{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:37:14Z","timestamp":1789605434592,"version":"build-2803163510"},"reference-count":54,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Israel Defense Forces (IDF) Medical Corps and Directorate of Defense Research & Development, Israeli Ministry of Defense","award":["1994\/19"],"award-info":[{"award-number":["1994\/19"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Soc Psychiatry"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In this prospective study, we examined pre-enlistment characteristics and pre-deployment protective factors of exposure to potentially morally injurious events (PMIEs) among Israeli active-duty combatants, as well as psychiatric symptomatology outcomes of exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A sample of 335 active-duty Israeli combatants participated in a 2.5-year prospective study with three waves of measurements (T1: 12\u2009months before enlistment, T2: 6\u2009months following enlistment- pre deployment, and T3: 18\u2009months following enlistment- post deployment). Participants\u2019 characteristics were assessed via semi-structured interviews (T1) and validated self-report measures (T2-T3) between 2019 and 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Latent Class Analysis (LCA) was used to identify three classes characterized by unique patterns of exposure to PMIEs (T2): Minimal Exposure (56.6%), Betrayal-Only (25.5%), and High Exposure (17.8%). Higher levels of pre-deployment psychological flexibility (T1) were associated with higher odds for inclusion in the high exposure class (T2). As compared to the minimal exposure class, both high exposure and betrayal-only classes were associated with higher levels of mental health symptoms and MI-related psychological outcomes (T2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This is the first prospective study of antecedents and outcomes of exposure to PMIEs among active-duty combatants. Clinicians treating combatants should be aware of the different types of exposure to PMIEs and their possible psychiatric outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00207640231152211","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T05:08:46Z","timestamp":1675400926000},"page":"1134-1144","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["A prospective investigation of protective factors for moral injury and psychiatric symptomatology among Israeli combatants: A Latent Class Analysis approach"],"prefix":"10.1177","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5409-196X","authenticated-orcid":false,"given":"Gadi","family":"Zerach","sequence":"first","affiliation":[{"name":"Department of Psychology, Ariel University, Ariel, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Ben-Yehuda","sequence":"additional","affiliation":[{"name":"Department of Health and Well-being, Medical Corps, IDF, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8865-5639","authenticated-orcid":false,"given":"Yossi","family":"Levi-Belz","sequence":"additional","affiliation":[{"name":"The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"bibr1-00207640231152211","author":"APA (American Psychiatric Association)","year":"2013","journal-title":"American Psychiatric Association"},{"key":"bibr2-00207640231152211","unstructured":"Asparouhov T., Muth\u00e9n B. 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