Moral Injury and Social Well-Being: A Growth Curve Analysis

Moral injury (MI) may occur in the context of committing transgressions (i.e., self-directed MI reactions), witnessing transgressions, or being the victims of others' transgressions (i.e., other-directed MI reactions) that violate an individual's moral principles. Veterans with MI may experience impaired social well-being (SWB). Studies on MI and veterans' SWB have focused almost exclusively on social support and used cross-sectional data. The present study used growth curve analyses to examine the associations between self- and other-directed MI reactions and veterans' levels of social support, social functioning, social activities, and social satisfaction over the first 18 to 21 months of their transition to civilian life (N = 9,566). The results demonstrated declines in all SWB outcomes, with self- and other-directed MI reactions having differential effects. Higher versus lower levels of other-directed MI reactions were related to lower baseline scores on all SWB outcomes, βs = -.06 to -.20, and steeper declines over time in social functioning, β = -.09, and social satisfaction, β = -.10. Higher versus lower levels of self-directed MI reactions were related to lower baseline levels of social functioning, β = -.07, but higher baseline levels of social activity, β = .04. Higher versus lower levels of self-directed MI reactions were related to a steeper decline in social activity over time, β = -.10. These findings present a more nuanced picture than that depicted by current MI theoretical frameworks and support further research to uncover moderators of the associations between self- and other-directed MI reactions and SWB outcomes.