{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T02:09:18Z","timestamp":1778206158970,"version":"3.51.4"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"3-4","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,27]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The present study\u2019s central aim was to examine two questions: (1) Will there be differences in mental health outcomes between medics and non-medics who sought help at the Israeli Combat Reaction Unit (CRU)? (2) Will there be differences in mental health outcomes between combatants and non-combatants?<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This cross-sectional study included files of 1,474 Israeli Defense Forces ex-service members (89% combatants, of whom 13% were medics; 11% non-combatants, of whom 6% were medics), who filled out questionnaires on admission for evaluation at the CRU.<\/jats:p><jats:p>Dependent variables were mental health measures and included two PTSD measures (Clinician-Administered PTSD Scale and PTSD Checklist for DSM-5), Beck Depression Inventory, Dissociative Experience Scale, and Brief Symptom Inventory. Military profession (medics vs. non-medics) and status (combatant vs. non-combatant) were the independent variables. Background variables were also examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found no substantial differences between medics and non-medics in the mental health measures. When looking at combat and non-combat separately, the non-combat medics (CMs), in general, were in better mental health conditions than the other three groups\u2014 CMs, non-medic combatants, and non-medic non-combatants\u2014all of whom had similar scores in the mental health measures. However, compared to the rest, non-CMs took considerably longer years before approaching the CRU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The elapsed time to seek help for non-MCs was explained by their reluctance to seek help, not being combatants, and being medics who are portrayed as resilient. Recommendations for encouraging this subgroup to seek help were given.<\/jats:p><\/jats:sec>","DOI":"10.1093\/milmed\/usad368","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T14:05:27Z","timestamp":1695045927000},"page":"e781-e788","source":"Crossref","is-referenced-by-count":7,"title":["The Psychological Impact of\u00a0Exposure to Battle on\u00a0Medics: A Cross-Sectional Study of\u00a0Ex-Soldiers Who Sought Help From the IDF Combat Reaction Unit"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-137X","authenticated-orcid":false,"given":"Leah","family":"Shelef","sequence":"first","affiliation":[{"name":"The School of Social Work, Sapir Academic College , D. N. Hof Ashkelon 79165, Israel"},{"name":"Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem , Jerusalem 91120, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uzi","family":"Bechor","sequence":"additional","affiliation":[{"name":"Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces , Ramat Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ofir","family":"Ohayon","sequence":"additional","affiliation":[{"name":"Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces , Ramat Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4727-4474","authenticated-orcid":false,"given":"Lucian","family":"Tatsa-Laur","sequence":"additional","affiliation":[{"name":"Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces , Ramat Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0909-8297","authenticated-orcid":false,"given":"Avishai","family":"Antonovsky","sequence":"additional","affiliation":[{"name":"Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces , Ramat Gan 5262000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"issue":"6","key":"2024022722291170800_R1","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1097\/acm.0000000000002618","article-title":"Clinical reasoning assessment methods: a scoping review and\u00a0practical guidance","volume":"94","author":"Daniel","year":"2019","journal-title":"Acad Med"},{"issue":"10","key":"2024022722291170800_R2","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1111\/medu.12775","article-title":"How to improve the teaching of\u00a0clinical reasoning: a narrative review and\u00a0a proposal","volume":"49","author":"Schmidt","year":"2015","journal-title":"Med Educ"},{"key":"2024022722291170800_R3","volume-title":"To Err Is Human Building a Safer Health System","author":"Kohn","year":"2000"},{"key":"2024022722291170800_R4","doi-asserted-by":"publisher","first-page":"i2139","DOI":"10.1136\/bmj.i2139","article-title":"Medical error\u2014the third leading cause of\u00a0death in\u00a0the US","volume":"353","author":"Makary","year":"2016","journal-title":"BMJ"},{"issue":"3","key":"2024022722291170800_R5","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.jagp.2015.05.004","article-title":"Prevalence of\u00a0post-traumatic stress disorder in\u00a0aging Vietnam-era veterans: veterans administration cooperative study 569: course and\u00a0consequences of\u00a0post-traumatic stress disorder in\u00a0Vietnam-era veteran twins","volume":"24","author":"Goldberg","year":"2016","journal-title":"Am J Geriatr Psychiatry"},{"issue":"1","key":"2024022722291170800_R6","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1002\/jts.20486","article-title":"Disparate prevalence estimates of\u00a0PTSD among service members who served in\u00a0Iraq and\u00a0Afghanistan: possible explanations","volume":"23","author":"Ramchand","year":"2010","journal-title":"J Traumatic Stress."},{"issue":"9524","key":"2024022722291170800_R7","doi-asserted-by":"publisher","first-page":"1731","DOI":"10.1016\/S0140-6736(06)68662-5","article-title":"The health of\u00a0UK military personnel who deployed to the 2003 Iraq war: a cohort study","volume":"367","author":"Hotopf","year":"2006","journal-title":"Lancet"},{"issue":"1","key":"2024022722291170800_R8","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1080\/09540261.2019.1601072","article-title":"Adjustment profiles of\u00a0Yom Kippur war veterans seeking delayed help from the IDF","volume":"31","author":"Shoval-Zuckerman","year":"2019","journal-title":"Int Rev Psychiatry"},{"issue":"1","key":"2024022722291170800_R9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1365-2648.2011.05708.x","article-title":"Combat stressors and\u00a0post-traumatic stress in\u00a0deployed military healthcare professionals: an integrative review","volume":"68","author":"Gibbons","year":"2012","journal-title":"J Adv Nurs"},{"key":"2024022722291170800_R10","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1037\/trm0000173","article-title":"Longitudinal effects of\u00a0deployment, recency of\u00a0return, and\u00a0hardiness on\u00a0mental health symptoms in\u00a0U.S. Army combat medics","volume":"25(3)","author":"Krauss","year":"2018","journal-title":"Traumatology"},{"key":"2024022722291170800_R11","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/j.jad.2020.08.027","article-title":"PTSD networks of\u00a0veterans with combat versus non-combat types of\u00a0index trauma","volume":"277","author":"Macia","year":"2020","journal-title":"J Affect Disord"},{"issue":"6","key":"2024022722291170800_R12","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1037\/mil0000025","article-title":"Killing versus witnessing trauma: implications for\u00a0the development of\u00a0PTSD in\u00a0combat medics","volume":"25","author":"Pitts","year":"2013","journal-title":"Mil Psychol"},{"key":"2024022722291170800_R13","first-page":"2","article-title":"Routine screening and\u00a0referrals for\u00a0PTSD after returning from Operation Iraqi Freedom in\u00a02005, U.S. Armed Forces","volume":"14(6)","author":"Martin","year":"2007","journal-title":"MSMR Medi Surveillance Mon Rep"},{"issue":"10","key":"2024022722291170800_R14","doi-asserted-by":"publisher","first-page":"2043","DOI":"10.1249\/MSS.0000000000000642","article-title":"Exercise enhances the behavioral responses to acute stress in\u00a0an animal model of\u00a0PTSD","volume":"47","author":"Hoffman","year":"2015","journal-title":"Med Sci Sports Exerc"},{"issue":"1","key":"2024022722291170800_R15","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2018.1463794","article-title":"Dissociative symptoms mediate the relation between PTSD symptoms and\u00a0functional impairment in\u00a0a sample of\u00a0military members, veterans, and\u00a0first responders with PTSD","volume":"9","author":"Boyd","year":"2018","journal-title":"Eur J Psychotraumatol"},{"issue":"5","key":"2024022722291170800_R16","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.cpr.2012.04.001","article-title":"Treating posttraumatic stress disorder in\u00a0first responders: a systematic review","volume":"32","author":"Haugen","year":"2012","journal-title":"Clin Psychol Rev"},{"issue":"8","key":"2024022722291170800_R17","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1176\/appi.ajp.161.8.1370","article-title":"Acute stress disorder, posttraumatic stress disorder, and\u00a0depression in\u00a0disaster or rescue workers","volume":"161","author":"Fullerton","year":"2004","journal-title":"Am J Psychiatry"},{"key":"2024022722291170800_R18","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1146\/annurev.publhealth.28.021406.144037","article-title":"First responders: mental health consequences of\u00a0natural and\u00a0human-made disasters for\u00a0public health and\u00a0public safety workers","volume":"28","author":"Benedek","year":"2007","journal-title":"Annu Rev Public Health"},{"issue":"11","key":"2024022722291170800_R19","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1176\/appi.ajp.2015.14121572","article-title":"Prospective longitudinal evaluation of\u00a0the effect of\u00a0deployment-acquired traumatic brain injury on\u00a0posttraumatic stress and\u00a0related disorders: results from the Army Study to Assess Risk and\u00a0Resilience in\u00a0Servicemembers (Army STARRS)","volume":"172","author":"Stein","year":"2015","journal-title":"Am J Psychiatry"},{"issue":"5","key":"2024022722291170800_R20","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1016\/j.injury.2015.10.078","article-title":"Augmentation of\u00a0point of\u00a0injury care: reducing battlefield mortality\u2014the IDF experience","volume":"47","author":"Benov","year":"2016","journal-title":"Injury"},{"issue":"1","key":"2024022722291170800_R21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.33140\/IJP","article-title":"Impairment among soldiers who were exposed to combat during military operation","volume":"3","author":"Shelef","year":"2018","journal-title":"Int J Psychiatry"},{"issue":"4","key":"2024022722291170800_R22","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1093\/schbul\/sbr047","article-title":"The relationship between risk of\u00a0hospitalization for\u00a0schizophrenia, SES, and\u00a0cognitive functioning","volume":"37","author":"Goldberg","year":"2011","journal-title":"Schizophr Bull"},{"issue":"1","key":"2024022722291170800_R23","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s40696-016-0014-7","article-title":"The contribution of\u00a0the socio\u2013demographic characteristics on\u00a0suicidal ideation among Israeli soldiers","volume":"2","author":"Shelef","year":"2016","journal-title":"Disaster Mil Med"},{"key":"2024022722291170800_R24","article-title":"The Clinician-Administered PTSD Scale for\u00a0DSM-5 (CAPS-5)","volume-title":"Assessment from the National Center for PTSD","author":"Weathers","year":"2013"},{"key":"2024022722291170800_R25","article-title":"The PTSD Checklist for\u00a0DSM-5 (PCL-5)","volume-title":"Scale from the National Center for PTSD","author":"Weathers","year":"2013"},{"key":"2024022722291170800_R26","volume-title":"Beck Depression Inventory","author":"Beck","year":"1987"},{"issue":"3","key":"2024022722291170800_R27","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1207\/s15327752jpa6703_13","article-title":"Comparison of\u00a0Beck Depression Inventories-IA and-II in\u00a0psychiatric outpatients","volume":"67","author":"Beck","year":"1996","journal-title":"J Pers Assess"},{"issue":"12","key":"2024022722291170800_R28","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1097\/00005053-198612000-00004","article-title":"Development, reliability, and\u00a0validity of\u00a0a dissociation scale","volume":"174","author":"Bernstein","year":"1986","journal-title":"J Nerv Ment Dis"},{"issue":"2","key":"2024022722291170800_R29","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1002\/jts.2490090204","article-title":"The long-term sequelae of\u00a0sexual abuse: support for\u00a0a complex posttraumatic stress disorder","volume":"9","author":"Zlotnick","year":"1996","journal-title":"J Trauma Stress"},{"issue":"3","key":"2024022722291170800_R30","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1017\/S0033291700048017","article-title":"The Brief Symptom Inventory: an introductory report","volume":"13","author":"Derogatis","year":"1983","journal-title":"Psychol Med"},{"key":"2024022722291170800_R31","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen","year":"1988","edition":"2nd ed"},{"key":"2024022722291170800_R32","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1007\/s12144-016-9451-1","article-title":"The relationships of\u00a0sense of\u00a0coherence and\u00a0self-compassion to worry: the mediating role of\u00a0personal intelligence","volume":"36","author":"Mowlaie","year":"2017","journal-title":"Curr Psychol"},{"key":"2024022722291170800_R33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/jehp.jehp_758_20","article-title":"Relationship between the sense of\u00a0coherence, self-directed learning readiness, and\u00a0academic performance in\u00a0Malaysian undergraduate dental students","volume":"10","author":"Siddiqui","year":"2021","journal-title":"J Educ Health Promot"},{"key":"2024022722291170800_R34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/heapro\/daab036","article-title":"Predicting mental burnout among Israeli Home Front Command soldiers during the COVID-19 pandemic","volume":"37(2)","author":"Antonovsky","year":"2021","journal-title":"Health Promot Int"},{"issue":"7","key":"2024022722291170800_R35","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/j.jpsychires.2009.10.010","article-title":"Predictors of\u00a0emotional distress reported by soldiers in\u00a0the combat zone","volume":"44","author":"Ferrier-Auerbach","year":"2010","journal-title":"J Psychiatr Res"},{"issue":"2","key":"2024022722291170800_R36","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1111\/j.1545-5300.2008.00252.x","article-title":"The contribution of\u00a0loneliness and\u00a0posttraumatic stress disorder to marital adjustment following war captivity: a longitudinal study","volume":"47","author":"Solomon","year":"2008","journal-title":"Fam Process"},{"issue":"4","key":"2024022722291170800_R37","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1176\/ajp.2006.163.4.659","article-title":"Trajectories of\u00a0PTSD: a 20-year longitudinal study","volume":"163","author":"Solomon","year":"2006","journal-title":"Am J Psychiatry"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/189\/3-4\/e781\/56773729\/usad368.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/189\/3-4\/e781\/56773729\/usad368.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,27]],"date-time":"2024-10-27T22:24:00Z","timestamp":1730067840000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/189\/3-4\/e781\/7276446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,3]]},"references-count":37,"journal-issue":{"issue":"3-4","published-online":{"date-parts":[[2023,10,3]]},"published-print":{"date-parts":[[2024,2,27]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usad368","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,3,1]]},"published":{"date-parts":[[2023,10,3]]}}}