Betrayal experiences among individuals living in war zones: A longitudinal study

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-05-08 DOI:10.1016/j.jpsychires.2025.05.023

Doron Amsalem , Shilat Haim-Nachum , Chana T. Fisch , Amit Lazarov , Yossi Levi-Belz , John C. Markowitz , Nitsa Nacasch , Milton L. Wainberg , Ido Lurie , Shlomo Mendlovic , Yuval Neria

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引用次数: 0

Abstract

Objective

Betrayal, a component of moral injury, refers to the harm caused by the deliberate actions or inaction of someone trusted, violating one's values and beliefs. This study examines the impact of betrayal experiences—specifically perceptions of failure by political and military leadership—on mental health outcomes among civilians in Israeli conflict zones, focusing on anxiety, depression, and posttraumatic stress disorder (PTSD). It also explores the relationship between betrayal and war-related factors such as traumatic loss, forced displacement, and income loss, along with the roles of gender and ethnicity. We hypothesized that higher betrayal levels would be associated with more severe mental health symptoms, and war-related experiences, female gender, and ethnic minority status would exacerbate these effects.

Methods

A longitudinal study was conducted with 1052 individuals (ages 18–40) living in northern and southern Israel, areas that were exposed to war and mass forced displacement of civilians. Participants were assessed at three time-points: February 2024, March 2024, and May 2024. Measures included the Moral Injury Events Scale focusing on betrayal, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Primary Care PTSD Screen for DSM-5. We measured changes over time using Linear Mixed Models.

Results

High levels of betrayal experiences were significantly associated with greater symptoms of anxiety, depression, and PTSD across all timepoints. Traumatic loss, forced displacement, and income loss were strong predictors of increased betrayal experiences, with women and ethnic minorities reporting higher levels of betrayal experiences over time.

Conclusions

Our findings underscore the impact of war-related stressors on the sense of betrayal. The study highlights the urgent need for targeted mental health interventions to address the psychological effects of betrayal, particularly among vulnerable groups. Future research should explore these dynamics in more diverse populations to better understand the broader implications of betrayal experiences.

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生活在战区的人的背叛经历：一项纵向研究

背叛是道德伤害的一个组成部分，是指被信任的人因故意的行为或不作为而造成的伤害，违背了自己的价值观和信仰。本研究考察了背叛经历——特别是政治和军事领导对失败的感知——对以色列冲突地区平民心理健康结果的影响，重点关注焦虑、抑郁和创伤后应激障碍（PTSD）。它还探讨了背叛与战争相关因素之间的关系，如创伤性损失、被迫流离失所和收入损失，以及性别和种族的作用。我们假设，较高的背叛水平与更严重的心理健康症状有关，而与战争有关的经历、女性性别和少数民族身份会加剧这些影响。方法对生活在以色列北部和南部的1052人（18-40岁）进行了纵向研究，这些地区暴露于战争和大规模被迫流离失所的平民。参与者在三个时间点进行评估：2024年2月、2024年3月和2024年5月。测量包括以背叛为重点的道德伤害事件量表、广泛性焦虑症-7、患者健康问卷-9和DSM-5的初级保健PTSD筛查。我们使用线性混合模型测量随时间的变化。结果在所有时间点上，高水平的背叛经历与更大的焦虑、抑郁和PTSD症状显著相关。创伤性损失、被迫流离失所和收入损失是背叛经历增加的有力预测因素，随着时间的推移，女性和少数民族报告的背叛经历水平更高。结论我们的研究结果强调了战争相关应激源对背叛感的影响。该研究强调，迫切需要有针对性的心理健康干预措施，以解决背叛的心理影响，特别是在弱势群体中。未来的研究应该在更多样化的人群中探索这些动态，以更好地理解背叛经历的更广泛含义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;