Objective

Following exposure to events that transgress moral beliefs and expectations rooted in cultural, organizational, and group-based ethical rules, veterans can experience psychological, social, and spiritual problems referred to as Moral Injury (MI). We examined patterns of exposure to potentially morally injurious events (PMIEs) among Israeli veterans as well as psychological and functional correlates of exposure.

Method

A sample of 381 Israeli veterans volunteered to complete a cross-sectional electronic survey between 2017−2018. Latent Class Analysis (LCA) was used to identify classes characterized by unique patterns of exposure to PMIEs and compare differences in psychological and functional problems.

Results

Three subgroups were identified: Moral Injury (12.1 %), Betrayal-Only (20.8 %), and Minimal Exposure (67.1 %). Whereas those in the betrayal-only class reported more traditional posttraumatic symptoms and those in the moral injury class reported more moral injury symptoms (i.e., guilt-related cognitions), some psychological problems were shared by veterans assigned to the moral injury and betrayal-only classes (e.g., entrapment). Importantly, while both those in the betrayal-only and moral injury classes had lower forgiveness relative to those in the minimal exposure class, those in the betrayal-only class received more familial support than did those in the moral injury class.

Conclusions

The study’s findings offer an overview of the complex associations between patterns of exposure to PMIEs and associated outcomes. Clinicians treating veterans coping with combat trauma should be aware of the unique and shared symptoms reported by those with moral injury and betrayal exposures.

中文翻译：

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以色列退伍军人中暴露于潜在道德伤害事件的模式：一种潜在的阶级分析方法

客观的

在经历了违反基于文化，组织和团体道德准则的道德观念和期望的事件后，退伍军人会遇到心理，社会和精神问题，称为道德伤害（MI）。我们检查了以色列退伍军人暴露于潜在道德伤害事件（PMIE）的方式以及暴露的心理和功能相关性。

方法

2017年至2018年之间，有381名以色列退伍军人的志愿者自愿完成了横断面电子调查。潜在类别分析（LCA）用于识别以暴露于PMIE的独特模式为特征的类别，并比较心理和功能问题的差异。

结果

确定了三个亚组：道德损伤（12.1％），仅背叛（20.8％）和最小暴露（67.1％）。而那些在唯一的背叛-类报道比较传统的创伤后症状和那些在精神伤害类的报道更加精神损害症状（即内疚相关的认知），一些心理问题被分配到老兵共享的精神伤害和背叛，只类（例如诱捕）。重要的是，相对于最低限度接触者，仅背叛者和精神伤害者的宽恕度都较低那些只出卖背叛的人比精神受到伤害的人得到了更多的家庭支持。

结论

该研究结果概述了PMIE暴露模式与相关结果之间的复杂关联。应对战斗创伤的退伍军人的临床医生应意识到，患有精神损伤和背叛的人所报告的独特且共有的症状。