The contribution of exposure to potentially morally injurious events to trajectories of posttraumatic stress symptoms among discharged veterans - a five-year study.

PURPOSE: Combatants and veterans are at risk of developing post traumatic stress symptoms (PTSS). The long-term responses to traumatic events are variable and can be classified into distinct PTSS trajectories. In this prospective study, we evaluated PTSS trajectories among combat veterans during the initial year after discharge from military service. Subsequently, we analyzed how combat exposure and PMIEs contributed to these trajectories. METHODS: Our study encompassed 374 combat veterans who participated in a five-year prospective study, with four waves of measurements, T1 - one year before enlistment, T2 - one month prior to discharge from military service (July 2021), and then again at six months (T3 - February 2022) and twelve months after discharge (T4, July-August 2022) . RESULTS: The utilization of Latent Profile Analysis (LPA) revealed a diverse array of PTSS trajectories. Predominantly, a resilient trajectory emerged as the most frequently observed (69.3%), with 'delayed onset'(13.6%), 'improving'(9.9%) and 'chronic'(6.1%) trajectories following in order. Importantly, multinominal regression analysis indicated that combat exposure and PMIE-betrayal contributed to alignment with symptomatic trajectories. CONCLUSIONS: This study represents the first of its kind to establish longitudinal, time-dependent associations between PMIEs and PTSS trajectories. These results emphasize the critical importance of ongoing screening and the development of tailored interventions for combat veterans.

Constellations of posttraumatic stress symptoms and posttraumatic growth among Israeli female combat veterans: A latent profile analysis approach.

OBJECTIVES: Posttraumatic stress disorder symptoms (PTSS) and posttraumatic growth (PTG) are possible reactions to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about patterns of both PTSS and PTG among female combat veterans is sparse. This study examines constellations of PTSS and PTG among Israeli female combat veterans, as well as military-related exposure and positive psychological correlates of these constellations. METHODS: A volunteer sample of Israeli women combat veterans (n = 885) responded to self-report questionnaires in a cross-sectional design study. RESULTS: Latent profile analysis (LPA) was used to identify four profiles characterized by unique constellations of PTSS and PTG: moderate PTSS and high PTG (33%), moderate PTSS and moderate PTG (30%), low PTSS and high PTG (30%), and low PTSS and PTG (5.5%). Higher levels of combat experiences were associated with higher odds of inclusion in the moderate PTSS and high PTG and moderate PTSS and moderate PTG profiles. Moreover, compared to the other classes, both low PTSS and high PTG and moderate PTSS and high PTG classes were associated with higher levels of satisfaction with life and happiness psychological outcomes. CONCLUSION: The study's findings offer an overview of the complex pattern of associations between PTSS, PTG, and associated predictors and outcomes. Clinicians treating female veterans should be aware of the varying reactions to military service challenges, including the presence of moderate to high levels of PTG reactions in addition to PTSS.

Aging together in the aftermath of war: marital adjustment and subjective age of veterans and their spouses.

OBJECTIVES: Trauma has long-term effects on those directly exposed to it, but it also impacts those closest to them, particularly one's spouse, as the marital relationship is of central importance for late-life development. Furthermore, traumatic experiences have been shown to be involved in an acceleration of aging, whether through physical health, or via psychological pathways, through an older subjective age. The present work seeks to examine the mutual connections between marital adjustment and the psychological accelerated aging of both spouses among military veterans of the Israeli 1973 Yom Kippur War. METHOD: Data from two assessments were drawn from a larger longitudinal study. In 2008 (T1) and again in 2015 (T2), 247 veterans and their wives were interviewed on their subjective age, marital adjustment, and PTSD symptoms. RESULTS: An actor-partner interdependence model combined with an autoregressive cross-lagged model, controlling for T1 PTSD symptoms revealed that men's subjective age at T1 was associated with women's subjective age at T2, and women's subjective age at T1 was associated with men's subjective age at T2. Women's marital adjustment at T1 was associated with men's marital adjustment at T2 but not the other way around. CONCLUSION: Spousal relationships are an important arena in the lives of older adult veterans. The present study contributes new knowledge regarding the paths that predict subjective age by taking account of the subjective age of one's spouse, as well as levels of marital adjustment. Insights regarding secondary traumatization, as well as gender differences, for the aging process are discussed.

Exposure to combat incidents within military and civilian populations as possible correlates of potentially morally injurious events and moral injury outcomes among Israeli combat veterans.

OBJECTIVES: Exposure to potentially morally injurious events (PMIEs) is considered a necessary but insufficient determinant of moral injury (MI) outcomes. However, a question remains regarding possible acts and the necessary features of PMIEs that should be considered transgressive and might lead to MI psychopathological outcomes. We aim to examine the links between exposure to combat incidents within civilian Palestinian populations (CPPs), PMIEs and MI-related outcomes of posttraumatic stress disorder (PTSD) symptoms (PTSS), trauma-related guilt and shame. We also aim to explore the mediating roles of subjective perceptions of PMIEs in the relationship between exposure to combat incidents within CPP and MI-related outcomes among combat veterans. METHOD: A volunteer sample of 716 Israeli combat veterans responded to self-report questionnaires in a cross-sectional design study. RESULTS: Exposure to combat incidents within CPP has been primarily associated with perpetration based PMIEs and MI-related guilt outcomes. Importantly, betrayal-based PMIEs mediated the association between reports of being the victim of verbal violence by militants and/or civilians and MI outcomes. Moreover, perpetration-based PMIEs mediated associations between reports of personal acts, or witnessing acts, of physical and verbal violence and degradation by militants and/or civilians, and MI outcomes. CONCLUSIONS: Military incidents within civilian populations are related to subjective perceptions of PMIEs and MI-related psychopathological outcomes. While betrayal-based experiences might serve as a mechanism to being a victim of verbal violence and MI outcomes, perpetration-based experiences might serve as mechanisms to physical, verbal and degradation incidents and MI outcomes.

Associations Between Posttraumatic Stress Symptoms, Anxiety Sensitivity, Socially Prescribed Perfectionism, and Severity of Somatic Symptoms Among Individuals with Fibromyalgia.

OBJECTIVES: The contribution of psychological risk factors to the intensification of pain experienced among individuals with fibromyalgia syndrome (FMS) is relatively under-studied. The present study aims to explore associations between FMS-related somatic symptom severity and two personality tendencies: anxiety sensitivity (AS) and socially prescribed perfectionism (SPP). Furthermore, the relative contributions of these personality tendencies are examined vis-à-vis the experience of potentially traumatic events (PTEs) and the psychopathology of posttraumatic stress symptoms (PTSS). METHODS: A volunteer sample of 117 Israeli adults with FMS responded to online validated self-report questionnaires regarding their PTEs, PTSS, somatic symptom severity, FMS, AS, and SPP in a cross-sectional study. RESULTS: Participants' self-reported PTSS rates (61.5%) were high. AS and SPP were positively related to somatic symptom severity. Interestingly, we found that PTSS positively predicted the severity of somatic symptoms above and beyond the contributions of AS and SPP. CONCLUSIONS: The present study supports the assumption that psychological risk factors may affect the expression of somatic symptoms and the interpretation of pain stimulus arising in the body that might eventually be experienced as excessively painful. The study also suggests that above and beyond psychological risk factors, PTSS may express a high predominance and affect pain perception among participants with FMS.

Emptiness Mediates the Association Between Pathological Narcissism and Problematic Smartphone Use.

The few studies that examined the association between narcissism and problematic smartphone use found mixed results. Moreover, the empirical examination of psychological mechanisms for this link is lacking. This study investigated the relationships between pathological narcissism, emptiness and problematic smartphone use. Participants included 278 young Israeli adults (159 males; Mage = 26.21) who completed a battery of self-report questionnaires. Our results show that narcissistic grandiosity, vulnerability and emptiness were positively related to problematic smartphone use. Importantly, emptiness mediated the relationships between pathological narcissism and problematic smartphone use. These findings highlight the mediating role of emptiness experience in the associations between pathological narcissism and problematic smartphone use and lend empirical support to the importance of the emptiness experience for compensatory behaviors such as heavy and compulsive smartphone usage by the pathological narcissist.

Posttraumatic growth among combat veterans and their siblings: A dyadic approach.

OBJECTIVES: We aimed to use a dyadic approach to assess the effects of veterans' posttraumatic stress disorder symptoms (PTSS) and siblings' secondary PTSS, as well as veterans' and siblings' relationship quality, on primary and secondary posttraumatic growth (PTG). METHOD: A volunteers' sample of 106 dyads of Israeli combat veterans and their close-in-age siblings responded to self-report questionnaires in a cross-sectional, dyadic design study. RESULTS: Veterans' primary PTG was positively associated with siblings' secondary PTG. Veterans' PTSS and siblings' secondary PTSS were associated with higher levels of primary and secondary PTG, respectively. Furthermore, among veterans, warmth in siblings' relationships was associated with higher levels of primary PTG. However, among siblings, rivalry in sibling relationships was associated with lower levels of secondary PTG. CONCLUSIONS: Both veterans' and siblings' PTSS are only related to their own PTG. Moreover, perception of siblings' relationship quality might have a differential effect on PTG among veterans and their siblings.

Attachment and social support mediate associations between Polyvictimization and psychological distress in early adolescence.

The current study assesses associations between multiple experience of traumatic events (polyvictimization), PTSD symptoms (PTSS) and psychiatric symptoms in early adolescence, and explores the mediating roles of attachment orientations and perceived social support in the associations between polyvictimization, PTSS and psychiatric symptoms. In 2001, a representative national sample of 390 Danish eighth-graders (M = 13.95, SD = .37) completed validated self-report questionnaires. Polyvictimization was related to higher PTSS and psychiatric symptoms. Importantly, polyvictimization was significantly linked to high attachment anxiety, which was linked with low perceived social support, which in turn was linked with high PTSS levels and psychiatric symptoms. Polyvictimization might have dire consequences in early adolescence. An individual's high attachment anxiety might be connected with lack of perceived social support, which should be seen as a possible psychological distress mechanism subsequent to exposure to a number of potentially traumatic events.

Intolerance of Uncertainty Moderates the Association Between Potentially Morally Injurious Events and Suicide Ideation and Behavior Among Combat Veterans.

Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as significant stressful combat events that may lead to mental health problems, including self-injurious thoughts and behavior (SITB). However, few studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SITB. In the current study, we aimed to examine the association between PMIEs and SITB among combat veterans and explore the moderating roles of intolerance of uncertainty (IU) in this association. A volunteer sample of 191 Israeli combat veterans was recruited during 2017. Participants completed validated self-report questionnaires in a cross-sectional study. Results indicated that two separate measures of PMIEs, the Perceived Perpetration by Oneself and Others subscale of the Moral Injury Events Scale (MIES) and the Causes subscale of the Moral Injury Questionnaire (MIQ-Causes), were positively associated with higher levels of SITB. Moreover, beyond the contributions of reserve duty, posttraumatic stress symptoms, and depressive symptoms, MIQ-Causes scores significantly predicted current SITB. Importantly, under low and average levels of inhibitory IU, significant positive effects were revealed for the MIQ-Causes on current SITB, R² = .34. Although veterans exposed to PMIEs are more prone to SITB, even years after their release from military service, their IU may temper the link between experiences of PMIEs and SITB.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) La Intolerancia a la Incertidumbre Modera la Asociación entre los Eventos Potencialmente Dañinos Moralmente, la Ideación, y las Conductas Suicidas entre los Veteranos Combatientes DAÑO MORAL Y SUICIDIO La exposición a los eventos potencialmente dañinos moralmente (PMIEs en sus siglas en inglés) entre los veteranos combatientes ha sido reconocidos como aquellos eventos de combate significativamente estresantes que pueden conllevar problemas de salud mental, incluyendo los pensamientos y las conductas autolesivos (SITB en su sigla en inglés). Sin embargo, solo unos pocos estudios han examinado los factores de riesgo y protectores que pueden explicar las condiciones en las que los PMIES podrían contribuir al desarrollo y mantención de los SITB. En el presente estudio, se busca examinar la asociación entre los PMIEs y los SITB entre los veteranos combatientes y explorar los roles moderadores de intolerancia a la incertidumbre (IU en su sigla en inglés) en esta asociación. Se reclutó durante el 2017 una muestra voluntaria de 191 veteranos combatientes israelíes. Los participantes completaron cuestionarios validados de auto-reporte de un estudio trasversal. Los resultados indicaron que las dos medidas distintas de los PMIEs, la subescala de Perpetración Percibida por Uno Mismo y Otros de la Escala de Eventos Dañinos Morales (MIES en sus siglas en inglés) y la subescala Causas del Cuestionario de Daño Moral (MIQ en sus siglas en inglés-Causas), se asociaron positivamente con niveles más altos de los SITB. Además, más allá de las contribuciones del servicio de reserva, los síntomas de estrés postraumáticos, y los síntomas depresivos, los puntajes de las MIQ-Causas predijeron significativamente los SITB actuales. De forma importante, con niveles bajos y medios de la inhibida IU, los efectos positivos significativos fueron revelados para las MIQ-Causas en los SITB actuales, R2 = .34. Aunque los veteranos expuestos a los PMIEs fueron más propensos a los SITB, incluso años después del término de su servicio militar, su IU podría mitigar la conexión entre las experiencias de los PMIEs y los SITB.

Moral injury process and its psychological consequences among Israeli combat veterans.

OBJECTIVES: We aim to examine the link between exposure to potentially morally injurious events (PMIEs) and posttraumatic stress disorder symptoms (PTSS). We also aim to explore the mediating roles of depressive attributions, trauma-related guilt and shame, and self-disgust in the relationship between PMIEs and PTSS among combat veterans. METHOD: A volunteers' sample of 191 Israeli combat veterans responded to self-report questionnaires in a cross-sectional design study. RESULTS: More than one-fifth of the sample reported experiencing PMIEs but only betrayal based experience was related to PTSS. Importantly, betrayal based experience was associated with depressive attributions which increased the level of trauma-related distressing guilt, intrinsic shame and self-disgust, which in turn were associated with high levels of PTSS. CONCLUSIONS: PMIEs, and especially betrayal based experiences, are related to PTSS among Israeli veterans. Depressive attributions, trauma-related distressing guilt, intrinsic shame, and self-disgust might serve as possible mechanisms for the links between PMIEs and PTSS.

The Roles of Fathers' Posttraumatic Stress Symptoms and Adult Offspring's Differentiation of the Self in the Intergenerational Transmission of Captivity Trauma.

OBJECTIVES: This prospective study aims to assess the role of fathers' posttraumatic stress disorder (PTSD) symptoms (PTSS), the course of these symptoms over the years, and the relationship between these symptoms and their adult offspring's own PTSS and level of differentiation of self. METHOD: A sample of 123 Israeli father-child dyads (79 ex-prisoners of war [ex-POWs] dyads and a comparison group of 44 veterans' dyads) completed self-report measures. The fathers participated in 2 waves of measurements (1991 and 2008), while the offspring took part in 2013-2014. RESULTS: Increase in the fathers' PTSS over the years was related to high levels of his offspring's PTSS. Among ex-POWs' offspring, self-differentiation mediated the association between the father's PTSS and offspring's PTSS. Thus, a greater increase in the ex-POWs' PTSS over time was correlated to lower levels of the offspring's self-differentiation, which in turn was correlated to higher rates of PTSS. CONCLUSION: Veterans' PTSS as well as offspring's self-differentiation are mechanisms of the intergenerational transmission of captivity trauma.

Anxiety Sensitivity Among First-Time Fathers Moderates the Relationship Between Exposure to Stress During Birth and Posttraumatic Stress Symptoms.

This longitudinal study examined posttraumatic stress disorder (PTSD) and anxiety symptoms among men attending the birth of their first offspring. Furthermore, we examined the moderating role of anxiety sensitivity (AS) and intolerance of uncertainty in the association between exposure to stress during birth and PTSD and anxiety symptoms. Participants were Israeli men (n = 171) who were assessed with self-report questionnaires during the third trimester of pregnancy (T1) and approximately a month following birth (T2). Results show that the rates of postnatal PTSD and anxiety symptoms were relatively low. Subjective exposure to stress during birth and AS predicted PTSD in T2, above and beyond other negative life events and PTSD in T1. In addition, AS moderated the relations between subjective exposure to stress during birth and PTSD symptoms. Pregnancy and childbirth professionals may benefit from the insight that men with high levels of AS might experience childbirth as a highly stressful situation with possible posttraumatic stress symptoms.

Indirect Exposure to Captivity Details Is Not Related to Posttraumatic Stress Symptoms Among the Spouses and Offspring of Former Prisoners of War.

Indirect exposure to the aversive details of the primary victim's traumatic event(s) has been introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) as a new event criterion (Criterion A4). However, this new criterion has been criticized for its significant emphasis on the exposure to trauma "details" or trauma narrative. This study assessed the associations between reported exposure to details about captivity and posttraumatic stress symptoms (PTSS) among 2 groups of family members of former prisoners of war (ex-POWs): spouses (n = 115) and adult offspring (n = 78). Results show that in both groups exposure to details regarding captivity was not significantly related to the severity of total PTSS and specifically, high levels of exposure to captivity details were related to lower avoidance symptoms among ex-POWs' spouses. Among offspring, exposure to paternal behaviors stemming from the fathers' posttraumatic stress disorder was related to PTSS, above and beyond negative life events, quality of relationship with the father, and exposure to captivity details (R2 = .34). These results suggest that behavioral displays of the fathers' posttraumatic symptoms, rather than the recounting of trauma-related details, is related to PTSS among ex-POWs' offspring.

The long-term implications of war captivity for mortality and health.

The current study aims to (1) assess the long-term impact of war captivity on mortality and various health aspects and (2) evaluate the potential mediating role of posttraumatic stress disorder (PTSD) and depressive symptoms. Israeli ex-prisoners of war (ex-POWs) (N = 154) and a matched control group of combat veterans (N = 161) were assessed on health conditions and self-rated health 18 years post-war (1991: T1). The whole population of ex-POWs, and the T1 sample of controls were then contacted 35 years after the war (2008: T2), and invited to participate in a second wave of measurement (ex-POWs: N = 171; controls: N = 116) Captivity was implicated in premature mortality, more health-related conditions and worse self-rated health. PTSD and depressive symptoms mediated the relationship between war captivity and self-rated health, and partially mediated the relationship between war captivity and health conditions, and these effects were amplified with age. Aging ex-POWs who develop psychiatric symptomatology should be considered a high-risk group entering a high-risk period in the life cycle. It is important to monitor ex-POWs and provide them with appropriate medical and psychological treatment as they age.

The associations between pathological narcissism, alexithymia and disordered eating attitudes among participants of pro-anorexic online communities.

PURPOSE: This study investigated the relationships between pathological narcissism, alexithymia, and disordered eating attitudes among participants of pro-anorexic online communities. Specifically, we explored the possible moderating role of alexithymia in the relationships between narcissistic vulnerability and disordered eating attitudes. METHODS: Participants included 97 Israeli female young adults who are active participants in pro-anorexic online communities. These participants completed a battery of self-reported questionnaires: The Pathological Narcissism Inventory (PNI); The Eating Attitudes Test-26 (EAT-26); and The Toronto Alexithymia Scale (TAS-20). RESULTS: Narcissistic grandiosity, vulnerability, and alexithymia were positively related to disordered eating attitudes. Alexithymia moderated the relationships between narcissistic vulnerability and the total score of disordered eating attitudes. Furthermore, alexithymia moderated the relationships between both narcissistic vulnerability and grandiosity and the oral control subscale of EAT-26. CONCLUSIONS: These findings highlight the interaction between the pathological narcissism and the fundamental trait of alexithymia that might put individuals at risk for disordered eating.

Posttraumatic growth among Israeli female combat veterans: The mediating roles of posttraumatic stress symptoms and self-efficacy.

Posttraumatic growth (PTG) is a possible common reaction to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about correlates of PTG among female combat veterans is sparse. This study examines associations between combat exposure, posttraumatic stress symptoms (PTSS), general self-efficacy (GSE), and PTG among Israeli female veterans. This is a cross-sectional studyA volunteer sample of female Israeli combat veterans (n = 616) and non-combat veterans (n = 484) responded to self-report questionnaires. Combat veterans reported higher levels of combat exposure, PTSS, GSE, and PTG, as compared to non-combat veterans. Among combat veterans, combat exposure and GSE were associated with greater PTG. Importantly, PTSS and GSE mediated the link between combat exposure and PTG. The study's findings are among the first to report about possible psychological growth outcomes among Israeli combat veterans. Clinicians treating female veterans coping with combat trauma should be aware of the heterogeneity of reactions to military service challenges and the importance of enhancing veterans' GSE to facilitate PTG.

The impact of moral injury on suicide risk among recently discharged Israeli veterans: A longitudinal moderated mediation model of trauma-related guilt and self-forgiveness.

BACKGROUND: Exposure to potentially morally injurious events (PMIEs) during military service has been associated with heightened trauma-related guilt levels, which in turn, could increase suicide risk among combat veterans. However, no longitudinal study has established temporal associations between these variables while examining a Moderated mediation model with self-forgiveness as a possible moderator of the PMIEs-suicide risk links during the first year following discharge. METHOD: Participants were 374 active-duty Israeli combatants who participated in a 5-year longitudinal study with three measurement points: 1 month before discharge from army service (T1), then 6 months (T2), and 12 months (T3) following their discharge. Data were assessed through semistructured interviews and validated self-report questionnaires. RESULTS: All PMIE dimensions at T1 were negatively associated with self-forgiveness at T1 and positively associated with levels of trauma-related guilt at T2 and suicide risk at T3. Our longitudinal moderated mediation model findings indicate that, among those reporting low levels of self-forgiveness, higher levels of PMIE-Self and PMIE-Others at T1 contribute to trauma-related guilt levels at T2, which, in turn, are linked to a higher suicide risk at T3 among those reporting low levels of self-forgiveness. CONCLUSIONS: Experiencing PMIEs, especially PMIE-Self and PMIE-Other, proved to be validated predictors of trauma-related guilt and, in turn, of suicide risk during the first year after the veterans' discharge. Combatants at their discharge from the military should have access to targeted self-forgiveness interventions, as these interventions can have a buffering effect on the development of suicidal ideation and behaviors following PMIEs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The impact of moral injury on trajectories of depression: a five-year longitudinal study among recently discharged Israeli veterans.

BACKGROUND: Perpetrating or witnessing acts that violate one's moral code are frequent among military personnel and active combatants. These events, termed potentially morally injurious events (PMIEs), were found to be associated with an increased risk of depression, in cross-sectional studies. However, the longitudinal contribution of PMIEs to depression among combatants remains unclear. METHOD: Participants were 374 active-duty combatants who participated in a longitudinal study with four measurement points: T1-one year before enlistment, T2-at discharge from army service, and then again 6- and 12-months following discharge (T3 and T4, respectively). At T1, personal characteristics assessed through semi-structured interviews. At T2-T4, PMIEs and depressive symptoms were assessed. RESULTS: At discharge (T2), a total of 48.7% of combatants reported experiencing PMIEs incident, compared with 42.4% at T3 and 30.7% at T4. We found a significant interaction effect in which combatants endorsing PMIEs at discharge reported higher severity of depression symptoms at discharge (T2) than combatants who reported no PMIEs. This effect decreased over time as depression levels were lower at T3 and T4. CONCLUSIONS: PMIE experiences, and especially PMIE-Betrayal experiences, were found to be valid predictors of higher severity of depression symptoms after the first year following discharge.

Longitudinal associations between exposure to potentially morally injurious events and suicidal ideation among recently discharged veterans - The mediating roles of depression and loneliness.

BACKGROUND: Exposure to potentially morally injurious events (PMIEs) during military service is associated with heightened suicidal ideation (SI). However, no longitudinal study has established temporal associations between these variables and examined the possible mediating roles of depression and loneliness in this effect. METHODS: 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 their discharge (T3 and T4, respectively). Data were assessed through semi-structured interviews and validated self-report questionnaires. RESULTS: Above and beyond pre-enlistment personal characteristics (T1) and combat exposure (T2), PMIEs-'betrayal' (T2) predicted more frequent SI over the past twelve months (T4) through the mediation of depression. Moreover, both PMIEs-'betrayal' and 'self' (T2) predicted more frequent SI over the past twelve months (T4) through the mediation of loneliness. LIMITATIONS: We used self-report measures to assess PMIEs and SI, which may suffer from various biases. CONCLUSIONS: Our findings are the first to provide evidence of longitudinal, temporal associations between exposure to PMIEs and SI. Notably, potential interventions might consider addressing the loneliness experienced following exposure to PMIEs during military service, among recently discharged traumatized veterans.

The contribution of maladaptive personality traits to PTSD and depression symptoms among Israeli female veterans.

OBJECTIVE: Exposure to potentially traumatic events during military service is associated with mental health problems such as posttraumatic stress disorder (PTSD) and depression symptoms. However, knowledge regarding the implications of maladaptive personality traits in psychopathology among female veterans is sparse. The present study aims to use the Diagnostic and Statistical Manual of Mental Disorders, fifth edition-an alternative model of personality disorder, to examine associations between maladaptive personality traits, PTSD and depression symptoms, among female Israeli veterans. METHOD: A volunteer sample of female Israeli combat veterans (n = 616) and noncombat veterans (n = 484) responded to self-report questionnaires in a cross-sectional study. RESULTS: Combat veterans reported higher levels of combat exposure and PTSD symptoms, but not depressive symptoms, than noncombat veterans. Combat veterans also reported lower levels of negative affectivity but higher levels of disinhibition than noncombat veterans. All five traits were positive predictors of PTSD and depression symptoms, with psychoticism constituting the strongest predictor. A moderated-mediation analysis indicated four traits (negative affectivity, detachment, disinhibition, and psychoticism) that had a moderating effect on the relationship between combat exposure and PTSD symptoms, and two of the traits (antagonism and disinhibition) that had a moderate effect on the relationship between combat exposure and depressive symptoms. CONCLUSIONS: Maladaptive personality traits play an important role in psychological distress following female veterans' combat service. Future prospective research is necessary to determine the temporal associations between preenlistment maladaptive personality traits and postdeployment mental health of veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).