Zerach Gadi, Levinstein Yoav, Levi-Belz Yossi
Dept. of Psychology, Ariel University, Ariel, Israel.
Dept. of Health and Well-being, Medical Corps, IDF, Israel; School of Social Work, Bar-Ilan University, Ramat-Gan, Israel.
Psychiatry Res. 2023 Sep;327:115392. doi: 10.1016/j.psychres.2023.115392. Epub 2023 Jul 30.
We evaluated longitudinal associations between subjective appraisals of transgressions of moral beliefs, values, and expectations (potential morally injurious events; PMIEs) and suicidal ideation (SI) among recently discharged combat veterans. Participants were 374 active-duty Israeli combatants who participated in a five-year longitudinal study with four measurement points: T1- one year before enlistment, T2- one month before discharge from army service, and then again six months and twelve months following discharge (T3 and T4, respectively). A history of lifetime suicidal ideation and behavior was associated with higher levels of subjective appraisals of PMIEs, as compared to no history of suicidal ideation and behavior. Above and beyond pre-enlistment personal characteristics, cross-lagged pathway analyses indicated significant bi-directional pathways between subjective appraisals of PMIEs and SI. For all PMIEs dimensions, SI was associated with greater subjective appraisals of PMIEs, on subsequent measurement. However, cross-lagged effects of PMIEs-'other' (T2) predicting SI (T3) and PMIEs-'betrayal' (T3) predicting SI (T4) were also found. Our findings are the first to provide evidence of longitudinal, temporal associations between subjective appraisals of PMIEs and SI, which might serve as potential intervention targets among recently discharged traumatized veterans.
我们评估了近期退伍的参战老兵中，对违背道德信念、价值观和期望（潜在的道德伤害事件；PMIEs）的主观评价与自杀意念（SI）之间的纵向关联。参与者为374名以色列现役参战人员，他们参与了一项为期五年的纵向研究，有四个测量点：T1——入伍前一年，T2——退伍前一个月，以及退伍后的六个月和十二个月（分别为T3和T4）。与无自杀意念和行为史相比，有终身自杀意念和行为史与更高水平的PMIEs主观评价相关。除入伍前的个人特征外，交叉滞后路径分析表明，PMIEs主观评价与SI之间存在显著的双向路径。对于所有PMIEs维度，在后续测量中，SI与更高的PMIEs主观评价相关。然而，也发现了PMIEs - “其他”（T2）预测SI（T3）以及PMIEs - “背叛”（T3）预测SI（T4）的交叉滞后效应。我们的研究结果首次提供了PMIEs主观评价与SI之间纵向、时间关联的证据，这可能成为近期退伍的创伤后老兵潜在的干预目标。
