ABSTRACT
Moral injury is a particular response to profoundly distressing life events that manifests in damage to basic human/relational capacities, such as trust, autonomy, initiative, competence, identity, and intimacy. This paper describes and presents preliminary outcomes of "Reclaiming Experiences And Loss," or "REAL," which is an innovative moral injury group therapy that was developed collaboratively by Veterans Affairs mental health and spiritual care providers. Clinical outcome measures collected pre- and post-group indicates that REAL is effective at reducing symptoms of post-traumatic stress disorder and depression. Additionally, a cohort case example demonstrates the impact of REAL as told through individual stories as well as the intersectionality and interactions that comprise a typical REAL cohort and are considered central to care. Implications for ongoing care and future research are discussed.
Subject(s)
Psychotherapy, Group , Stress Disorders, Post-Traumatic , Veterans , Humans , Mental Health , Spirituality , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Veterans/psychologyABSTRACT
OBJECTIVES: Theoretical support for the moral injury (MI) construct is mounting, yet empirical support has lagged behind. A conceptual model has been proposed, but studies have not yet explored the constellation of symptoms within treatment-seeking Veterans. METHODS: Veterans (N = 212) seeking trauma recovery services completed measures of potential MI symptoms that functioned as indicators in person-centered Latent Profile Analysis. Differences in exposure to potentially morally injurious experiences (pMIEs) were compared across profiles using logistic regression. RESULTS: Three profiles emerged that varied by symptom severity, levels of trauma-related guilt, and levels of dispositional forgiveness. Exposure to pMIEs predicted membership in a class consistent with proposed MI symptomatology. CONCLUSIONS: Person-centered approaches are useful for identifying a distinct group of veterans whose trauma recovery may benefit from specifically targeting moral emotions, consistent with the emerging construct of MI .
Subject(s)
Combat Disorders/physiopathology , Exposure to Violence , Guilt , Morals , Psychological Trauma/physiopathology , Stress Disorders, Post-Traumatic/physiopathology , Veterans , Adult , Exposure to Violence/psychology , Humans , Male , Middle Aged , Retrospective Studies , Veterans/psychologyABSTRACT
OBJECTIVE: This study examined whether exposure to morally injurious experiences (MIEs) contribute to mental health problems among returning Veterans via meaning made of possible traumas. METHOD: A total of 131 Iraq and/or Afghanistan Veterans completed assessments of exposure to possible warzone traumas, meaning made of a salient stressor from their lives, and mental health symptomatology (e.g., posttraumatic stress, depression, suicidality). RESULTS: Structural equation modeling findings revealed that MIEs were indirectly linked with mental health outcomes via the extent to which Veterans were able to make meaning of their identified stressors. However, we also found that the direct path from MIEs to mental health problems was statistically significant. CONCLUSION: These findings provide preliminary evidence that difficulties with meaning making could serve as a mediating pathway for how MIEs increase the risk for adjustment problems after warzone service, but that other factors associated with moral injury also have a bearing on psychological functioning among Veterans.
Subject(s)
Combat Disorders/psychology , Life Change Events , Morals , Stress Disorders, Post-Traumatic/psychology , Veterans/psychology , Afghan Campaign 2001- , Depressive Disorder/psychology , Female , Humans , Iraq War, 2003-2011 , Male , Mental Health , Pacific States , Psychometrics , Students , Suicide/psychology , Surveys and Questionnaires , UniversitiesABSTRACT
Meaning made of stress has been shown to be a unique predictor of mental and physical health. In this study, we examined the unique associations between two facets of meaning made of stress (comprehensibility and footing in the world) and suicide risk and life-threatening behavior among military veterans who have transitioned to college were examined, controlling for demographic factors, religiousness, combat-related physical injury, combat exposure, depressive symptoms, and posttraumatic stress symptoms. Findings suggest that comprehensibility (having "made sense" of a stressor) is uniquely associated with lower suicide risk and a lower likelihood of driving under the influence of drugs or alcohol and engaging in self-mutilating behaviors.
