{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:28:35Z","timestamp":1780068515454,"version":"3.54.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Traumatic Stress"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Suicide is one of the leading causes of death among military personnel, and help\u2010seeking is crucial to combating it. Research has not yet investigated the role that potentially morally injurious events (PMIEs), particularly betrayal, may play in moderating the effect of battlefield experiences on these variables. Data from 694 U.S. Army personnel, all of whom had at least one combat deployment, were analyzed to examine battlefield life\u2010threatening experiences (LTEs), suicidal ideation, help\u2010seeking behavior, PMIEs, depressive symptoms, anxiety symptoms, posttraumatic stress disorder (PTSD) symptoms, and aggression. Analyses revealed a significant interaction between LTEs and betrayal\u2010type PMIEs predicting both a higher likelihood of suicidal thoughts and planning, relative risk ratio = 1.729,\n                    <jats:italic>z<\/jats:italic>\n                    = 2.13,\n                    <jats:italic>p<\/jats:italic>\n                    =\u00a0.034, 95% confidence interval (CI) [1.043, 2.863], and help\u2010seeking from fewer sources, incident rate ratio = 0.927,\n                    <jats:italic>z<\/jats:italic>\n                    = \u22122.26,\n                    <jats:italic>p<\/jats:italic>\n                    =\u00a0.024, 95%\n                    <jats:italic>CI<\/jats:italic>\n                    = [0.868, 0.990]. These effects held even when controlling for depressive symptoms, anxiety symptoms, PTSD symptoms, and aggression. The findings suggest that betrayal\u2010type PMIEs have a significant moderating effect on the impact of LTEs on suicidal ideation and help\u2010seeking behavior, and this effect cannot be explained by the experience of the other four measured symptoms of psychological distress.\n                  <\/jats:p>","DOI":"10.1002\/jts.23172","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T04:43:26Z","timestamp":1748925806000},"page":"1071-1078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Perceived betrayal moderates the effects of battlefield experiences on suicidal ideation and help\u2010seeking"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0865-424X","authenticated-orcid":false,"given":"James F. M.","family":"Cornwell","sequence":"first","affiliation":[{"name":"School of Psychology, Counseling, and Family Therapy Wheaton College  Wheaton Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5573-3506","authenticated-orcid":false,"given":"Stephen W.","family":"Krauss","sequence":"additional","affiliation":[{"name":"Walter Reed Army Institute of Research  Silver Spring Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9455-7480","authenticated-orcid":false,"given":"Michael D.","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Behavioral Sciences and Leadership United States Military Academy  West Point New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5266-4747","authenticated-orcid":false,"given":"Elizabeth L.","family":"Wetzler","sequence":"additional","affiliation":[{"name":"Department of Behavioral Sciences and Leadership United States Military Academy  West Point New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.neuropsych.19020036"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22221"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0099852"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191115590855"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12163"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/tra0001773"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000475"},{"key":"e_1_2_6_10_1","unstructured":"Cox A. L. &Castro C. A.(2006 April 24\u201326).Mental health needs assessment [Conference presentation]. Human Factors and Medicine Panel Symposium Brussels Belgium.https:\/\/ntrl.ntis.gov\/NTRL\/dashboard\/searchResults\/titleDetail\/ADA472785.xhtml"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044\u20108260.1996.tb01207.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1037\/tra0001134"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22362"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040603"},{"issue":"5","key":"e_1_2_6_15_1","first-page":"2","article-title":"U.S. Army mortality surveillance in active duty soldiers, 2014\u20132019","volume":"31","author":"Kaplansky G. F.","year":"2024","journal-title":"Medical Surveillance Monthly Report"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00332747.2022.2120310"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22635"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525\u20101497.2001.016009606.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2009.07.003"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721005274"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED\u2010D\u201013\u201000017"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/jramc\u20102017\u2010000877"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112722"},{"key":"e_1_2_6_25_1","unstructured":"Weathers F. W. Litz B. T. Keane T. M. Palmier P. A. Marx B. P. &Schnurr P. P.(2013).The PTSD Checklist for DSM\u20105 (PCL\u20105).https:\/\/www.ptsd.va.gov\/professional\/assessment\/adult\u2010sr\/ptsd\u2010checklist.asp"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1037\/pspi0000334"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ab.21595"},{"key":"e_1_2_6_28_1","first-page":"54","article-title":"Force protection from moral injury: Three objectives for military leaders","volume":"92","author":"Zust J.","year":"2019","journal-title":"Joint Force Quarterly"}],"container-title":["Journal of Traumatic Stress"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jts.23172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T03:08:41Z","timestamp":1766027321000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jts.23172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/jts.23172"],"URL":"https:\/\/doi.org\/10.1002\/jts.23172","archive":["Portico"],"relation":{},"ISSN":["0894-9867","1573-6598"],"issn-type":[{"value":"0894-9867","type":"print"},{"value":"1573-6598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,3]]},"assertion":[{"value":"2024-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}