Depression, PTSD, and suicidal ideation among ex-ultra-Orthodox individuals in Israel

Introduction: Disaffiliating from an ultra-Orthodox society is complex and challenging. The process includes dealing with culture shock, traumatic experiences, education gaps, and disconnection from familiar surroundings. Thus, ex-ultra-Orthodox individuals (ex-ULTOIs) may face loneliness, lack of belongingness, and loss of meaning, which may relate to high psychological distress such as depression and suicide ideation. In the present study, we sought to shed light on the distress of ex-ULTOIs in Israel and to understand the disaffiliation-related characteristics that may relate to their distress levels.Method: The sample comprised 755 participants, aged 19-54, who left their ultra-Orthodox Jewish lifestyle and communities. Participants completed self-report questionnaires tapping depression, anxiety, posttraumatic stress disorder (PTSD) symptoms, suicide ideation and behaviour, as well as demographics and disaffiliation-related characteristics.Results: Nearly half of the sample (N = 332, 45.9%) reported symptom intensity meeting the current criteria for major depressive disorder. Moreover, 46.7% reported symptoms meeting PTSD criteria, and 34.5% reported having suicidal ideations in the past year. Hierarchical regression analyses revealed that the intensity of past negative life events, the nature of motives for disaffiliation, and the longer duration of the disaffiliation process contributed to the severity of distress.Conclusions: The study's findings reveal that ex-ULTOIs suffer from high mental pain levels, particularly depression, PTSD, and suicidal risk. Importantly, experiencing disaffiliation as traumatic and longer durations of the process may facilitate greater mental pain and distress symptoms. These findings emphasize that ex-ULTOIs must be continually assessed, especially when their disaffiliation processes are experienced as traumatic.