Category: PTSD

Symposium

Moral Injury, PTSD, and Suicidal Behavior Among National Guard Personnel

Saturday, November 18
12:00 PM - 1:30 PM
Location: Sapphire Ballroom A, Level 4, Sapphire Level

Keywords: PTSD Posttraumatic Stress Disorder | Suicide | Cognitive Vulnerability
Presentation Type: Symposium

The concept of moral injury has been proposed to be distinct from traditional models of trauma and PTSD that are based in large part on fear and anxiety models. Proposed symptoms of moral injury, especially guilt and shame, have been found to be associated with increased risk of suicidal thoughts and behaviors among trauma survivors, and may account for elevated suicide risk among military personnel with PTSD. To date, however, the proposed differences (and similarities) between moral injury and PTSD have yet to be empirically investigated. In light of this knowledge gap, the present study was aimed at examining the similarities and differences in the signs and symptoms of PTSD and moral injury, and to determine if the combination of these two constructs is associated with increased risk for suicidal thoughts and behaviors in a sample of 930 National Guard personnel from the states of Utah and Idaho. Participants completed an anonymous online survey that included the PTSD Checklist for DSM-5, the Differential Emotions Scale-IV, the Patient Health Questionnaire-9, the self-report version of the Self-Injurious Thoughts and Behaviors Interview, the Nightmare Disorder Checklist, and the Interpersonal Support Evaluation List. Items were selected from these scales to capture the proposed symptom manifestations of both PTSD and moral injury, as well as their overlap. Exploratory structural equation modeling (ESEM) was used to test a measurement model of PTSD and moral injury. Results confirmed that PTSD and moral injury were distinct constructs characterized by unique symptoms, although depressed mood loaded onto both PTSD and moral injury. A structural model was next constructed and indicated that the interaction of PTSD and moral injury was associated with significantly increased risk for suicide ideation and attempts. Results suggest that PTSD and moral injury are separate constructs with unique signs and symptoms. The combination of PTSD and moral injury confers increased risk for suicidal thoughts and behaviors, and differentiates between military personnel who have attempted suicide and those who have only thought about suicide.

Craig Bryan

Executive Director & Associate Professor
National Center for Veterans Studies at The University of Utah

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Moral Injury, PTSD, and Suicidal Behavior Among National Guard Personnel



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