Meaning Making and Change in Situational Beliefs Serially Mediate the Relationship Between Moral Injury and Posttraumatic Stress Disorder

The association between moral injury and the development of serious social, behavioral, and psychological problems has been demonstrated in a limited but growing body of literature. At present, there is a dearth of evidence pertaining to the mechanism in explaining the relationship between moral injury and posttraumatic stress disorder. This study seeks to examine the serial mediating roles of meaning making and change in situational beliefs in the relationship between moral injury and PTSD. A sample of 737 police officers deployed on fieldwork who have experienced at least one morally injurious event were given psychometric scales assessing moral injury, meaning making, change in situational beliefs, and PTSD. Serial mediation analysis reveals that the positive association between the experience of morally injurious events and PTSD could be accounted for by the decrease in meaning making process and lack of change in situational beliefs. The findings highlight the importance of meaning making and changing situational beliefs in resolving inconsistent thoughts or actions against one's moral code (i.e., moral injury) that ultimately affects one's psychological health.