Moral injury in U.S. combat veterans: Results from the national health and resilience in veterans study

2017 ◽  
Vol 34 (4) ◽  
pp. 340-347 ◽  
Author(s):  
Blair E. Wisco ◽  
Brian P. Marx ◽  
Casey L. May ◽  
Brenda Martini ◽  
John H. Krystal ◽  
...  
Keyword(s):  
National Health ◽  
Combat Veterans ◽  
Moral Injury

scholarly journals Moral injury and substance use disorders among US combat veterans: results from the 2019–2020 National Health and Resilience in Veterans Study

2021 ◽  
pp. 1-7
Author(s):  
Shira Maguen ◽  
Brandon Nichter ◽  
Sonya B. Norman ◽  
Robert H. Pietrzak
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
National Health ◽  
Combat Veterans ◽  
Population Based ◽  
Moral Injury ◽  
Increased Risk ◽  
Assessment And Treatment ◽  
Multivariable Analyses ◽  
Nationally Representative

Abstract Background Exposure to potentially morally injurious events (PMIEs) is associated with increased risk for substance use disorders (SUDs), although population-based studies remain limited. The goal of this study was to better understand the relationships between PMIE exposure and lifetime and past-year alcohol use disorder (AUD), drug use disorder (DUD), and SUD. Methods Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 1321 combat veterans. Multivariable analyses examined associations between three types of PMIE exposure (perpetration, witnessing, and betrayal), and lifetime and past-year AUD, DUD, and SUD, adjusting for sociodemographic variables, combat exposure severity, prior trauma, and lifetime posttraumatic stress disorder and major depressive disorder. Results Perpetration was associated with increased odds of lifetime AUD (OR 1.15; 95% CI 1.01–1.31) and lifetime SUD (OR 1.18; 95% CI 1.03–1.35). Witnessing was associated with greater odds of past-year DUD (OR 1.20; 95% CI 1.04–1.38) and past-year SUD (OR 1.14; 95% CI 1.02–1.28). Betrayal was associated with past-year AUD (OR 1.20; 95% CI 1.03–1.39). A large proportion of the variance in past-year AUD was accounted for by betrayal (38.7%), while witnessing accounted for 25.8% of the variance in past-year DUD. Conclusions Exposure to PMIEs may be a stronger contributor to SUDs among veterans than previously known. These findings highlight the importance of targeted assessment and treatment of moral injury among veterans with SUDs, as well as attending to specific types of morally injurious experiences when conceptualizing and planning care.

scholarly journals “I knew it was wrong the moment I got the order”: A narrative thematic analysis of moral injury in combat veterans.

2019 ◽  
Vol 11 (4) ◽  
pp. 396-405 ◽  
Author(s):  
Philip Held ◽  
Brian J. Klassen ◽  
Joanne M. Hall ◽  
Tanya R. Friese ◽  
Marcel M. Bertsch-Gout ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Combat Veterans ◽  
Moral Injury ◽  
The Moment

scholarly journals To Understand and Support Contemporary Veterans Utilizing Biblical Combat Veteran Types

2018 ◽  
Vol 72 (4) ◽  
pp. 232-240 ◽  
Author(s):  
Jan Grimell
Keyword(s):  
Pastoral Care ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Combat Veterans ◽  
Stress Disorder ◽  
Real Life ◽  
Moral Injury ◽  
Post Traumatic Stress ◽  
Combat Veteran ◽  
Post Traumatic

This article continues to build on the biblical combat veteran types (BCVTs) which were recently presented as a tool to describe and understand biblical combat veterans through the lenses of post-traumatic stress disorder and moral injury. The purpose of this article is to connect the BCVTs with real-life cases so as to show the potential usefulness of the biblical types. This article further develops a model for pastoral care which integrates this tool.

War and the Soul

The Good Kill ◽  
2021 ◽  
pp. 15-39
Author(s):  
Marc LiVecche
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Combat Veterans ◽  
Stress Disorder ◽  
Clinical History ◽  
Clinical Work ◽  
Moral Injury

Chapter 1 explores in greater detail both the medical and phenomenological foundations of moral injury and its consequences upon the morally injured. It examines the clinical history that led to the recognition of the need for a diagnosis different than, though related to, posttraumatic stress disorder, and it zeroes in on moral injury’s relationship to killing in combat. It goes on to demonstrate the ubiquity of the belief, even among warfighters, that killing is morally evil—even if it is also morally necessary in war. Through again referencing clinical work, and introducing some of the key clinicians focusing on the moral injury construct, the paradoxical relationship between killing and moral injury is then linked to the suicide crisis afflicting combat veterans.

Moral Injury and Suicide Ideation Among Israeli Combat Veterans: The Contribution of Self-Forgiveness and Perceived Social Support

2020 ◽  
pp. 088626052092086
Author(s):  
Yossi Levi-Belz ◽  
Neta Dichter ◽  
Gadi Zerach
Keyword(s):  
Social Support ◽  
Combat Veterans ◽  
Suicide Ideation ◽  
Perceived Social Support ◽  
Protective Role ◽  
Moral Injury ◽  
Self Report ◽  
Cross Sectional ◽  
Self Forgiveness ◽  
Cross Sectional Design

Modern warfare within a civilian setting may expose combatants to severe moral challenges. Whereas most of these challenges are handled effectively, some potentially morally injurious events (PMIEs) may have deleterious psychological, spiritual, and interpersonal effects among them, which may increase the risk for suicide ideation and behaviors (SIB). In this study, we aimed to examine the protective role of self-forgiveness and perceived social support on the relationship between exposure to PMIEs and SIB among combat veterans. A sample of 191 Israeli combat veterans completed validated self-report questionnaires in a cross-sectional design study, tapping moral injury, SIB, perceived social support, and self-forgiveness. Veterans with a history of SIB revealed higher levels of exposure to PMIEs and lower levels of self-forgiveness and perceived social support than veterans with no SIB history. Moreover, beyond the contributions of the PMIE dimensions, significant contributions of self-forgiveness and perceived social support to current suicide ideation (SI) were found. Importantly, the moderating model indicated that higher social support moderated the link between PMIEs and current SI. Based on the current findings, it can be suggested that self-forgiveness and perceived social support are important contributors to lower SI levels among veterans with PMIEs. It can be further suggested that interpersonal support may help veterans develop a sense of belongingness and bonding, which is a plausible basis for diminishing the risk of SI following PMIE exposure.

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