Objective: War-related stressors, such as economic loss, traumatic loss, and forced displacement, are well-documented risk factors for psychopathology. The mechanisms connecting war-related stressors to psychiatric symptoms remain unclear, particularly among civilians in conflict zones. Betrayal-related moral injury-feeling abandoned or let down by trusted leaders or institutions-can erode a sense of safety and justice and intensify distress. The present study examined whether such appraisals represent a psychological pathway linking war-related stressors to depression, posttraumatic stress disorder (PTSD), and anxiety.
Method: Civilians (N = 681, Mage = 31.3 years, SD = 5.6) exposed to conflict zones in southern and northern Israel following the October 7, 2023, events were recruited using an online platform. We conducted a longitudinal study with assessments in February, March, and May 2024 (Days 1, 30, and 90, respectively), evaluating participants' exposure to war-related stressors, betrayal-related moral injury (measured using the Moral Injury Events Scale), and depression, PTSD, and anxiety symptoms. We hypothesized that betrayal would mediate the relationships between war-related stressors and all symptom types.
Results: Economic loss directly influenced all three outcomes, whereas traumatic loss directly affected only PTSD. Betrayal mediated the associations between both economic and traumatic loss and psychopathology outcomes-depression, PTSD, and anxiety-but did not mediate the associations between displacement and these outcomes.
Conclusions: The findings underscore the role that a sense of betrayal may play in the relationships between economic and traumatic loss and mental health outcomes. Targeted interventions addressing betrayal may help mitigate these symptoms in civilians exposed to trauma. (PsycInfo Database Record (c) 2026 APA, all rights reserved).