Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel.
Department of Behavioral Sciences, Ruppin Academic Center, Emek-Hefer, Israel.
J Trauma Stress. 2019 Jun;32(3):424-436. doi: 10.1002/jts.22366. Epub 2019 Feb 5.
Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as significant stressful combat events that may lead to mental health problems, including self-injurious thoughts and behavior (SITB). However, few studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SITB. In the current study, we aimed to examine the association between PMIEs and SITB among combat veterans and explore the moderating roles of intolerance of uncertainty (IU) in this association. A volunteer sample of 191 Israeli combat veterans was recruited during 2017. Participants completed validated self-report questionnaires in a cross-sectional study. Results indicated that two separate measures of PMIEs, the Perceived Perpetration by Oneself and Others subscale of the Moral Injury Events Scale (MIES) and the Causes subscale of the Moral Injury Questionnaire (MIQ-Causes), were positively associated with higher levels of SITB. Moreover, beyond the contributions of reserve duty, posttraumatic stress symptoms, and depressive symptoms, MIQ-Causes scores significantly predicted current SITB. Importantly, under low and average levels of inhibitory IU, significant positive effects were revealed for the MIQ-Causes on current SITB, R² = .34. Although veterans exposed to PMIEs are more prone to SITB, even years after their release from military service, their IU may temper the link between experiences of PMIEs and SITB.
接触潜在的道德伤害事件(PMIEs)已被承认为重大的应激性战斗事件,可能导致心理健康问题,包括自伤思想和行为(SITB)。然而,很少有研究探讨可以解释 PMIEs 如何导致 SITB 发展和维持的风险和保护因素。在当前的研究中,我们旨在检验战斗老兵中 PMIEs 与 SITB 之间的关联,并探讨不确定性容忍度(IU)在这种关联中的调节作用。在 2017 年期间,我们招募了 191 名以色列战斗老兵作为志愿者样本。参与者在横断面研究中完成了经过验证的自我报告问卷。结果表明,PMIEs 的两个单独测量,道德伤害事件量表(MIES)的自我和他人感知行为子量表和道德伤害问卷(MIQ-Causes)的原因子量表,与 SITB 的高水平呈正相关。此外,除了预备役、创伤后应激症状和抑郁症状的贡献外,MIQ-Causes 分数显著预测了当前的 SITB。重要的是,在低和平均水平的抑制性 IU 下,MIQ-Causes 对当前 SITB 存在显著的正效应,R² =.34。尽管接触 PMIEs 的退伍军人更容易出现 SITB,即使在他们从军队退役多年后也是如此,但他们的 IU 可能会缓和 PMIEs 经历与 SITB 之间的联系。