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Moral Injury and Posttraumatic Stress Symptoms as Predictors of Hostility and Suicidal Ideation in Male Combat Veterans

Durham, Tory A
http://rave.ohiolink.edu/etdc/view?acc_num=toledo1462190648

Abstract Details

2017, Doctor of Philosophy, University of Toledo, Psychology - Clinical.
The purpose of the present study was to examine the moderating effects of moral injury between posttraumatic stress symptoms (PTSS) and two externalizing constructs: potential harm to self (i.e., suicidal ideation) and to others (i.e., hostility). Moral injury is a relatively new construct that broadly encompasses feelings of guilt associated with engaging in a potentially amoral or unethical combative situation. In addition to experiencing a moral injury, military veterans are vulnerable to developing additional pathology, most notably posttraumatic stress disorder (PTSD). Other complaints reported by combat veterans are suicidal ideation and hostility. PTSD is associated with its own set of complications such as high comorbidity, difficulty with diagnosis due to comorbidity and overlapping symptoms and poor treatment outcomes and thus examining additional moderators and constructs is critical. Moral injury has demonstrated relations in the extant literature with PTSD, suicidality and hostility. These existing relations prompted the present study to examine moral injury as a potential moderator between PTSD symptom clusters (i.e., reexperiencing, avoidance, negative alterations in mood and cognitions (NAMC) and alterations in arousal and reactivity (AAR)) and hostility and suicidal ideation, independently. i The present study utilized a subsample of combat-exposed male veterans (n = 377) selected from a larger sample of veterans who participated in the National Health and Resilience in Veterans Study (NHRVS). Five moderations were analyzed such that moral injury-perceived transgressions (MIES-PT) was hypothesized to moderate the relationship between 1) reexperiencing and suicidal ideation, 2) avoidance and suicidal ideation, 3) NAMC and suicidal ideation, 4) NAMC and hostility, and 5) AAR and hostility. Results demonstrated that MIES-PT significantly contributed to the relationships between reexperiencing, avoidance and NAMC and suicidal ideation, consistent with the hypotheses. Results also demonstrated that MI-PT significantly contributed to the relationship between AAR and hostility but not NAMC and hostility. The effect sizes across all interactions were quite small however. The results contribute to the scant literature current available on moral injury. These results also suggest that hostility may be more related to the arousal symptoms of PTSD than the numbing symptoms in DSM-5, which is somewhat inconsistent with prior research.
Jon Elhai (Committee Chair)
Jason Levine (Committee Member)
Sarah Francis (Committee Member)
Amy Bixler (Committee Member)
Kamala London (Committee Member)
67 p.
Clinical Psychology; Psychology
posttraumatic stress symptoms, moral injury, hostility, suicidal ideation

Recommended Citations

Citations

  • Durham, T. A. (2017). Moral Injury and Posttraumatic Stress Symptoms as Predictors of Hostility and Suicidal Ideation in Male Combat Veterans [Doctoral dissertation, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1462190648

    APA Style (7th edition)

  • Durham, Tory. Moral Injury and Posttraumatic Stress Symptoms as Predictors of Hostility and Suicidal Ideation in Male Combat Veterans. 2017. University of Toledo, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1462190648.

    MLA Style (8th edition)

  • Durham, Tory. "Moral Injury and Posttraumatic Stress Symptoms as Predictors of Hostility and Suicidal Ideation in Male Combat Veterans." Doctoral dissertation, University of Toledo, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1462190648

    Chicago Manual of Style (17th edition)

toledo1462190648
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This open access ETD is published by University of Toledo and OhioLINK.