Moral injury among US combat veterans with and without PTSD and depression

被引:17
作者
Norman, Sonya B. [1 ,2 ]
Nichter, Brandon [2 ,6 ]
Maguen, Shira [3 ,4 ]
Na, Peter J. [5 ,6 ]
Schnurr, Paula P. [1 ,7 ]
Pietrzak, Robert H. [5 ,8 ,9 ]
机构
[1] Natl Ctr PTSD, White River Jct, VT USA
[2] Univ Calif San Diego, Dept Psychiat, 9500 Gilman Dr, La Jolla, CA 92093 USA
[3] San Francisco VA Hlth Care Syst, San Francisco, CA USA
[4] Univ Calif San Francisco, San Francisco, CA 94143 USA
[5] Yale Sch Med, Dept Psychiat, New Haven, CT USA
[6] VA Connecticut Healthcare Syst, West Haven, CT USA
[7] Geisel Sch Med Dartmouth, Hanover, NH USA
[8] VA Connecticut Healthcare Syst, Natl Ctr PTSD, West Haven, CT USA
[9] Yale Sch Publ Hlth, Dept Social & Behav Sci, New Haven, CT USA
关键词
Moral injury; PTSD; Depression; Military; Trauma; Veterans; POSTTRAUMATIC-STRESS-DISORDER; NATIONAL-HEALTH; RESILIENCE; EXPOSURE; EVENTS; BURDEN;
D O I
10.1016/j.jpsychires.2022.07.033
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background: Questions persist about how often potentially morally injurious events (PMIEs) are associated with posttraumatic stress disorder (PTSD) and depression. Methods: This study examined the overlap of morally injurious events with probable PTSD and depression in a nationally representative sample of U.S. combat veterans (n = 1,321, mean age 59.1, 93.7% male). Results: Most veterans with probable PTSD (72.2%), probable depression (72.4%), and probable PTSD and/or depression (68.4%), endorsed experiencing PMIEs; 31.1-35.3% of these participants endorsed perpetration, 45.1-50.4% endorsed witnessing others, and 52.6-55.7% endorsed betrayal. The prevalence of PMIEs among veterans without current probable PTSD and/or depression was 33.7%, 32.3%, and 31.5%, respectively; 7.9-9.1% of these participants endorsed perpetration-based PMIEs, 19.2-20.3% witnessing, and 19.8-21.8% endorsed betrayal. PMIEs were more prevalent among veterans with probable PTSD or depression relative to those without (ORs ranging 2.14-3.32; p's < 0.001). Conclusions: This is the first nationally representative study to examine the prevalence of PMIEs among veterans with and without probable PTSD or depression. Results highlight the importance of understanding distress and functional impairment in these veterans to evaluate whether they may benefit from intervention. PMIEs were strikingly more prevalent among veterans with probable PTSD and depression, suggesting that veterans without PMIEs are the minority among combat veterans with these disorders.
引用
收藏
页码:190 / 197
页数:8
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