Exploring potentially morally injurious events and mental health in a UK representative population

Introduction: Potentially morally injurious events (PMIEs) are events which conflict with an individual's deeply held moral convictions and beliefs. PMIE research has focused on potentially at-risk populations such as military personnel. However, limited research has examined PMIEs and their association with mental health and functioning in the general population. The current cross-sectional study aims to explore the prevalence of PMIEs and associated mental health and functioning in a UK representative sample. The secondary aim is to provide an overview of the health and wellbeing of the sample, thus offering context for interpreting the PMIE results.Methods: Participants were recruited via Prolific to obtain a UK nationally representative sample of 2,385 adults (M_age = 46.79, SD_age = 15.43). Participants completed a questionnaire which included the Moral Injury Outcome Scale to assess PMIE exposure and moral injury symptoms, and measures of other health and functioning, such as common mental health difficulties (CMDs; anxiety and depression).Results: Overall, 59.58% of the total sample reported PMIE exposure. The most prevalent health concerns were loneliness (38.45%), insomnia (35.22%), problematic alcohol use (34.55%), and CMDs (30.86%). The prevalence of posttraumatic stress disorder (PTSD) was 3.61% and complex-PTSD in the sample was 6.96%. Those who reported PMIE exposure had significantly higher scores on measures of CMDs, physical health, anger, loneliness, PTSD, and complex-PTSD than those who had not reported PMIE exposure. Additionally, those who reported PMIE exposure had significantly lower scores on the sleep quality measure, indicating poorer sleep.Discussion: The findings highlight how PMIE exposure extends beyond at-risk occupation groups while demonstrating the association between PMIEs and mental health and functioning in a UK representative sample. This study did not explore the prevalence of moral injury or its association with outcomes. Future research should explore the development of moral injury and effects in the general population.