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道德伤害与社会福祉:增长曲线分析。

Moral Injury and Social Well-Being: A Growth Curve Analysis.

机构信息

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.

出版信息

J Trauma Stress. 2020 Aug;33(4):587-597. doi: 10.1002/jts.22567. Epub 2020 Jul 13.

Abstract

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.

摘要

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。

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