The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, 40250, Emek Hefer, Israel.
Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel.
Sci Rep. 2024 Aug 4;14(1):18021. doi: 10.1038/s41598-024-69035-w.
With about 1200 individuals murdered, the massacre of October 7th was one of the deadliest terrorist attacks in modern history. The mental health consequences of terrorist attacks have been documented. However, little is known of the impact of the potentially morally injurious experience (PMIE) of betrayal--in which individuals feel betrayed by leaders they once trusted--on levels of psychological burden in the aftermath of such an attack. In this national prospective cohort study, we examined to what extent the PMIE of betrayal exacerbates the risk for posttraumatic stress disorder (PTSD) and depression in the wake of the October 7th terrorist attack. A representative sample of 710 Israeli adults (362 female, 51.1%), Jews (557, 79.9%) and Arabs (153, 20.1%), aged 18-85 (M = 41.01, SD = 13.72) completed validated self-report questionnaires assessing PTSD, depression, and PMIE-betrayal at two timepoints: T1, in August 2023 (6-7 weeks before the attack) and T2, in November 2023 (5-6 weeks after the attack). In two hierarchical logistic regressions, we found that experience of PMIE-betrayal predicted diagnoses of both PTSD (OR 1.92, 95% CI 1.26-2.92) and depression (OR 2.03, 95% CI 1.37-3.01) at T2, beyond probable PTSD/depression at T1 and demographic and trauma-related variables. Moreover, in two repeated-measure analyses predicting PTSD/depression symptoms, we found significant interactions between PTSD/depression trajectories and PMIE-betrayal, meaning that the increase of PTSD/depression symptoms was significantly higher among participants experiencing betrayal in the context of the attack. Our study highlights the impact of PMIE of betrayal on the dramatic increase in psychopathology following the October 7th terror attack on Israel's population. Clinicians treating individuals coping with PTSD and depression should attend to their patients' possible exposure to betrayal following the attack. Moreover, national leaders and policymakers should take significant steps to repair the public's betrayal experience.
在大约 1200 人被谋杀的情况下，10 月 7 日的大屠杀是现代历史上最致命的恐怖袭击之一。恐怖袭击对心理健康的影响已经有记录。然而，对于潜在的道德伤害体验（PMIE）的影响知之甚少——个人感到被他们曾经信任的领导人背叛——在这种袭击之后，对心理负担的影响。在这项全国前瞻性队列研究中，我们研究了在 10 月 7 日恐怖袭击后，背叛的 PMIE 在多大程度上加剧了创伤后应激障碍（PTSD）和抑郁的风险。一个有代表性的 710 名以色列成年人样本（362 名女性，51.1%），犹太人（557 名，79.9%）和阿拉伯人（153 名，20.1%），年龄在 18-85 岁之间（M=41.01，SD=13.72），在两个时间点完成了经过验证的自我报告问卷，评估了 PTSD、抑郁和 PMIE-背叛：T1，在 2023 年 8 月（袭击前 6-7 周）和 T2，在 2023 年 11 月（袭击后 5-6 周）。在两次分层逻辑回归中，我们发现 PMIE-背叛的经历预测了 PTSD（OR 1.92，95%CI 1.26-2.92）和抑郁（OR 2.03，95%CI 1.37-3.01）的诊断在 T2 时，超过了 T1 时可能的 PTSD/抑郁和人口统计学和创伤相关变量。此外，在两个预测 PTSD/抑郁症状的重复测量分析中，我们发现 PTSD/抑郁轨迹和 PMIE-背叛之间存在显著的相互作用，这意味着在袭击背景下经历背叛的参与者的 PTSD/抑郁症状增加幅度显著更高。我们的研究强调了 PMIE 对以色列民众在 10 月 7 日恐怖袭击后心理病理急剧增加的影响。治疗创伤后应激障碍和抑郁的个体的临床医生应关注他们的患者在袭击后可能遭受的背叛。此外，国家领导人和政策制定者应采取重大步骤来修复公众的背叛经历。
