{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T10:59:42Z","timestamp":1773226782315,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1-2","license":[{"start":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:00:00Z","timestamp":1622246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Exposure to distressing sights (DSs) during combat missions may cause emotional distress. The present study aimed to investigate the association between exposure to DSs involving severe injuries and fatalities during rescue missions and emotional distress, in Israeli Air Force (IAF) helicopter flight engineers (FEs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Cross-sectional design using self-report questionnaires. The independent variables included demographics, personal, and military variables\u2014exposure to DSs throughout a whole career service. The dependent variables included Depression (Beck Depression Inventory); State-Trait Anxiety Inventory; Post-traumatic stress disorder (PTSD Checklist\u2014PCL-5); Somatization (Patient Health Questionnaire); Maslach Burnout Inventory; and Coping Strategies (The Brief COPE). The variables PTSD, depression, and anxiety were examined twice: once as dichotomous variables according to the pathology cutoff point and again as a continuous variable to reveal the intensity of symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Participants were 106 IAF helicopter FEs (mean age\u2009=\u200939.32, SD\u2009=\u20098.75). Linear regression revealed that initial exposure to distressing battlefield sights (i.e., exposure to severe injuries and fatalities) was a predictor of depression symptoms. Career service FEs aged 31\u201340 were found to be at the highest risk of emotional distress, with a predictive factor for anxiety symptoms. Use of nonadaptive coping strategies was found to predict depressive symptoms, anxiety symptoms, and post-traumatic stress symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A significant association was found between exposure to DSs involving severe injuries and fatalities during rescue missions and anxiety, depression, somatization, and burnout. This population is generally perceived as tough and resilient, and this study has a unique contribution in identifying its vulnerabilities. Psychological intervention is crucial after participating in such missions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usab219","type":"journal-article","created":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T15:00:26Z","timestamp":1622300426000},"page":"e301-e310","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of Emotional Distress in Combat Military Flight Engineers"],"prefix":"10.1093","volume":"188","author":[{"given":"Reoot","family":"Cohen-Koren","sequence":"first","affiliation":[{"name":"Psychology Branch, Israeli Air Force , Ramat-Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dror","family":"Garbi","sequence":"additional","affiliation":[{"name":"Psychology Branch, Israeli Air Force , Ramat-Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley","family":"Gordon","sequence":"additional","affiliation":[{"name":"Psychology Branch, Israeli Air Force , Ramat-Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirit","family":"Yavnai","sequence":"additional","affiliation":[{"name":"Medical Corps, Israel Defense Force , Ramat-Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifat","family":"Erlich Shoham","sequence":"additional","affiliation":[{"name":"Aero-Medical Section, Israeli Air Force , Ramat-Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-137X","authenticated-orcid":false,"given":"Leah","family":"Shelef","sequence":"additional","affiliation":[{"name":"Psychology Branch, Israeli Air Force , Ramat-Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,5,29]]},"reference":[{"issue":"4","key":"2023010800030059600_R1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1177\/1534765611429079","article-title":"Mental health in first responders: a review and recommendation for prevention and intervention strategies","volume":"17","author":"Kleim","year":"2011","journal-title":"Traumatology"},{"issue":"2","key":"2023010800030059600_R2","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1017\/S1049023X00005859","article-title":"Disaster medical assistance teams: what psychosocial support is needed?","volume":"23","author":"Stevens","year":"2008","journal-title":"Prehosp Disaster Med"},{"issue":"8 Suppl","key":"2023010800030059600_R3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.7205\/MILMED-D-13-00501","article-title":"Symptoms of psychological distress and post-traumatic stress disorder in United States Air Force \u201cdrone\u201d operators","volume":"179","author":"Chappelle","year":"2014","journal-title":"Mil Med"},{"key":"2023010800030059600_R4","article-title":"Prevalence of high emotional distress and symptoms of post-traumatic stress disorder in US Air Force active duty remotely piloted aircraft operators (2010 USAFSAM survey results)","author":"Chappelle","year":"2012"},{"key":"2023010800030059600_R5","article-title":"Facets of occupational burnout among US Air Force active duty and national guard\/reserve MQ-1 predator and MQ-9 reaper operators (no. 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