Moral Injury and Suicidal Ideation after Military Service: Mediating and Moderating Factors
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The term “moral injury” has recently been introduced to describe psychopathology resulting from perpetrating or bearing witness to an event that transgresses deeply held moral beliefs, typically in relation to military service. Two studies examined relations between potentially morally injurious events (PMIEs) during military service, self-conscious emotions, and negative mental health outcomes. The potential moderating contributions of social support and psychopathic personality traits on these relations were also assessed. A subset of 40 of the 501 veterans who completed a detailed on-line survey was also interviewed to gain a more thorough understanding of individual experiences. Veterans who had experienced higher numbers of PMIEs were significantly more likely to experience depression symptoms and suicidal ideation, as well as guilt and shame related to their military service, but high levels of social support decreased the likelihood of negative mental health outcomes and subsequent guilt and shame; psychopathic personality traits did not moderate these relations. Qualitative analysis of the interviews confirmed that social support plays a key role in the prevention of moral injury-related symptoms. Social support was crucial to reintegration after deployment for many veterans. Results indicate that adequate social support following PMIEs may reduce the likelihood of psychopathology. Implications of this study and future directions are discussed.