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Exploring Associations Between Deployment-Related Events and Moral Injury Outcomes in Post-9/11 Veterans.
Paola E Fernandez1, Esther Kim1, Jason A Nieuwsma2
1Psychology Department, University of South Alabama.
Traumatology
|December 22, 2025
Summary
Moral injury may develop after military service due to events violating moral beliefs. Unit support during deployment can significantly reduce moral injury outcomes in veterans.
Area of Science:
- Psychology
- Military Mental Health
- Trauma Studies
Background:
- Moral injury is a trauma-related condition linked to events that transgress deeply held moral beliefs and values.
- The influence of protective and detrimental experiences during military deployment on moral injury development post-service remains under-examined.
Purpose of the Study:
- To investigate the association between potentially morally injurious events (PMIEs) and moral injury outcomes in post-9/11 combat veterans.
- To examine the role of deployment-related factors, including unit support, in the development of moral injury after military transition.
Main Methods:
- A cross-sectional survey was administered to 309 Post-9/11 combat veterans after their military separation.
- Participants completed measures including the Deployment Risk and Resilience Inventory-2 (DRRI-2), Moral Injury Events Scale, and Expressions of Moral Injury Scale - Military version.
- Multivariate regression analysis was used, controlling for posttraumatic stress disorder symptom severity.
Main Results:
- Veterans reporting moral injury outcomes generally experienced fewer relational supports and more adverse events, both pre-deployment and during service.
- Exposure to PMIEs (transgression and betrayal) was uniquely associated with greater moral injury outcomes.
- Perceived unit support during deployment was uniquely and inversely associated with moral injury outcomes.
Conclusions:
- Findings confirm a link between PMIE exposure and moral injury outcomes in combat veterans.
- Cohesive and supportive military units during deployment appear crucial in mitigating moral injury development.
- Interventions should consider both addressing PMIEs and fostering unit cohesion to support veterans' mental health.
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