Moral Injury and Spiritual Struggles in Military Veterans: A Latent Profile Analysis

• Published in: Journal of traumatic stress 2019-06, Vol.32 (3), p.393-404
• Main Authors: Currier, Joseph M., Foster, Joshua D., Isaak, Steven L.
• Format: Article
• Language: English
• Subjects: Moral injury; Morality; Religion; Spirituality
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1002/jts.22378

War‐related traumas can lead to emotional, relational, and spiritual suffering. Drawing on two community samples of war zone veterans from diverse military eras (Study 1, N = 616 and Study 2, N = 300), the purpose of this study was to examine patterns of constellations between outcomes related to moral injury (MI) and common ways in which veterans may struggle with religion or spirituality, defined as divine, morality, meaning, interpersonal, and doubt. Results from latent profile analyses revealed three distinct classes across the samples, based on psychometrically validated instruments: (a) no MI‐related outcomes or spiritual struggles (nondistressed group; Study 1 = 72.7%, Study 2 = 75.0%); (b) MI‐related outcomes and equivalent or lower degrees of spiritual struggles relative to MI‐related outcomes (psychological MI group; Study 1 = 19.2%, Study 2 = 17.0%); and (c) MI‐related outcomes and salient struggles with religious faith or spirituality, both within their own profiles and compared to other groups (spiritual MI group; 8.1% and 8.0% in the two samples). When we compared severity of spiritual struggles within MI groups, turmoil with God or a higher power emerged as a defining feature of the spiritual MI group in both samples. In addition, secondary analyses revealed membership in this third group was linked with greater importance of religion or spirituality before military service, χ2(1, N = 616 and 300) = 4.468–8.273. Overall, although more research is needed, these findings highlight the possible utility of differentiating between psychological and spiritual subtypes of MI according to war zone veterans’ religious or spiritual backgrounds. Resumen Spanish s by Asociación Chilena de Estrés Traumático (ACET) Daño moral y luchas espirituales en veteranos de guerra: Un análisis de perfil latente DAÑO MORAL Y LUCHAS ESPIRITUALES Los traumas relacionados con la guerra pueden llevar al sufrimiento emocional, relacional, y espiritual. Basado en dos muestras comunitarias de veteranos de la zona de guerra de diversas épocas militares (Estudio 1, N = 616 y Estudio 2, N = 300), el objetivo de este estudio fue examinar los patrones de las constelaciones entre los resultados relacionados con el daño moral (DM) y las formas comunes en las que los veteranos pueden lidiar con la religión y/o la espiritualidad, definidas como divinas, moralidad, significado, interpersonal, y duda. Los resultados de los análisis de perfiles latentes revelaron tres clases distintas,