is not merely a function of quantity but rather reflects the profound emotional impact and existential vulnerability triggered by the perceived threat to a child’s safety

Gender differences in stress, coping strategies, and mental health

Gender differences were analyzed across two key aspects. The first addressed differences between mothers and fathers in the levels of the explanatory variables (perceived stress and coping strategy use) and in the level of the outcome variable (mental health). The second focused on gender differences in the strength of the associations among these variables, particularly the extent to which perceived stress and coping strategies were linked to mental health for mothers and fathers, respectively.

Regarding differences in the explanatory variables, mothers reported higher levels of perceived stress than fathers and tended to engage more intensively in coping efforts. Specifically, mothers made greater use of emotional support seeking, active distraction and spiritual practices. These results reflect gendered socialization processes that encourage empathy, emotional openness, and the legitimization of distress expression in women, while promoting emotional restraint, self-control, and avoidance of vulnerability in men. Moreover, they align with prior literature indicating that women tend to experience and express more emotional distress (Nolen-Hoeksema, 2012) and are more likely to employ emotion-focused and spiritual coping strategies (Matud, 2004).

Despite the general tendency for women to report poorer mental health than men, the current findings revealed no significant gender differences in reported mental health. One possible explanation is the operation of two offsetting mechanisms. Mothers may have benefited from greater use of coping strategies, which could enhance mental health. Fathers, typically socialized to suppress emotional vulnerability, may have been less willing than mothers to express complaints regarding their mental health due to heightened concern for their children’s safety. These opposing dynamics may have converged, resulting in similar mental health reports across genders.

Moreover, similar to the absence of gender differences in mental health and in the relationships between perceived stress and mental health, the association between stress and coping strategies did not differ significantly by gender (rejection of Hypothesis 6). This suggests that although mothers and fathers may differ in their levels of perceived stress and in some of the coping strategies they employ, the psychological mechanisms linking stress and coping to mental health appear to operate similarly across genders.

It is possible that gender differences tend to diminish in the context of intense stress, such as the shared and overwhelming concern for combatant children, leading to comparable internal emotional and cognitive processes among mothers and fathers. This interpretation is consistent with Galatzer-Levy et al. (2018), who argued that psychological adjustment to potentially traumatic events depends less on demographic factors such as gender, and more on internal personal processes.

One notable exception to the lack of gender differences emerged in the relationship between the use of the active distraction strategy and mental health. Among fathers, frequent use of this strategy was associated with poorer mental health, whereas among mothers, it was linked to better mental health. This difference may reflect gendered interpretations of the strategy’s meaning and utility. Mothers may deliberately use active distraction as a tool to regulate emotions and gain temporary relief when circumstances feel beyond their control. In contradistinction, fathers may perceive reliance on this strategy during such situations as a sign of inefficacy or failure, thereby exacerbating their emotional distress. This explanation aligns with Pudrovska’s (2010) findings, which demonstrated that men experiencing uncontrollable stressors often suffer greater psychological burden when engaging in coping strategies that conflict with traditional masculine norms.

Theoretical contribution

Although the cognitive appraisal model developed by Lazarus and Folkman (1984) was not the primary theoretical framework for this study, it offers a useful conceptual lens for interpreting the findings. The model distinguishes between two main types of coping: Problem-focused coping which aims to eliminate or reduce the source of stress by taking direct action (e.g., seeking solutions, changing the situation), and emotion-focused coping which aims to regulate the emotional response to stress (e.g., avoidance, denial, or seeking emotional support) when the source of stress cannot be altered.

In the specific context of this study, of combatants’ parents, problem-focused coping was largely unavailable. These parents had no real ability to remove the source of their distress and could not remove their children from the battlefield or alter military policy. The uncontrollability of the situation made problem-focused strategies largely irrelevant, as such strategies require the possibility of influencing or resolving the stressor. According to Lazarus and Folkman’s approach, when individuals perceive that they have some control over a situation, they are more likely to engage in problem-focused coping. However, when control is absent, as was the case here, people tend to shift toward emotion-focused coping. The findings of this study support this theoretical claim and go a step further by refining our understanding of emotion-focused strategies under conditions of extreme stress. Specifically, the results point to two qualitatively distinct subtypes of emotion-focused coping: Proactive emotion-focused strategies such as seeking emotional support and engaging in active distraction, which are outward-directed and provide short-term relief, and introspective emotion-focused strategies such as positive reframing, spirituality, and faith, which are inward-directed and involve deeper emotional and cognitive processing aimed at making meaning of the experience.

This conceptual distinction contributes to a more refined understanding of emotional coping under extreme and uncontrollable stress. It also introduces a new evaluative dimension: the direction of engagement (outward vs. inward) and the depth of psychological processing involved in each subtype of the emotion-focused strategy.

A further theoretical contribution relates to gender. While gender roles and socialization, as described by Eagly and Wood (1991), shape how stress is experienced and how coping strategies are selected, the deeper emotional-cognitive mechanisms that mediate the relationship between stress and mental health appear to operate similarly in both mothers and fathers. This suggests that under conditions of profound and uncontrollable stress, emotion-focused coping mechanisms may be largely gender-neutral at the internal psychological level.

Limitations and recommendations for future research

This study has several limitations that should be considered when interpreting the findings. First, the study’s cross-sectional design prevents causal conclusions regarding the directionality of effects. It is possible that low mental health contributes to higher stress perception, or that individuals with lower mental health are less likely to use adaptive coping strategies. Longitudinal studies are needed to better understand the dynamic nature of stress and coping among combatants’ parents during wartime. Second, the study relied on self-report questionnaires, which are subject to bias, especially concerning sensitive issues like mental health and substance use. Future studies could benefit from combining self-reports with behavioral measures of stress and coping. Third, while the study captured a diverse sample of Israeli parents, it did not account for factors such as prior exposure to trauma, personality traits, or relationship quality with the combatant child, all of which may influence the stress-coping dynamic. Expanding future research to include these investigating directions could enhance the explanatory power of stress models in wartime settings.

Practical implications

From a practical perspective, the findings highlight the importance of developing targeted interventions that encourage parents to adopt coping strategies that are both adaptive and emotionally sustainable. These may include planned and organized activities – such as guided sessions for positive reframing, meaning-making workshops, and regular access to spiritual counseling – that provide intentional and supportive environments for building ongoing resilience. Given the gender differences found in the frequency and type of coping strategies, support programs should be tailored to address both mothers’ and fathers’ distinct needs. Efforts should be made to legitimize emotional expression among fathers and promote their access to supportive and meaningful coping frameworks. Mental health professionals, community leaders, and military support systems should adopt a more attentive and sensitive approach, rather than assuming that parents will cope on their own. By acknowledging and addressing their psychological needs, these systems can play a critical role in reducing parental distress and strengthening family resilience during times of crisis.

Ethical approval

This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The study protocol was reviewed and approved by the Institutional Ethics Committee (IEC) or Institutional Review Board (IRB).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The author does not plan to share data for this article due to proprietary considerations. The data used in this study are owned by a third party and cannot be shared due to intellectual property or confidentiality agreements.