Anxiety-buffer disruption in combat soldiers: the contributions of exposure to combat-related threats, attachment anxiety, and ideological threat to mental health and addiction

Background: We applied the existential-social psychological perspective of anxiety buffer disruption theory to explain the emergence of psychopathological reactions–post-traumatic stress (PTS) symptoms, depression, anxiety, and substance and behavioral addictions–following exposure to combat-related threats. Method: Israeli reserve soldiers in the Swords of Iron war (N = 357) completed measures of exposure to combat-related threats during the war, attachment anxiety, political voting, mental health (PTS, anxiety, depression) and problematic substance use and behavioral addictions. Results: In support of our hypotheses, exposure to combat-related threats was associated with increased severity of PTS symptoms, depression, and problematic alcohol consumption, especially among soldiers with high levels of attachment anxiety and those who voted for left/center-wing political opposition parties (for whom the war might be experienced as a threat to their political views). Among left/center-wing political opposition voters, there were also indirect effects of exposure to combat-related threats, attachment anxiety, and political voting on depression, anxiety, and substance and behavioral addictions via PTS severity. Conclusions: Findings highlight the transdiagnosis quality of anxiety buffer disruption theory, specifically of attachment anxiety and political-worldview threat, as predictors of both mental health problems and substance and behavioral addictions.