Amplified PTSD Symptoms From Self-Attributed Moral Transgressions Are Linked to Internalized Moral Identity During Military Deployment

Author:

Sowden Walter J12ORCID,Jones Rachell L2

Affiliation:

1. Department of Behavioral Health, Tripler Army Medical Center , Honolulu, HI 96859, USA

2. Operational Research Team, Walter Reed Army Institute of Research , Silver Spring, MD 20910, USA

Abstract

ABSTRACT Introduction Military personnel frequently experience stressful, morally challenging situations that can lead to posttraumatic stress disorder (PTSD). The relationships between moral identity, transgressive acts, and symptoms related to posttraumatic stress disorder (i.e., posttraumatic stress symptoms; PTSS) among U.S. Army Soldiers were assessed. Materials and Methods A convenience cohort of 1,547 soldiers completed a survey assessing moral identity and PTSS before deployment. A subset of 505 soldiers completed another survey assessing transgressive acts and PTSS during deployment. Exploratory and confirmatory factor analyses were conducted to determine the underlying factor structure of the measures of moral identity and transgressive acts. Generalized linear modeling, robustness checks, and sensitivity analysis were used to evaluate the predictive relationships. Results Moral identity did not directly predict PTSS during deployment. However, self-attributed and betrayal-based transgressive acts were significant predictors. Specifically, self-attributed transgressive acts and PTSS were moderated by internalized moral identity; individuals with a higher internalized moral identity experienced more severe PTSS following self-attributed transgressive acts. These findings were consistent across various model checks, including covariate adjustments, data imputation, and the application of a data quality filter. Conclusions The study highlights the significant role of self-attributed moral transgressions during deployment in the development of PTSS among military service members—especially in those with a strong internalized moral identity. This finding suggests a “target of opportunity” for the development of intervention strategies that mitigate PTSS by addressing the moral dimensions of military service.

Funder

Military Operational Medicine Research Program

Publisher

Oxford University Press (OUP)

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