The Relationship Between the Level of Emotional Distress and the Sense of Self-Efficacy and Social Support Among Reservists After Their Participation in the Iron Sword War

Background: Military service during wartime constitutes a significant risk factor for the development of psychological distress, with particular emphasis on depressive and anxiety disorders and post-traumatic stress disorder (Hoge et al., 2004). Studies indicate high rates of these disorders among combat-exposed soldiers compared to the general population. These rates stem mainly from exposure to life-threatening traumatic events, such as violent combat and the loss of comrades-in-arms (Ramchand et al., 2010; Tanielian & Jaycox, 2008). In recent years, there has been growing recognition that alongside the risk of negative consequences resulting from exposure to trauma, resilience resources exist that can protect against these adverse effects. The current study is grounded in Conservation of Resources theory (Hobfoll, 1989), which offers a theoretical framework for analyzing coping with stress, focusing on personal and social resources as associated with lower levels of psychological distress (Hobfoll & Ford, 2010). The theory describes four categories of resources: material resources, condition resources, personal resources, and energy resources (Hobfoll, 2012).

Method: The study is a quantitative study, whose data were collected as part of a clinical intervention with reservists during the Iron Swords War, in collaboration with the IDF Clinical Branch and following approval by the Military Helsinki Committee. The study examined the relationship between the level of psychological distress- the level of post-traumatic symptoms, anxiety symptoms, and depressive symptoms- and resilience resources such as social support and sense of self-efficacy, at two time points: shortly after the completion of reserve duty (T1) and approximately three months later (T2). In addition, the relationship between cumulative trauma- exposure to traumatic events that occurred prior to combat - and distress symptoms was examined, as well as the relationship between the combatant's role during combat and the level of psychological distress. The sample at the first time point included 371 reservists (all male, ages 21–46), of whom 68 also responded to the repeated measurement. The research instruments included the PCL-5 questionnaire for post-traumatic symptoms, the GAD-7 for anxiety symptoms, and the PHQ-8 for depressive symptoms, an abbreviated version of the General Self-Efficacy Scale (GSES), and an abbreviated version of the Multidimensional Scale of Perceived Social Support (MSPSS). To examine Hypotheses 1–8, three multiple linear regression analyses were conducted, and to examine Hypotheses 9–10, repeated-measures moderation analyses were conducted using the Memore macro.

Results: The study findings indicated that personal and social resilience resources are associated with lower levels of psychological distress among reservists. Social support was found to be the most significant and consistent resilience resource,  and was associated with lower levels of post-traumatic symptoms, anxiety symptoms, and depressive symptoms. Sense of self-efficacy was also found to be significantly associated with lower levels of psychological distress. In contrast, the loss of a close friend in the events of October 7, prior to combat, was identified as a consistent and significant risk factor for higher levels of psychological distress across all three distress measures. In addition, combat as an attached force was associated with higher levels of post-traumatic symptoms, but not with anxiety or depressive symptoms. In the longitudinal analyses, no significant moderation effects of social support or sense of self-efficacy on the change in distress measures over time were found.

Conclusions and Significance of the Study: The study findings reinforce Conservation of Resources theory and highlight the centrality of social support as the most significant resilience resource among reservists. The findings point to the need to develop programs for strengthening reservists' social support networks, both during and after service, with the involvement of family and the civilian community. The findings also highlight the importance of targeted screening and follow-up of combatants who experienced personal loss prior to combat, and the need for dedicated interventions for combatants serving as an attached force. Early identification of at-risk combatants, combined with the strengthening of resilience resources, may reduce the risk of developing chronic psychological illness among a population bearing a heavy security burden.

The study carried clinical and theoretical significance. At the clinical level, the questionnaires were distributed to all reservists in the unit with the intention of identifying signs of distress at an early stage and offering professional interventions, in accordance with the importance of early identification documented in the literature (Rothbaum et al., 2012). At the theoretical level, the study narrowed existing knowledge gaps: it focused on the population of reservist soldiers and conducted repeated measurement to examine the change in distress over time; it addressed the cumulative trauma unique to the Iron Swords War, which began with a sequence of personal traumatic events prior to combat and continued even after the reservists' discharge; and it broadened the treatment of psychological distress beyond post-traumatic symptoms, integrating anxiety and depressive symptoms as well. The study findings contribute to a deeper understanding of the consequences of exposure to combat and to the development of future intervention directions tailored to the population of reservists.