Prevalence of Potentially Morally Injurious Events in Operationally Deployed Canadian Armed Forces Members

Hansen, Kevin T.; Nelson, Charles; Kirkwood, Ken

doi:10.1002/jts.22710

Cited by 10 publications

(11 citation statements)

References 25 publications

(42 reference statements)

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“…This would also support Hansen's (2021) finding that younger soldiers were more susceptible to moral injury as lower ranks are generally younger. From previous studies findings, I would expect to see a positive relationship between the length of deployment and PMIEs, further, I would also expect a negative relationship between PMIEs and age.…”

Section: Moral Injurysupporting

confidence: 67%

“…However, due to the differing findings it remains unclear what type of relationship will be found between rank and PMIE. Additionally, females were significantly less likely to encounter a PMIE (Hansen, 2021), and therefore, have lower rates of PMIE exposure. This may be related to the small number of females within the Canadian Defence force, where this study took place, and so there would fewer opportunities for PMIE related experiences.…”

Section: Moral Injurymentioning

confidence: 97%

“…I hypothesise that PMIEs will be positively associated with longer deployments (Hansen, 2021) and younger age (Hansen, 2021). It is unclear whether PMIEs will show a positive relationship with ranks (Hansen, 2021) or a negative relationship (Held, et al, 2019).…”

Section: Risk Factorsmentioning

confidence: 97%

“…In the past, greater risk of PMIEs have been found among being of a younger age, a reservist (parttime soldier), of a senior non-commissioned rank (SGT-CWO; see Appendix A for rank acronyms) and being on deployment for longer than 121 days (Hansen, 2021). These associations are likely made to the increased likelihood that individuals within these demographics have of witnessing an event that can be characterised a PMIE.…”

Section: Moral Injurymentioning

confidence: 99%

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Experiences of Potentially Morally Injurious Events among New Zealand Defence Force Personnel

Henderson¹

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Help-seeking for mental health concerns, and the barriers that individuals encounter that prevent them from help-seeking, are particularly important to address within the military. Among other reasons, untreated mental health concerns have been associated with increased homelessness, alcohol abuse, and relationship breakdowns (Dandeker, et al., 2003; As cited in Walker, 2010). Within the New Zealand Defence Force (NZDF) context, barriers to help-seeking have been associated with experiencing greater psychological distress (Hom, et al., 2020). One specific form of distress that has the potential to impact the overall well-being of NZDF personnel is moral injury - the harm that occurs to individuals when an event occurs that conflicts with that individual’s personal beliefs or morals (MacDonald, et al., 2018). The purpose of this research is to identify the impact of moral injury on NZDF personnel, and specifically how it impacts help-seeking behaviours. The role of guilt and shame was examined as the driving force behind this relationship. A survey of 4092 NZDF personnel was examined, 1947 of whom had been deployed. Of the deployed individuals, 23.6% had reported exposure to a potentially morally injurious event (PMIE), and 18.2% had experienced guilt or shame over an event whilst on deployment. Counter to expectations, there was no significant relationship found between PMIEs and future help-seeking intentions, nor did guilt mediate the relationship between PMIEs and help-seeking. However, concerns regarding the impact that help-seeking would have on one’s career (professional concerns) functioned as a suppressor variable and, once included, accounted for 36.2% of the relationship between PMIEs and help-seeking. Further, emotions of guilt and shame were found to account for 49.2% of the variance in PMIEs and the barrier of professional concerns. These findings suggest that the role that guilt and shame have on the relationship between PMIEs and help-seeking occurs indirectly, through the relationship between PMIEs and career concerns. The role of guilt and shame was complex, and included associations with help-seeking - for individuals who held professional concerns, help-seeking decreased. However, for individuals who held less professional concerns, help-seeking increased. Guilt and shame also protected against the relationship between PMIEs with distress and mental health concerns in a moderation, and enhanced relationship warmth for individuals who had experienced a PMIE. This suggests that experiencing guilt and shame whilst on deployment may also have positive implications on an individual’s overall well-being, as opposed to a purely negative impact. The protective aspect of guilt and shame should be further explored within soldiers' pre-deployment training, so they are better prepared for the possibility of experiencing these adverse emotions, and to explain how both guilt and shame can serve a beneficial purpose.

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Section: Moral Injurysupporting

confidence: 67%

Section: Moral Injurymentioning

confidence: 97%

Section: Risk Factorsmentioning

confidence: 97%

Section: Moral Injurymentioning

confidence: 99%

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Experiences of Potentially Morally Injurious Events among New Zealand Defence Force Personnel

Henderson¹

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“…This complicates research into the prevalence of both PMIEs and MI. The prevalence of PMIE exposure has been studied predominantly in military populations in the United States (8)(9)(10) and Canada (11,12), with prevalence rates ranging from 4.8% for perpetration (9) to 65% for exposure to any PMIE (11). Research into the prevalence of MI has mostly been conducted using different versions of the Moral Injury Symptoms Scale-Military Version (MISS-M) (13).…”

Section: Introductionmentioning

confidence: 99%

Moral Injury in Trauma-Exposed, Treatment-Seeking Police Officers and Military Veterans: Latent Class Analysis

Mensink¹,

Schagen²,

Aa³

et al. 2022

Front. Psychiatry

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Exposure to morally injurious events may have a severe, prolonged negative impact on psychosocial functioning, known as moral injury (MI). Research into the prevalence of MI has mostly focused on event exposure rather than on psychosocial impact. Also, the relationship between MI and post-traumatic stress disorder (PTSD) remains a matter of interest. The aim of this study was to identify MI and PTSD symptom profiles among trauma-exposed, treatment-seeking police officers and military veterans, and to explore demographic and clinical differences between symptom profiles. Latent class and multinomial regression analyses were conducted in a sample of 1,703 participants, using the Clinician-Administered PTSD Scale for DSM-5 and the Brief Symptom Inventory. Four classes of participants were identified, labeled as a MI class (n = 192; 11.27%), a MI-PTSD class (n = 565; 33.18%), a PTSD class (n = 644; 37.82%), and a Neither MI-nor PTSD class (n = 302; 17.73%), resulting in 44.45% (n = 757) of participants who met an MI symptom profile with or without PTSD. There were significant differences between the classes in terms of gender as well as PTSD and comorbid psychopathology symptom severity, the latter of which was highest in the MI-PTSD class. In conclusion, a substantial subgroup of trauma-exposed, treatment-seeking police officers and military veterans could be classified as suffering from MI. Routinely screening for MI in treatment-seeking police officers and military veterans is recommended, and interventions aimed at relieving MI in these populations may be indicated.

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The contribution of exposure to potentially morally injurious events to trajectories of posttraumatic stress symptoms among discharged veterans – a five-year study

Levinstein,

Zerach,

Levi-Belz

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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Prevalence of Potentially Morally Injurious Events in Operationally Deployed Canadian Armed Forces Members

Cited by 10 publications

References 25 publications

Experiences of Potentially Morally Injurious Events among New Zealand Defence Force Personnel

Experiences of Potentially Morally Injurious Events among New Zealand Defence Force Personnel

Moral Injury in Trauma-Exposed, Treatment-Seeking Police Officers and Military Veterans: Latent Class Analysis

The contribution of exposure to potentially morally injurious events to trajectories of posttraumatic stress symptoms among discharged veterans – a five-year study

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