War‐related traumas can lead to emotional, relational, and spiritual suffering. Drawing on two community samples of war zone veterans from diverse military eras (Study 1, N = 616 and Study 2, N = 300), the purpose of this study was to examine patterns of constellations between outcomes related to moral injury (MI) and common ways in which veterans may struggle with religion or spirituality, defined as divine, morality, meaning, interpersonal, and doubt. Results from latent profile analyses revealed three distinct classes across the samples, based on psychometrically validated instruments: (a) no MI‐related outcomes or spiritual struggles (nondistressed group; Study 1 = 72.7%, Study 2 = 75.0%); (b) MI‐related outcomes and equivalent or lower degrees of spiritual struggles relative to MI‐related outcomes (psychological MI group; Study 1 = 19.2%, Study 2 = 17.0%); and (c) MI‐related outcomes and salient struggles with religious faith or spirituality, both within their own profiles and compared to other groups (spiritual MI group; 8.1% and 8.0% in the two samples). When we compared severity of spiritual struggles within MI groups, turmoil with God or a higher power emerged as a defining feature of the spiritual MI group in both samples. In addition, secondary analyses revealed membership in this third group was linked with greater importance of religion or spirituality before military service, χ2(1, N = 616 and 300) = 4.468–8.273. Overall, although more research is needed, these findings highlight the possible utility of differentiating between psychological and spiritual subtypes of MI according to war zone veterans’ religious or spiritual backgrounds.

Objective This practice‐based evidence study examined trajectories of God representations and psychological distress among Christians participating in spiritually integrated psychotherapies (SIPs). Methods In total, 17 clinicians practicing SIPs in a mid‐sized city on the US Gulf Coast implemented session‐to‐session assessments of these outcomes with 158 clients over a 4‐month period and also reported their use of specific spiritual interventions after each session (e.g., affirmed client's divine worth). Results Multivariate growth modeling revealed clients' psychological distress decreased over the study period whereas authoritarian God representations increased and benevolent God representations remained stable. In addition, clients who increased in benevolent representations of God had a greater likelihood of experiencing alleviation of psychological distress. Conclusion These findings affirm the potential efficacy of SIPs and cultural importance of belief in a benevolent deity as a source of strength, identity, and potential healing among Christians clients who prefer a spiritually integrated approach in psychotherapy.

Military personnel may encounter morally injurious events that lead to emotional, social, and spiritual suffering that transcend and/or overlap with mental health diagnoses (e.g., post-traumatic stress disorder [PTSD]). Advancement of scientific research and potential clinical innovation for moral injury (MI) requires a diversity of measurement approaches. Drawing on results from the bifactor model in Currier et al.'s (2017) psychometric evaluation of the Expressions of Moral Injury Scale-Military version (EMIS-M), this study validated a four-item short form of the instrument with two samples of veterans with a history of war-zone service. Namely, despite the reduced number of items, the EMIS-M-Short Form (SF) yielded favourable internal consistency and comparable levels of convergent validity with theoretically related constructs (e.g., PTSD and struggles with morality and ultimate meaning) as the full-length version. Notwithstanding the possible utility of distinguishing betweenself-and other-directed forms of MI, factor analytic results further revealed that the EMIS-M-SF was best conceptualized with a unidimensional factorial model that might allow for a general assessment of MI-related outcomes. Overall, these initial results suggest that the EMIS-M-SF may hold promise as a short, reliable, and valid assessment of overall outcomes related to a possible MI.

Suicide is a leading cause of death among Service Members and Veterans (SM/Vs) who suffer from posttraumatic stress disorder (PTSD). Recent research has found significant associations between the interpersonal theory of suicide (ITS) and PTSD symptomatology. Furthermore, findings suggest positive and negative forms of religious coping can varyingly contribute to risk for both PTSD and suicidal behavior. However, models of suicidal ideation to action (e.g., ITS), to our knowledge, have not accounted for the role of religious coping. As such, this study examined the possible influence of both positive and negative religious coping on pathways between PTSD and suicidal desire (i.e., thwarted belongingness [TB] and perceived burdensomeness [PB]) in a community sample of 201 SM/Vs. Analyses revealed positive religious coping may be a significant protective factor for TB, but not PB, even in presence of high PTSD symptomatology. Additionally, negative religious coping appeared to exacerbate the impact of PTSD symptomatology on PB. These findings highlight the potential benefit in assessing for religiousness and/or spirituality (R/S) factors when conceptualizing risk for suicide.

Abstract:The Commitment-Reflectivity Circumplex (CRC) model is a structural model of religious orientation that was designed to help organize and clarify measurement of foundational aspect of religiousness. The current study successfully replicated the CRC model using multidimensional scaling, and further evaluated the reliability, structure, and validity of their measures in both a university student sample (Study 1) and a nationally representative sample (Study 2). All 10 subscales of the Circumplex Religious Orientation Inventory (CROI) demonstrated good reliability across both samples. A two-week test-retest of the CROI showed that the subscales are stable over time. A confirmatory factor analysis of the CROI in the representative adult sample demonstrated good model fit. Finally, the CROI's validity was examined in relation to the Intrinsic, Extrinsic and Quest measures. Overall, the CROI appears to clarify much of the ambiguity inherent in the established scales by breaking down what were very broad orientations into very specific suborientations. The results suggest that the CRC model is applicable for diverse populations of adults. In addition, the CROI appears to be construct valid with good structural and psychometric properties across all 10 subscales.