Sowden Walter J, Jones Rachell L
Department of Behavioral Health, Tripler Army Medical Center, Honolulu, HI 96859, USA.
Operational Research Team, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
Mil Med. 2024 Aug 19;189(Supplement_3):156-164. doi: 10.1093/milmed/usae064.
Military personnel frequently experience stressful, morally challenging situations that can lead to posttraumatic stress disorder (PTSD). The relationships between moral identity, transgressive acts, and symptoms related to posttraumatic stress disorder (i.e., posttraumatic stress symptoms; PTSS) among U.S. Army Soldiers were assessed.
A convenience cohort of 1,547 soldiers completed a survey assessing moral identity and PTSS before deployment. A subset of 505 soldiers completed another survey assessing transgressive acts and PTSS during deployment. Exploratory and confirmatory factor analyses were conducted to determine the underlying factor structure of the measures of moral identity and transgressive acts. Generalized linear modeling, robustness checks, and sensitivity analysis were used to evaluate the predictive relationships.
Moral identity did not directly predict PTSS during deployment. However, self-attributed and betrayal-based transgressive acts were significant predictors. Specifically, self-attributed transgressive acts and PTSS were moderated by internalized moral identity; individuals with a higher internalized moral identity experienced more severe PTSS following self-attributed transgressive acts. These findings were consistent across various model checks, including covariate adjustments, data imputation, and the application of a data quality filter.
The study highlights the significant role of self-attributed moral transgressions during deployment in the development of PTSS among military service members-especially in those with a strong internalized moral identity. This finding suggests a "target of opportunity" for the development of intervention strategies that mitigate PTSS by addressing the moral dimensions of military service.
军事人员经常经历压力大且在道德上具有挑战性的情况，这可能导致创伤后应激障碍（PTSD）。本研究评估了美国陆军士兵的道德认同、违规行为与创伤后应激障碍相关症状（即创伤后应激症状；PTSS）之间的关系。
一个由1547名士兵组成的便利样本队列在部署前完成了一项评估道德认同和PTSS的调查。505名士兵的子集在部署期间完成了另一项评估违规行为和PTSS的调查。进行探索性和验证性因素分析以确定道德认同和违规行为测量指标的潜在因素结构。使用广义线性模型、稳健性检验和敏感性分析来评估预测关系。
道德认同在部署期间并未直接预测PTSS。然而，自我归因的和基于背叛的违规行为是显著的预测因素。具体而言，自我归因的违规行为和PTSS受到内化道德认同的调节；内化道德认同较高的个体在自我归因的违规行为后经历更严重的PTSS。这些发现在各种模型检验中都是一致的，包括协变量调整、数据插补和数据质量过滤器的应用。
该研究强调了部署期间自我归因的道德违规行为在军事人员PTSS发展中的重要作用——特别是在那些具有强烈内化道德认同的人员中。这一发现为制定干预策略提供了一个“机会目标”，该策略通过解决军事服务的道德层面来减轻PTSS。
