Examining the associations among moral injury, difficulties with emotion regulation, and symptoms of PTSD, depression, anxiety, and stress among Canadian military members and Veterans: A preliminary study

ABSTRACT

Introduction: Moral injury (MI) refers to the psychological distress associated with perceived betrayals or perceived transgressions of one's moral values. It has been studied primarily among military personnel and Veterans and has been found to be associated with posttraumatic stress disorder (PTSD), depression, anxiety, and other psychiatric symptoms. Recently, research has begun to investigate MI and its potential risk factors. Difficulties with emotion regulation (ER), which refers to difficulties with managing and moderating emotions, is a transdiagnostic factor associated with several psychiatric conditions, including PTSD, depression, and anxiety. The objective of the current study was to investigate the relations among MI;symptoms of PTSD, depression, anxiety, and stress;and difficulties with ER in a sample of Canadian military personnel and Veterans. A secondary aim was to discuss the potential relevance of these relations for military personnel, Veterans, and front-line health care workers during the COVID-19 pandemic. Methods: Assessments of MI, PTSD, depression, anxiety, stress, and difficulties with ER were administered to Canadian military personnel and Veterans. Correlational analyses were used to assess the relation of MI to these symptoms. Results: Increased levels of MI were associated with avoidance and alterations in mood and cognition symptom clusters of PTSD. Perceived betrayals were also significantly correlated with PTSD-related alterations in mood and cognition symptoms. Symptoms of PTSD were significantly associated with depression, anxiety, and stress. Difficulties with ER were significantly correlated with symptoms of PTSD, depression, anxiety, and stress, but not with MI (p = 0.07). Discussion: These results reveal an association between MI and specific symptom clusters of PTSD, and they highlight the association between difficulties with ER and symptoms of psychiatric illness among Canadian military personnel and Veterans. The potential implications of these findings and future work examining MI in military personnel, Veterans, and front-line health care workers during the COVID-19 pandemic are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) Introduction: Le prejudice moral (PM) designe la detresse psychologique decoulant des perceptions de trahison et de transgression de ses propres valeurs morales. Il a surtout ete etudie chez les membres du personnel militaire et les veterans, et il a ete etabli qu'il est associe au trouble de stress post-traumatique (TSPT), a la depression, a l'anxiete et a d'autres symptomes psychiatriques. Recemment, les recherches ont commence a porter sur les facteurs de risque potentiels du PM. Les troubles de regulation affective (RA), qui designent les difficultes a gerer et a moderer ses emotions, sont des facteurs transdiagnostiques lies a divers troubles psychiatriques, y compris le TSPT, la depression et l'anxiete. La presente etude vise a examiner les relations entre le PM, les symptomes de TSPT, la depression, l'anxiete, le stress et les troubles de RA aupres d'un echantillon de membres du personnel militaire et de veterans canadiens. Un objectif secondaire consistait a examiner la pertinence potentielle de ces relations pour le personnel militaire, les veterans et les travailleurs de la sante de premiere ligne pendant la pandemie de COVID-19. Methodologie Les chercheurs ont evalue le PM, le TSPT, la depression, l'anxiete, le stress et les troubles de RA du personnel militaire et des veterans. Ils ont utilise des analyses de correlation pour evaluer le lien entre le PM et ces symptomes. Resultats Un taux eleve de PM etait relie de maniere significative aux grappes d'evitement, de perturbations de l'humeur et de symptomes cognitifs relatifs aux TSPT. La perception de trahison etait egalement associee de maniere significative aux perturbations de l'humeur et aux symptomes cognitifs lies aux TSPT. Les symptomes de TSPT avaient un lien significatif avec la depression, l'anxiete et le stress. Les troubles de RA etaient correles de maniere significative avec les symptomes de TSPT, la depression, l'anxiete et le stress, mais pas avec le PM (p = 0,07). Discussion: Ces resultats revelent une association entre le PM et des grappes precises de symptomes de TSPT et font ressortir le lien entre les troubles de RA et les symptomes de maladie psychiatrique chez les membres du personnel militaire et les veterans canadiens. Les repercussions potentielles de ces constatations et les futurs travaux sur le PM chez les membres du personnel militaire, les veterans et les travailleurs de premiere ligne pendant la pandemie de COVID-19 sont abordes. (PsycInfo Database Record (c) 2022 APA, all rights reserved)