Introduction

A traumatic event is a scary, shocking, or dangerous experience that can affect someone physically and emotionally.1 Numerous types of traumatic events such as experiencing abuse, being in an accident or natural disaster, and watching violent news footage on social media are associated with adverse psychological consequences such as depression anxiety, and Acute Stress Disorder (ASD).2–4 ASD is a psychological disorder that can arise within one month after a person experiences or observes a traumatic incident.2,5 It may last from three days to four weeks.5 ASD is characterized by the incapability to cope with a hurtful event. Symptoms include severe anxiety, dissociation, disturbing thoughts, emotional dazing, and avoidance of reminders of the traumatic event.5,6

Nowadays there is a war in the Gaza Strip.7 This war has garnered extensive media attention and coverage, with ferocious, vicious, violent, and traumatic pictures and videos being available on numerous social media platforms.7,8 Social media encompasses a range of technologies that enable users to exchange ideas and information. With platforms like Facebook, Instagram, X platform (previously known as Twitter), and YouTube, over 4.7 billion individuals worldwide engage in social media, accounting for approximately 60% of the global population. In early 2023, the majority of users (94.8%) utilized chat and messaging applications and websites, closely followed by social platforms, which were accessed by 94.6% of users.9 The development of technology like smartphones and the rise of social media platforms such as Twitter and Facebook have made it easier for the public to access real-time media coverage of events.10 This means that people worldwide can now view graphic images of potentially traumatic events constantly, sometimes as they happen, without any filtering.10,11 While technology has undoubtedly revolutionized communication and access to information, the rise of social media has brought about a host of negative psychological effects.12–14 Constant exposure to curated images, cyberbullying, and the pressure to portray an idealized version of oneself have contributed to increased rates of anxiety, depression, and low self-esteem among users.12–14 The addictive nature of social media also leads to decreased real-life social interactions and feelings of isolation.

Initial indications indicate that exposure to social media coverage of the Gaza War events may lead to negative psychological effects.11,15 Students in Jordan, like their counterparts globally, come across reports on the Gaza conflict through media outlets, including social networking sites.12 The distressing visuals and videos depicting devastation and hardship in Gaza can deeply affect the youth, potentially resulting in issues such as acute stress disorders. Although Jordan is considered a stable Middle Eastern country, the Israeli-Palestinian struggle always affects it. Jordan shares a border with the West Bank and Israel and is considered the second-largest host of refugees, with a significant Palestinian population resulting from past refugee resettlement waves.12,13 Moreover, almost 50–60% of Jordan’s population has Palestinian roots.13 This demographic and cultural link generates a strong sense of unity and connection with the Palestinian cause; these ties between Jordan and Palestine add a deep emotional response to the conflict in Gaza.

Reports from the media about traumatic events can broaden the scope of these events, turning local occurrences into widespread collective traumas.10,16 This expansion is facilitated by the constant availability of news through digital platforms and the 24-hour news cycle.11 Prolonged exposure to media coverage can intensify public anxiety and fear, potentially leading to negative psychological effects.11,15,17 Research suggests extensive media coverage following disasters and violent events may have unintended harmful consequences, impacting a broader audience and exacerbating distress by feeding into worries about future similar events.18

Exposure to media coverage of collective trauma is linked to Acute Stress (AS), but the specific aspects of media exposure (such as quantity, graphic content, and videos) that contribute to this distress are not well understood.11,17 While research has primarily focused on adults experiencing ASD (Bryant et al, 2016), adolescents can also be affected.19 Adolescents, who are often active on social media and rely on it for news, are particularly impacted by graphic images.19,20 The increasing prevalence of ASD among adolescents exposed to graphic Gaza news footage on social media is a growing concern.20,21 Understanding the impact of such content on adolescents is crucial due to their ongoing brain development in cognitive, emotional, and social domains.21

Although the precise incidence of ASD among adolescents exposed to Gaza news footage is not well-documented, studies have revealed that exposure to violent content on social media can have a substantial effect on mental health.11,15,17 Numerous factors have been recognized as being connected with the development of acute stress disorders among adolescents who view violent news footage on social media.19,20,22 These factors can comprise personal characteristics, social aspects, and the nature of the content itself. Personal characteristics factors include first, Age usually younger adolescents are more vulnerable to the harmful effects of exposure to traumatic content as a result of their developing brains and emotional skills.23 Second, Gender most literature reported that females experience symptoms of ASD after viewing traumatic content more than males. Another factor that may contribute to developing ASD is social support, an absence of social support, such as a robust family or peer network, can raise the risk of developing ASD symptoms.20,22,24 Furthermore, a major factor is the viewed content itself. The more severe the event shown in the news footage, the more likely an adolescent is to develop ASD symptoms. Additionally, the more frequently an adolescent is exposed to the content, the higher the possibility of developing ASD.25,26

This research aims its lens at young people, specifically adolescents, to delve into how troubling news can hammer their mental health because they are in a delicate phase of growing up, have lots of media thrown at them, might see their schoolwork suffer, and could deal with aftermath effects down the road. Youths are undeniably really prone to get stressed out and impacted by outside stuff, which nails them as an important group for poking around to get what troubles they are wrestling with in our world crammed with media today and cooking up some plans to help keep them on an even keel. So, this study aimed to examine the impact of watching Gaza news footage on social media among Jordanian adolescents. And explore the experiences of watching Gaza news footage on social media from the perspective of adolescents.

Material and Methods Design

The study utilized an explanatory sequential mixed methods design, comprising two phases: a quantitative phase followed by a qualitative phase. The quantitative design used a descriptive, cross-sectional survey design to examine Acute Stress Disorder among students. Self-reported data was collected at a single point in time to analyze stress levels among students. The students with high-stress scores were invited to face-to-face interviews to discuss their experiences and stressors. To obtain insight, explore in depth the effect of watching Gaza traumatic news footage. This approach was chosen to gain insight, explore complexity, and examine the richness of the phenomenon under study27 (Figure 1).

Figure 1 Explanatory Mixed Methods Design.

Setting

This study was conducted in two government high schools in the Hashemite Kingdom of Jordan (Jordan): School A is located in Amman the capital city of Jordan, with a total students number of 950; 40 in tenth grade, 35 in eleventh grade, and 20 in twelfth grades. School B is located in north Jordan with a total students number of 390; 29 in tenth grade, 33 in eleventh grade, and 23 in twelfth grade.

Participation and Sampling

During the quantitative part of the study, the researchers used a convenience sampling technique to collect data due to time constraints as ASD usually develops within the first month after the event and appropriateness for the study design. The study was conducted from 10/10/2023 until 6/11/2023. The researcher focused on the adolescent group because it is a unique stage of human development and an important time for laying the foundations of good health. Any psychological problems faced during this stage may affect how they feel, think, make decisions, and interact with the world around them.28 In addition, GITNUX MARKETDATA REPORT 2024 reported that 95% of adolescents have access to a smartphone and 45% are “almost constantly” on the internet Also, 95% of students bring their phones to class every day, 92% use them to text in class.29 Therefore, this makes them more likely to access social media content. Also, the World Health Organization (WHO) reported many factors that can contribute to stress during adolescence including exposure to adversity, hormone change, pressure to conform with peers, and exploration of identity.30 Media influence and gender norms can exacerbate the disparity between an adolescent’s lived reality and their perceptions or aspirations for the future. Raosoft sample size calculation was used with a margin of error of 5% and a confidence level of 95%, the population size was 244 students with a total respondents of 180 students. The researchers used the following inclusion criteria: (1) Regular students; (2) Age between 15 to 18; (3) High school; (4) Willing to participate; (5) Arabic speaker;(6) Having a smartphone; (7) Follows the Gaza news images and videos on social media; (8) Exposure to social media between 2 to 30 days after Gaza war began. While, in the qualitative part a non-probabilistic, purposive sampling method was used. The students with high-stress scores were invited to a face-to-face interview to discuss their experiences. For the qualitative sample calculation, the researchers interviewed the students until they reached the saturation point of the data, which was after interviewing 13 students.

Instruments Student Demographic Data Questionnaire

The student demographic data questionnaire was developed by researchers based on the literature review.31–33 The data for the students were collected via self-reported. Information obtained included the student’s gender, age, Grade level, time spent each day watching news footage Gaza attack on social media, and social media platforms.

Perceived Stress Scale (PSS)

The Perceived Stress Scale (PSS) was developed by Sheldon Cohen (1988).24 The Perceived Stress Scale (PSS) was created by Sheldon Cohen in 1988 and is commonly used to assess how individuals perceive stress levels. This 10-item questionnaire evaluates the extent to which life situations are perceived as stressful. Respondents rate each item on a standardized 5-point Likert scale from 0 (never) to 4 (very often). Upon completion, the scores are tallied to provide an overall measure of perceived stress, with a total score range of 0 to 40. Higher scores indicate higher levels of perceived stress. Interpreting the scores: 0–13 signifies low stress, 14–26 indicates moderate stress, and 27–40 signifies high perceived stress. The Arabic version of the scale is reliable and valid.28

Instrument for Qualitative

Qualitative semi-structured in-depth interview was used to conduct this study and identify the themes that indicate students’ experience after Watching Gaza News Footage on social media. The interviews were guided by two open-ended questions:

a. Tell me about your experience after Watching Gaza News Footage on social media. b. What are the factors that increase your stress after Watching Gaza News Footage on social media?

Four nursing PhD experts reviewed the interview questions to assess their practicality and accuracy. Following their review, minor language adjustments were recommended and subsequently implemented.

Data Collection

Data collection for this study was conducted in two phases: the quantitative phase followed by the qualitative phase. The former includes the administration of the PSS to students, whereas the latter includes semi-structured in-depth interviews with selected students (Figure 2).

Figure 2 Flowchart of Data Collection.

In the quantitative phase, before commencing the process of data collection, the researcher visited schools to meet the school managers as well as to collect information about the schools and students. After collecting all required information. PSS Self-reported questionnaire was distributed among the students.

In the qualitative phase, a semi-structured in-depth interview was conducted for students with high stress levels. An interview takes nearly sixty minutes. To ensure privacy and avoid disruptions, the students were interviewed in a private room. The researcher began by greeting the students and then explaining the purposes and methodology of the interview. The researcher emphasizes information privacy and their choice to leave the interview at any time. Students were encouraged to express their thoughts and feelings. The researcher did not move on until they ran out of information to provide regarding a certain question. The researcher ended the interview by thanking the participants.

Ethical Considerations

This study complies with the Declaration of Helsinki. Permission to conduct this research was granted by the Research Ethics Committee of the Ministry of Education (No.987452). The researchers provided information about the study’s objectives to both students and their parents, ensuring voluntary participation, anonymity, and the option to withdraw at any point. Written consent was obtained from parents. The participants informed consent included the publication of anonymized responses, and the questionnaires were coded and securely stored in sealed envelopes to protect the anonymity of the participants.

Data Analysis

The researchers utilized the SPSS Graduate Pack version 20.0 to analyze the quantitative data. Descriptive statistics such as mean, standard deviation, and percentage were employed to characterize the sample. The study assessed the levels of acute stress disorder in students following exposure to Gaza News Footage on social media by calculating total scores on the Perceived Stress Scale (PSS), comparing means, and determining the frequency of acute stress distress levels. While, for the qualitative data transcription, translation, coding, and analysis emerging themes and subthemes were completed by the researchers. Reviewing and refining the themes by experts and Interpretation.

Results Demographic Data

A total of 180 used a smartphone is respond to the questionnaire. Their mean age was 15.8 (SD = 6.23). Most of them were in the 12 grades (62 (34.4%) and more than half of them were male (94, 52.2%), the majority (n = 166) of the students had Internet access on their mobile.

Moreover, all of them are watching Gaza news on social media (180, 100%), the majority watched between 4 to 7 hours/day (110, 61.2%) while 25% (45) watched more than 7 hours/day. They used different types of platforms with Facebook and YouTube being the highest type used 180 (100%), while Twitter (old) / X 98 (54.4%) is the used lowest platform.

Acute Stress Level

The result showed that the students experienced high stress levels, with a mean score of 3.78 (SD = 1.24). 70% of students reported high levels of stress on PPS, while 11% of students reported low stress levels. Table 1

Table 1 Total Scores of the Perceived Stress Scale (PPS) (N = 180)

The Influence of Students’ Characteristics on Acute Stress Level

Most students experience significant levels of perceived stress, with 70% reporting high-stress levels. The study found that factors such as gender, the amount of time spent watching news footage about the Gaza attack on social media each day, and the presence of social support from family or peers are significantly linked to stress levels (p < 0.05). Table 2

Table 2 The Influence of Students’ Characteristics on Acute Stress Level

Themes of Qualitative Analysis

Thematic analysis of textual data from interview transcripts and field notes yielded three major themes with seven subthemes, as presented in the (Box 1).

Box 1 The Themes of Qualitative Studies

The First Theme is Extreme Emotional Responses

The analysis of the interview data revealed three major categories of intense emotions experienced by the students Shock, Sadness, and hopelessness.

Shock

The majority of students were shocked after viewing the Gaza News Footage on social media, describing the situation as an unbelievable crisis. Many of them had never witnessed such disturbing scenes before.

One of the students recounted his experience as below:

I was very shocked by the scenes of killing, blood, and destruction of homes and the people inside them. I never see criminal scenes like this war.

Sadness

Several students conveyed a profound sense of sorrow that impacted not just themselves, but also their entire social circle and family.

One of the students recounted his experience as below:

After I watched news footage Gaza attack on social media, and described the footage to my family and friends, my friends became very sad and there was no laughter like the previous time. Also, my house became gloomy.

Hopelessness

The majority of students expressed feelings of despair and helplessness towards the people of Gaza due to various reasons such as being unable to send food or provide support, and lack of access to water and housing. Some also felt a sense of resentment towards their own lives due to the hopelessness of the situation.

Another student f recounted her experience as below:

What can I do for Gaza? I am Just One Person…. I feel hopeless.

Illustrative quotes for student g as below:

I am trying to understand my feelings. I know I have had it before. Last month I saw a video on Facebook. A Palestinian child is on the ground, unable to walk due to an injury in his leg, and no one helps him. I want to carry him. I want to help him but unfortunately ….I can’t. I feel helpless. what I can do?.

The Second Theme is Sources of Stressors

Students reported multiple factors contributing to their acute stress disorder, including two major factors distressing images and a lack of social support.

Horrific Scenes All students revealed that the distressing images they viewed on social media, such as destroyed buildings, deceased individuals, wounded on the streets, explosive attacks, bloodshed, and the sight of deceased children and animals trapped in debris, were extremely horrifying leading to increase their stress levels.

Illustrative quotes from student r as below:

Horrific scenes nightmare wake up every night. The scene of a dead child pulled out from under the rubble of his demolished house make me cry a lot. Gaza….when I saw the horrific scenes I started crying.

Social Support Some students stated that their primary source of acute stress disorder is the absence of social support. They mentioned that they are unable to share their emotions with their parents or friends due to various reasons, such as their parents and friends being too busy, lacking interest, or feeling embarrassed to express their feelings.

Illustrative quotes for student b as below:

It’s very painful when you can’t express sadness about the situation to my parents because they are always busy and don’t have time to sit and hear me … Also my friends aren’t interested in the war news ….It is really painful.

The Third Theme is the Impact of Stress

The majority of students stated that the news footage affects them physically and psychologically.

A- Physical Impact

The findings indicate that students experience a range of physical complaints including abdominal pain, increased heart rate, and respiratory rate tiredness, headaches, difficulty concentrating, and flashbacks.

Illustrative quotes for student h as below:

I feel tired; I cannot sleep at night due to nightmares… I do not take enough rest …. I had a headache….I cannot concentrate on my study …

Psychological Impact

All students reported several psychological problems such as anxiety, nightmares, sadness, sleep disturbance, anorexia, Anhedonia, negativity, and crying.

Illustrative quotes for student f as below:

I have nightmares… I always see the scenes of killed children …. The blood on the street ….I lost the joy in my favorite activities. this year I didn’t celebrate my birthday … How could I celebrate while the children have been killed ….I feel the world is become a dark, offal place.

Integration of Themes

The qualitative findings of this study revealed several key themes, including intense emotional reactions, factors contributing to acute stress disorders, and the impact of stress. The first theme identified was that viewing Gaza news footage on social media is a distressing experience for students, with nearly all students reporting strong negative emotional responses. These emotions include shock, sadness, distress, and hopelessness. Various factors contribute to the development of acute stress disorders among students, such as witnessing graphic scenes of death and destruction, including images of deceased children, women, and individuals. Additionally, the lack of social support exacerbates student stress, as they struggle to express their feelings without adequate support.

Furthermore, students expressed that they have been significantly affected both physically and psychologically by watching Gaza News Footage on social media. Additionally, continuous exposure to stressors has resulted in students experiencing physical symptoms such as tiredness, headaches, difficulty concentrating, and flashbacks, as well as psychological issues including anxiety, nightmares, sadness, disrupted sleep patterns, lack of pleasure in activities, negative thoughts, and tearfulness. It seems that students who view Gaza News Footage on social media are prone to experiencing intense emotions as a result of being exposed to numerous stress-inducing sources. This prolonged exposure to stressors and intense emotions can lead to both physical and psychological issues for the students.

Discussion

In this research study, PSS results showed high-stress levels (70%, M=3.78, SD =1.24) among Jordanian high school students after watching Gaza’s new footage. These findings are consistent with namouras research findings a strong correlation between stress and social media traumatic events.4,8,24,34

In addition, another study assessed the level of perceived stress and psychological morbidities among secondary school students, they found that 11.9% had low stress, 63.7% had average stress, and 24.4% were highly stressed.35 This highlighted that adolescents show a higher stress level percentage in the present study (70% high-stress level). However, this study’s findings revealed that 11% of students mentioned feeling stress levels after viewing Gaza news footage, on media. There are explanations for this outcome. Some young individuals might not have found the videos particularly distressing or traumatic depending on their tolerance for content. They could also be desensitized to violence due to exposure to material on social media or other platforms. Additionally, some adolescents may possess coping strategies that help them effectively process and manage stress preventing them from reporting stress levels. Moreover, having a support system, in place could assist adolescents in navigating their emotions post-viewing thereby lessening the impact of stress. Lastly, some adolescents may choose not to express their feelings out of fear of being judged or stigmatized for being affected by the videos themselves.36,37 Research observed the negative impact on mental health, with few studies noting some potential benefits such as helping individuals cope and feel connected during times of isolation. The most prominent negative outcomes of excessive or problematic social media use on the mental well-being of young people and students include anxiety, depression, and stress.12,14 For example, Adolescents in a conflict-affected region in Ukraine experienced significant psychological distress due to both traumatic events and everyday stressors.38

Students’ ways of dealing with situations can greatly affect how teenagers handle and manage stress. Teens with coping strategies may find it easier to handle content without experiencing intense stress. Conversely, those lacking coping mechanisms may be more susceptible to feelings of hopelessness, helplessness, and sadness after viewing materials.28 Furthermore, the type of news footage itself can impact reactions. Videos showing violence or traumatic events are more likely to trigger emotions compared to less intense content. Factors such as students’ backgrounds, including experiences or mental health issues can also influence how they respond emotionally to distressing videos. It is important to consider neuroinflammation as a factor influencing stress levels in adolescents. Studies indicate that neuroinflammation can impact mood regulation and emotional responses potentially affecting how individuals process and cope with situations.39,40 Exploring the role of neuroinflammation in reactions to distressing content could offer insights into the mechanisms, behind stress resilience.40 Nevertheless, it’s crucial to recognize the study constraints, like factors that could skew the results. For example, The incidence of psychological distress increased during the outbreak of COVID-19 than the normal period.41 Accordingly, for the adolescents in this study, the impact of COVID-19 might influence mental health and could be stressful events for adolescents. Furthermore, the current study results exhibited that the most significant contributors to students’ acute stress levels are related to student’s characteristics. It showed that female students experienced higher stress levels than male students, a finding which is congruent with other previous studies that examined the stress response among both genders. It is well-documented that females often show higher levels of acute stress compared to males.42 This variation could be attributed to vulnerability, hormonal, genetic, and environmental factors that impact the manner a person responds to stressors.42,43

Age usually is a substantial factor in shaping the impact of traumatic news footage on acute stress. Although there was no significant difference between the age groups (10th 11th, and 12th grade) in this study, the three grade levels have high stress levels. This is congruent with several previous researches that presented that adolescents are more vulnerable to the harmful effects of stress due to their developing brains and emotional regulation skills. Furthermore, age can affect students’ capability to handle the emotions generated by these events.7,19,24 Most studies observed a negative impact of stressful events found in social media on Adolescents’ mental health, with few studies noting some potential benefits such as helping individuals cope and feel connected during times of isolation. The most prominent negative outcomes of excessive or problematic social media use on the mental well-being of young people and students include anxiety, depression, and stress.12,14 For example, Adolescents in a conflict-affected region in Ukraine experienced significant psychological distress due to both traumatic events and everyday stressors.38

Another important factor contributing to ASD is the amount of time students spend watching disturbing news footage, especially on issues like the war in Gaza, which could have momentous consequences for their mental and emotional health.34,44

The current study results showed various degrees of stress correlated to the duration of watching the news footage, the longer the students watched the higher stress level they exhibited. This is consistent with previous researches that explore the potential effects based on the length of exposure, it is well documented that any exposure will cause stress, and a short exposure to distressing news footage could cause an increase in anxiety levels.34 Graphic and intense imagery may induce instant stress responses.4,7,22 Exposure over several days could contribute to disturbing thoughts related to the traumatic events represented in the news footage. Students might have difficulties to disengage from the mental images.7,10,22 Furthermore, extended exposure over a prolonged period (over weeks) might contribute to a variety of physical, emotional, and cognitive health issues.10,11,22 Furthermore, social support could have a substantial role in decreasing acute stress among high school students.25,26 In this study the students with low social support exhibited high levels of stress while the students with high social support exhibited lower levels of stress, these results are congruent with numerous researches. Several researches have shown that social support helps students better understand and manage their stress.

On the other hand, the qualitative thematic analysis of textual data from interview transcripts and field notes showed a substantial impact of news coverage of the Gaza conflict on high school students, in terms of their emotional, psychological, and physical well-being. They describe extreme emotional responses as they observe the violence and suffering of innocent civilians. Watching graphic images and reports of death and demolition makes them feel sad, afraid, and even guilty. Moreover, the continuous damaging news contributed to a sense of hopelessness and despair. These emotional responses have been detailed in the namouras research study after news coverage of various kinds of disasters and violence.34,42,44

Moreover, students stated that the major source of their stress comes from the nature of the content related to the conflict in Gaza on social media platforms which repeatedly comprises realistic pictures and videos illustrating victims and destruction. This exposure raised their levels of fear, anxiety, and distress. Research has shown that repeated exposure to violent or traumatic content could contribute to intensifying feelings of helplessness and hopelessness.34,44 The excessive and often unfiltered content probably will make it mostly impactful on adolescents.24

Additionally, some students specified that their primary source of ASD is the absence of social support. They mentioned that they are unable to share their emotions with their parents or friends due to various reasons, such as their parents and friends being too busy, and lacking interest. Several studies revealed that students who have strong social support can handle the emotional issues associated with exposure to violent footage on social media.25,26 For example, a study published by the American Psychological Association found that adolescents who received emotional support from their family and friends had less harmful psychological effects from exposure to social media coverage of the conflict.45

Another research confirmed a robust support network, comprising of family and friends will provide comfort, understanding, and a sense of belonging. This support can help to improve anxiety and depression.25,26

Another important result of the qualitative analysis was the psychological and physical impact of stress designated by the students. A profound psychological impact of the exposure to Gaza violent footage on social media was reported by the students, it was significant, extensive, and wide-ranging affecting several aspects of their mental health and well-being. It included flashbacks and intrusive thoughts related to the violent content they saw. These flashbacks can be difficult, painful, and disruptive, leading to a re-experience of the traumatic imaginings or scenes repetitively. This could significantly impair the student’s daily functioning. Similar results were reported by several researchers who investigated the effect of violent footage on social media.3,5,11

The psychological impact of viewing violence on social media extends to sleep disturbances such as difficulties in falling asleep, nightmares, and insomnia. Sleep disturbance was reported frequently by several researchers as a common consequence of exposure to trauma.46–48

Most of the students stated that exposure to violence on social media disturbs their eating habits, potentially leading to anorexia. Witnessing violence disrupts their appetite, resulting in reduced food intake and weight loss.49

Additionally, feelings of fatigue and tiredness, negativity, and Anhedonia were stated by students. These feelings were well documented in the literature that investigated the effect of violence on adolescents,50 They affirmed that endless traumatic content can drain the person’s energy, leading to persistent feelings of tiredness, fatigue, and lethargy.45,50

Also, the students described many physical health impacts of exposure to violent footage, and usage of nonconventional weapons on social media such as headaches, difficulty concentrating, tiredness, abdominal pain, increased heart rate, and respiratory rate. Previous research has revealed that stress can cause a variety of health problems, such as headaches, gastrointestinal problems, and insomnia symptoms.6,10,15,51

Implications in Nursing Practice

Early discovery of acute stress levels among students who use social media to follow the Gaza war will help the nurses play a vital role in identifying and addressing mental health issues, including acute stress, particularly in vulnerable populations such as students. By recognizing the impact of social media exposure on acute stress levels, nurses can implement early interventions to support students’ mental well-being. This may involve providing education on healthy social media usage, offering coping strategies for managing distressing content, and promoting self-care practices. Additionally, nurses can collaborate with mental health professionals to develop targeted interventions and support services tailored to the specific needs of students affected by the Gaza war-related social media exposure. By proactively addressing acute stress in this context, nurses can contribute to the overall mental health and resilience of students during times of conflict and crisis.

In addition, identifying and understanding these factors that contribute to their stress is essential for developing interventions that protect them from potential consequences and harm while promoting their mental health. Nurses and mental health teams with educators and parents can work together to provide support and resources for these students to assist in alleviating the effects of acute stress caused by exposure to distress news footage.

Strengths and Limitation

This study has the unique strength of having the capability to gather real-time data. The researchers had an exceptional opportunity to identify immediate reactions and responses from students and apprehend authentic emotions and behaviors in the moment. In addition, the researchers were able to reach a large sample size of students for their study. This could produce more inclusive and representative results, providing insights into how a major portion of the population is affected by exposure to distressing content. Furthermore, the study could offer a universal perception of how people from different regions are affected by similar events. The comparative analysis could add to a better understanding of cross-cultural variances in responses to trauma. On the other hand, there is a limitation I this study such as students may be already having a tendency towards feeling higher levels of stress and anxiety. Which may affect generalizability of the research finding. Also, the researchers have a limited control on participants’ level and amount of exposure to traumatic content. Unevenness in viewing and frequency of engagement with such traumatic content could present confounding variables that complicate data analysis.

Recommendation for Future Research

The researchers recommend conducting longitudinal studies to assess the long-term impact of exposure to distressing news on students’ mental health. Also, there is a need for new research to implement randomized controlled trials to evaluate the effectiveness of different interventions in reducing stress levels among students in the context of the three major themes revealed in the study (Extreme Emotional Responses, Sources of Stressors, and Impact of Stress). Extreme Emotional Responses, Sources of Stressors, and Impact of Stress. In addition, there is a need for comparative studies examining how adolescents from diverse cultural backgrounds respond to similar traumatic events shown in news footage on social media to improve our understanding of cultural effects on stress reactions and recognize culturally sensitive approaches to addressing acute stress disorders.

Conclusion

This study revealed a high prevalence of acute stress disorder among adolescents in Jordan after watching Gaza news footage on social media. The findings indicate that a significant proportion of students experienced elevated stress levels, with various risk factors such as gender, daily exposure to news footage, and social support influencing their stress levels. The qualitative insights provided further depth into the emotional responses and impacts of stress experienced by these adolescents. Addressing these findings is crucial for developing effective interventions to support adolescents in managing stress in the digital age.

Abbreviations

ASD, Acute Stress Disorder; AS, Acute Stress; WHO, World Health Organization; PSS, Perceived Stress Scale; SD, Standard Deviation.

Data Sharing Statement

The data used in this research is available upon request from the corresponding author.

Ethics Approval and Informed Consent

This study complies with the Declaration of Helsinki. Permission to conduct this research was granted by the Research Ethics Committee of the Ministry of Education (No.987452). The researchers provided information about the study’s objectives to both students and their parents, ensuring voluntary participation, anonymity, and the option to withdraw at any point. The participants informed consent included the publication of anonymized responses, and the questionnaires were coded and securely stored in sealed envelopes to protect the anonymity of the participants.

Disclosure

The authors report no conflicts of interest in this work.

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