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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

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Who needs what? Cluster-based profiles of treatment seekers after October 7

WHO NEEDS WHAT? CLUSTER-DERIVED PROFILES OF POST OCTOBER 7 TREATMENT-SEEKERS

Four distinct clinical profiles emerged among treatment seekers, and moral injury stood out as a separate clinical dimension independent of symptom severity.

The aim was to identify distinct subgroups based on symptoms, resilience, and functioning among trauma survivors seeking help in a context of ongoing traumatic stress, and to inform personalized intervention planning by describing each subgroup’s demographic and trauma history profile. Of the 3,913 individuals in the NATAL clinical intake database, 2,260 with one or more missing measures were excluded, and 1,653 (42%) with complete data across seven dimensions were included in the analysis; assessments comprised initial intake data collected during the year following the October 7, 2023 attacks and the subsequent war, through the end of 2024. K-means cluster analysis was applied to seven standardized (z-scored) dimensions (k = 4): PTSD (PCL-5, 0–80), depression (PHQ-8, 0–24), anxiety (GAD-7, 0–21), exposure to potentially morally injurious events (PMIE, 0–40), moral injury outcomes (MIOS, 0–56), resilience (0–40), and functional impairment (0%–100%). One-way ANOVA showed significant differences across all dimensions (all p < 0.001; F values were 915 for PHQ-8, 843 for PCL-5, 780 for GAD-7, 705 for MIOS, 690 for PMIE, 610 for resilience, and 520 for functional impairment). Four profiles were identified: Resilient Majority (n = 490, 28%; mean PCL-5 19, PHQ-8 6, GAD-7 5, highest resilience at 27, functional impairment 46%), High-Symptom and Complex Profile (n = 339, 20%; PCL-5 56, PHQ-8 19, GAD-7 17, PMIE 33, MIOS 31, lowest resilience at 20, functional impairment 68%), Moderate General Distress (n = 448, 26%; PCL-5 42, PHQ-8 15, GAD-7 14, PMIE 16, MIOS 18, functional impairment 57%), and the Moral Injury profile, termed the “hidden wound” (n = 453, 26%; PCL-5 34, PHQ-8 9, but the second-highest PMIE and MIOS scores at 27 and 20, respectively, resilience 26). Regarding trauma history, childhood abuse or neglect and sexual trauma were reported most frequently in the High-Symptom cluster (11% and 21%); while this cluster had a more balanced gender distribution (59% male), the Moral Injury cluster consisted of 72% male veterans and had the highest rate of exposure to conflict or war across all clusters (55%). The profiles differed not only in symptom severity but also in symptom patterns and moral injury; persistent moral injury despite high resilience disrupted the expected inverse relationship between symptoms and resilience and pointed to feelings of guilt and betrayal not captured by standard PTSD screening. In conclusion, incorporating moral injury into routine assessment and allocating treatment according to profiles are recommended; the cross-sectional design, complete data being available for only 42% of individuals, exclusive reliance on self-report, and the specificity of the findings to the Israeli context in 2023–2024 are the main limitations.

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