Psychiatry Res. 2026 Jan 18;358:116959. doi: 10.1016/j.psychres.2026.116959. Online ahead of print.
ABSTRACT
BACKGROUND: The October 7th, 2023, terrorist attacks and subsequent war in Israel constituted an unprecedented assault on the civilian population, resulting in widespread trauma, a collapse of physical and psychological safety, and civilians’ perceptions that the government’s actions did not prioritize their safety and interests. This study investigates how the disruption of world assumptions, experiences of institutional betrayal, and childhood maltreatment (CM) contributed to multilevel stress outcomes, affecting Israeli civilians’ perceptions of their mind, body, and relationships.
METHODS: A community sample of 690 Israeli adults completed questionnaires assessing war exposure, CM, institutional betrayal, world assumptions, acute stress disorder (ASD), disturbances in self-organization (DSO), and somatization. A moderated mediation model was tested to examine whether CM and institutional betrayal moderated the relationship between war exposure and the distress outcomes, via world assumptions.
RESULTS: War exposure was indirectly associated with ASD, DSO, and somatization through shattered world assumptions. This relationship was significantly moderated by institutional betrayal (B = -.075, p = .002); higher levels of institutional betrayal amplified the impact of war exposure on world assumptions. The indirect effects of war exposure on ASD, DSO, and somatization via world assumptions were moderated by institutional betrayal (ps < 0.05), but not CM (ps > 0.05).
CONCLUSION: Institutional betrayal plays a significant role in shaping trauma responses to war exposure and societal crises by eroding trust and contributing to multidimensional distress. Interventions should address institutional betrayal to promote healing and restore societal trust.
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