Moral Injury and Posttraumatic Growth Among Combat Soldiers
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Traditional treatments for psychopathology following combat have focused on PTSD and fear based responses. Moral injury theory extends beyond fear by addressing the negative consequences of moral challenges faced in the combat theatre, including acts of transgressions and feelings of betrayal. However, positive psychologists posit that combat experience may also result in concurrent posttraumatic growth occurring in the domains of Appreciation of Live, Personal Strength, Relationships with Others, New Possibilities and Spiritual Change. The purpose of the current study was to examine the relationship between moral injury and posttraumatic growth among combat survivors. Specifically, we expected betrayal to be experienced as victimization, resulting in greater posttraumatic growth compared to transgressions. Transgressions, in contrast, were predicted to lead to less growth due to internalization of guilt and shame. Transgressions were also predicted to moderate the relationship between deployment length and posttraumatic growth. Participants were 218 veterans and soldiers who had served in combat and responded to a survey posted to military relevant online groups. One hundred and four participants met criteria to be included in the final analyses. Consistent with predictions, both moral injury (80%) and posttraumatic growth (83.7%) were highly prevalent in this sample. Feelings of betrayal were positively correlated with all domains of posttraumatic growth with the exception of Spiritual Change. Contrary to predictions, transgressions were found to be unrelated to posttraumatic growth with the exception of a trend towards a small negative relationship with Personal Strength. Transgressions were not found to influence the relationship between deployment length and posttraumatic growth. Clinical implications and directions for future research are discussed.