Exploring the maladaptive cognitions of moral injury within a primarily combat-trauma military sample

Post-Traumatic Stress Disorder (PTSD) is a prominent mental health condition that affects military personnel. Moral injury is another mental health concern among military personnel that requires further investigation. Moral injury results when the individual is exposed to a situation or event that violates their moral code. Meanwhile, PTSD results when there is a substantial threat of harm. Although distorted cognitions are core components of PTSD symptomatology, there is no research of cognitions in moral injury. The current study examined how maladaptive cognitions (i.e., self-worth and judgment, threat of harm, forgiveness of the situation reliability, trustworthiness of others, forgiveness of others, forgiveness of self, and atonement) may be associated with either moral injury or PTSD.

Participants (N = 253) were recruited online and eligible for the study if they endorsed a previous deployment, answered military-specific questions, and reported clinical levels of distress on PTSD and Moral Injury self-report measures. An overwhelming majority of participants experienced foreign deployment(s; 90.1%).

Data indicated that moral injury was defined by atonement, self-worth and judgment, reliability and trustworthiness of others, and forgiveness of others while PTSD was defined by threat of harm and forgiveness of the situation. Forgiveness of self was not associated with moral injury nor PTSD.

The results highlighted that moral injury and PTSD are associated with distinct maladaptive cognitions. The results of the current study can assist in treatment of moral injury and PTSD by identifying the maladaptive cognitions specific to moral injury that may be targets for change during treatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).