Moral injury process and its psychological consequences among Israeli combat veterans

Gadi Zerach, Yossi Levi-Belz

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Objectives: We aim to examine the link between exposure to potentially morally injurious events (PMIEs) and posttraumatic stress disorder symptoms (PTSS). We also aim to explore the mediating roles of depressive attributions, trauma-related guilt and shame, and self-disgust in the relationship between PMIEs and PTSS among combat veterans. Method: A volunteers' sample of 191 Israeli combat veterans responded to self-report questionnaires in a cross-sectional design study. Results: More than one-fifth of the sample reported experiencing PMIEs but only betrayal based experience was related to PTSS. Importantly, betrayal based experience was associated with depressive attributions which increased the level of trauma-related distressing guilt, intrinsic shame and self-disgust, which in turn were associated with high levels of PTSS. Conclusions: PMIEs, and especially betrayal based experiences, are related to PTSS among Israeli veterans. Depressive attributions, trauma-related distressing guilt, intrinsic shame, and self-disgust might serve as possible mechanisms for the links between PMIEs and PTSS.

Original languageEnglish
Pages (from-to)1526-1544
Number of pages19
JournalJournal of Clinical Psychology
Volume74
Issue number9
DOIs
StatePublished - Sep 2018

Keywords

  • PTSD
  • depressive attributions
  • guilt
  • moral injury
  • self-disgust
  • shame

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