ABSTRACT
This study aims to analyse trends in PTSD over time among combat veterans who participated in war or major military operations. This retrospective cohort study included 4376 veterans (4027 males; 97.9%) of the Israel Defence Forces (IDF) who sought assistance from the army’s Combat Stress Reactions Unit (CSRU) between January 1, 2000 and June 30, 2024. Background and service data were obtained from CSRU electronic records, along with PTSD self-report questionnaires (PTSD Checklist [PCL-5]). We found PTSD levels lowest during two specific periods of major warfare: 2014 (average score 38.9, SD = 20.15) and 2024 (average score 36.8, SD = 18.13). Conversely, between 2015 and October 2023, years with intermittent lower-intensity military operations, levels were higher, ranging from 43.0 (SD = 18.59) to 50.1 (SD = 17.72). Data analysis also highlights a significant increase in applications to the CSRU from 2014 onward. This continued in 2024, with 703 soldiers (16.1% of sample) applying to the unit—the highest number in a single year. PTSD levels were neither higher nor consistent in times of intense warfare. The relatively low levels of PTSD recorded during these times suggest complex factors influence PTSD development, beyond time since exposure to traumatic events.