Clearinghouse for Military Family Readiness at Penn State, The Pennsylvania State University, University Park, Pennsylvania, USA.
Social Science Research Institute, The Pennsylvania State University, University Park, Pennsylvania, USA.
J Trauma Stress. 2020 Aug;33(4):587-597. doi: 10.1002/jts.22567. Epub 2020 Jul 13.
Moral injury (MI) may occur in the context of committing transgressions (i.e., self-directed MI reactions), witnessing transgressions, or being the victims of others' transgressions (i.e., other-directed MI reactions) that violate an individual's moral principles. Veterans with MI may experience impaired social well-being (SWB). Studies on MI and veterans' SWB have focused almost exclusively on social support and used cross-sectional data. The present study used growth curve analyses to examine the associations between self- and other-directed MI reactions and veterans' levels of social support, social functioning, social activities, and social satisfaction over the first 18 to 21 months of their transition to civilian life (N = 9,566). The results demonstrated declines in all SWB outcomes, with self- and other-directed MI reactions having differential effects. Higher versus lower levels of other-directed MI reactions were related to lower baseline scores on all SWB outcomes, βs = -.06 to -.20, and steeper declines over time in social functioning, β = -.09, and social satisfaction, β = -.10. Higher versus lower levels of self-directed MI reactions were related to lower baseline levels of social functioning, β = -.07, but higher baseline levels of social activity, β = .04. Higher versus lower levels of self-directed MI reactions were related to a steeper decline in social activity over time, β = -.10. These findings present a more nuanced picture than that depicted by current MI theoretical frameworks and support further research to uncover moderators of the associations between self- and other-directed MI reactions and SWB outcomes.
道德伤害（MI）可能发生在违反个人道德原则的行为（即自我导向的 MI 反应）、目睹违反行为或成为他人违反行为（即他人导向的 MI 反应）的情况下。患有 MI 的退伍军人可能会经历社会福利受损。关于 MI 和退伍军人社会福利的研究几乎完全集中在社会支持上，并使用了横断面数据。本研究使用增长曲线分析，在退伍军人向平民生活过渡的前 18 至 21 个月期间，考察了自我和他人导向的 MI 反应与退伍军人的社会支持、社会功能、社会活动和社会满意度水平之间的关系（N=9566）。结果表明，所有社会福利结果都呈下降趋势，自我和他人导向的 MI 反应具有不同的影响。与其他定向 MI 反应较高的退伍军人相比，其他定向 MI 反应较低的退伍军人的所有社会福利结果的基线得分较低，βs=-0.06 至-0.20，社会功能和社会满意度的下降速度更快，β=-0.09 和β=-0.10。与自我导向 MI 反应较高的退伍军人相比，自我导向 MI 反应较低的退伍军人的社会功能基线水平较低，β=-0.07，但社会活动的基线水平较高，β=0.04。与自我导向 MI 反应较高的退伍军人相比，自我导向 MI 反应较低的退伍军人的社会活动下降速度更快，β=-0.10。这些发现比当前 MI 理论框架所描绘的更为细致，并支持进一步的研究，以揭示自我和他人导向的 MI 反应与社会福利结果之间的关联的调节因素。
