PDF(Pubmed)
Abstract：
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.
摘要：
大约有1200人被谋杀，10月7日的大屠杀是现代历史上最致命的恐怖袭击之一。恐怖袭击的精神健康后果已记录在案。然而,人们对背叛的潜在道德伤害经历（PMIE）的影响知之甚少，在这种背叛之后，个人感到被他们曾经信任的领导人背叛了。在这项全国性的前瞻性队列研究中，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)和抑郁症的风险.710名以色列成年人的代表性样本(362名女性，51.1%)，犹太人（557，79.9％）和阿拉伯人（153，20.1％），18-85岁(M=41.01，SD=13.72)完成了评估创伤后应激障碍的有效自我报告问卷，抑郁症,和PMIE背叛在两个时间点：T1，在2023年8月（攻击前6-7周）和T2，在2023年11月（攻击后5-6周）。在两个分层逻辑回归中，我们发现,PMIE背叛的经验可预测T2时PTSD(OR1.92,95%CI1.26-2.92)和抑郁(OR2.03,95%CI1.37-3.01)的诊断,超过T1时可能的PTSD/抑郁以及人口统计学和创伤相关变量.此外，在预测PTSD/抑郁症状的两个重复测量分析中，我们发现PTSD/抑郁轨迹和PMIE背叛之间存在显著的相互作用，这意味着在攻击背景下经历背叛的参与者中，PTSD/抑郁症状的增加明显更高。我们的研究强调了在10月7日以色列人口遭受恐怖袭击后，背叛的PMIE对精神病理学急剧增加的影响。治疗患有PTSD和抑郁症的患者的临床医生应注意他们的患者在发作后可能遭受背叛。此外，国家领导人和政策制定者应该采取重大措施来修复公众的背叛经历。
