Morally injurious events and psychological distress among veterans: Examining the mediating role of religious and spiritual struggles

Wyatt R. Evans, Melinda A. Stanley, Terri L. Barrera, Julie J. Exline, Kenneth I. Pargament, Ellen J. Teng

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Objective: Potentially morally injurious events (PMIEs)-violations (perpetrated or witnessed) of one's deeply held beliefs or values-have been associated with several forms of psychological distress. The values violated by PMIEs are often influenced by one's religion/spirituality (r/s). Struggles with one's r/s beliefs and/or practices may also contribute to elevated psychological distress. To further develop a framework for understanding and treating the sequelae of PMIE exposure, we examined the role of r/s struggles in the relation between PMIE exposure and psychological distress. Method: A diverse sample of 155 veterans at a large Veterans Affairs medical center completed questionnaires assessing PMIE exposure, r/s struggles, and psychological distress. Results: Findings revealed greater PMIE exposure predicted elevated r/s struggles as well as elevated symptoms of anxiety and posttraumatic stress disorder (PTSD). Likewise, greater r/s struggles predicted elevated anxiety, PTSD, and depression symptoms. Regression analyses revealed r/s struggles fully mediated the relation between PMIE exposure and anxiety as well as PTSD, and a significant indirect effect of PMIE exposure on depression symptoms through r/s struggles was observed. Follow-up analyses revealed that no specific domain of r/s struggles accounted for the relation between PMIE exposure and psychological distress; rather, the overarching construct of r/s struggles accounted for this relation. Conclusion: These findings advance the evolving theoretical framework of moral injury, elucidating the salience of r/s struggles in the development of distress. Implications for moral injury intervention call for attention to potential dissonance between actions (witnessed or perpetrated) and r/s underpinnings of the individual's moral framework.

Original languageEnglish (US)
Pages (from-to)360-367
Number of pages8
JournalPsychological Trauma: Theory, Research, Practice, and Policy
Volume10
Issue number3
DOIs
StatePublished - May 2018
Externally publishedYes

Keywords

  • Morally injurious events
  • Psychological distress
  • Religious/spiritual struggles
  • Veterans

ASJC Scopus subject areas

  • Social Psychology
  • Clinical Psychology

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