Maguen Shira, Griffin Brandon J, Copeland Laurel A, Perkins Daniel F, Finley Erin P, Vogt Dawne
San Francisco VA Health Care System, USA; University of California, San Francisco, USA.
San Francisco VA Health Care System, USA; University of California, San Francisco, USA.
J Psychiatr Res. 2020 Nov;130:97-103. doi: 10.1016/j.jpsychires.2020.06.020. Epub 2020 Jul 26.
Our goal was to identify gender differences in the prevalence and outcomes of exposure to potentially morally injurious events (PMIEs) in a sample of U.S. military veterans. In a national sample of post-9/11 veterans (n = 7200) weighted to reflect the larger population of newly separated U.S. veterans, we conducted gender-stratified analyses of the prevalence of exposure to PMIEs and their associations with psychological and functional problems. Veterans reported exposures stemming from witnessing (27.9%), perpetrating (18.8%), and being betrayed (41.1%). Women more frequently reported witnessing- and betrayal-based PMIEs, but no gender differences were observed for perpetration-based PMIEs. Psychological distress was associated with witnessing and betrayal among women and with witnessing, betrayal, and perpetration among men. Whereas betrayal was most consistently associated with functional impairment across domains for women, perpetration was most consistently associated with functional impairment for men. Moral injury contributes to psychological and functional problems among a significant minority of military veterans, although effects vary based on PMIE type and gender. Implications for veterans and other populations who experience moral injury are discussed.
我们的目标是在美国退伍军人样本中确定接触潜在道德伤害事件（PMIEs）的患病率及后果方面的性别差异。在一个经过加权以反映新退役美国退伍军人总体情况的9·11后退伍军人全国样本（n = 7200）中，我们对接触PMIEs的患病率及其与心理和功能问题的关联进行了性别分层分析。退伍军人报告的接触源包括目睹（27.9%）、实施（18.8%）和被背叛（41.1%）。女性更频繁地报告基于目睹和背叛的PMIEs，但基于实施的PMIEs未观察到性别差异。心理困扰与女性中的目睹和背叛以及男性中的目睹、背叛和实施有关。虽然背叛在各领域中与女性的功能损害最一致相关，但实施与男性的功能损害最一致相关。道德伤害在相当一部分退伍军人中导致心理和功能问题，尽管影响因PMIE类型和性别而异。本文讨论了对经历道德伤害的退伍军人及其他人群的启示。
