Moral injury, posttraumatic stress disorder, and religious involvement among U.S. veterans

Nagy A. Youssef, Elizabeth Boswell, Shashana Fiedler, Rebecca Jump, Elizabeth Lee, Mark Yassa, Fazal Khan, Ananda Pathiraja, David Rizk, Michelle Pearce, Keisha O'Garo, Joseph M. Currier, Harold G. Koenig

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Traumatic experiences can cause ethical conflicts. "Moral injury" (MI) has been used to describe this emotional/cognitive state, and could contribute to the development of posttraumatic stress disorder (PTSD) or block its recovery. We examine the relationship between MI and PTSD, and the impact of religious involvement (RI) on that relationship. METHODS: We conducted a study of 120 veterans enrolled at the Charlie Norwood VA Medical Center in Augusta, Georgia. Standard measures of PTSD symptoms, MI, and RI were administered. Regression models were used to examine correlates of PTSD symptoms and the moderating or mediating effects of RI. RESULTS: A strong relationship was found between MI and PTSD symptoms (r = 0.54, P ≤ .0001), and between MI and RI (r = -.41, P ≤ .0001), but only a weak relationship was found between RI and PTSD symptoms (r = -.17, P = .058). RI did not mediate or moderate the relationship between MI and PTSD symptoms in the overall sample. However, among non-Middle Eastern war theater veterans, a significant buffering effect of religiosity was found. CONCLUSIONS: MI has a strong positive relationship with PTSD symptoms and an inverse relationship with RI. RI did not mediate or moderate the relationship between MI and PTSD in the overall sample, but it moderated this relationship in non-Middle Eastern war theater veterans.

Original languageEnglish (US)
Pages (from-to)113-121
Number of pages9
JournalAnnals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
Volume30
Issue number2
StatePublished - May 1 2018

    Fingerprint

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Youssef, N. A., Boswell, E., Fiedler, S., Jump, R., Lee, E., Yassa, M., Khan, F., Pathiraja, A., Rizk, D., Pearce, M., O'Garo, K., Currier, J. M., & Koenig, H. G. (2018). Moral injury, posttraumatic stress disorder, and religious involvement among U.S. veterans. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists, 30(2), 113-121.