A prospective investigation of protective factors for moral injury and psychiatric symptomatology among Israeli combatants: A Latent Class Analysis approach

Gadi Zerach, Ariel Ben-Yehuda, Yossi Levi-Belz

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: In this prospective study, we examined pre-enlistment characteristics and pre-deployment protective factors of exposure to potentially morally injurious events (PMIEs) among Israeli active-duty combatants, as well as psychiatric symptomatology outcomes of exposure. Methods: A sample of 335 active-duty Israeli combatants participated in a 2.5-year prospective study with three waves of measurements (T1: 12 months before enlistment, T2: 6 months following enlistment- pre deployment, and T3: 18 months following enlistment- post deployment). Participants’ characteristics were assessed via semi-structured interviews (T1) and validated self-report measures (T2-T3) between 2019 and 2021. Results: Latent Class Analysis (LCA) was used to identify three classes characterized by unique patterns of exposure to PMIEs (T2): Minimal Exposure (56.6%), Betrayal-Only (25.5%), and High Exposure (17.8%). Higher levels of pre-deployment psychological flexibility (T1) were associated with higher odds for inclusion in the high exposure class (T2). As compared to the minimal exposure class, both high exposure and betrayal-only classes were associated with higher levels of mental health symptoms and MI-related psychological outcomes (T2). Conclusions: This is the first prospective study of antecedents and outcomes of exposure to PMIEs among active-duty combatants. Clinicians treating combatants should be aware of the different types of exposure to PMIEs and their possible psychiatric outcomes.

Original languageEnglish
Pages (from-to)1134-1144
Number of pages11
JournalInternational Journal of Social Psychiatry
Volume69
Issue number5
DOIs
StatePublished - Aug 2023

Keywords

  • PTSD
  • combatants
  • moral injury

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