Investigating the relationship between guilt and shame proneness and moral injury in veterans that have experienced active deployment

Moral injury accounts for the intense negative emotions, such as guilt and shame which some military personnel experience following exposure to events which transgress their deeply held moral beliefs. This study investigated the role of PTSD, guilt and shame in predicting moral injury in a sample of ex-military personnel that had been exposed to active deployment. This was an internet-mediated research design; participants were recruited through an online social media site. British military veterans (n = 104) completed an online battery of self-report measures. Participants were male (n=99) and female (n=5) with a mean age of 47 years. Fifty-one percent of participants achieved scores on a measure of PTSD which would indicate a probable PTSD diagnosis. Guilt and shame were not predictors of moral injury. PTSD was the only significant predictor, accounting for 42% of the variance, with a medium effect size. Clinicians may find it useful to assess veterans for moral injury, particularly those presenting with PTSD. In order to provide detailed assessments it may be helpful for clinicians to further their own understanding of moral injury. Future research should look to establish an evidence base for psychological interventions for moral injury. Closer consideration of contributing factors, such as type of trauma and historical trauma is also needed to develop the construct of moral injury.