The role of PTSD, guilt and shame in predicting moral injury in veterans that have experienced active deployment.

Paper one is a literature review of ten empirical studies. It reviews what is known about the relationship between killing in combat and PTSD, exploring the question within a military and veteran population. The findings highlighted that those who kill in combat are more likely to report greater severity of PTSD symptoms, although there is some disparity. Other factors, such as victim characteristics and gender, may influence this relationship. Some of the studies were limited by lack of a representative sample and generalisability. There were also issues with transparency, which limits the reliability of some of the conclusions made.
Paper two is an empirical study. This was internet-mediated research which explored the relationship between PTSD, guilt, shame and moral injury in a British veteran population. 104 participants took part in the study. A standard multiple regression analysis was conducted on the data. Findings indicated a significant relationship between PTSD and moral injury. The results did not support the hypothesis that guilt and shame would predict moral injury. The findings are discussed, along with their clinical implications, limitations and direction for future research.
Paper three is an executive summary. This has been written as an accessible document intended for dissemination of the findings of the empirical study to a veteran and general population. The research method, findings and clinical implications have been summarised within this report.