Morally Injurious Events and Psychological Distress Among Veterans: Examining the Mediating Role of Religious and Spiritual Struggles
Morally Injurious Events and Psychological Distress Among Veterans: Examining the Mediating Role of Religious and Spiritual Struggles
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DOI：
10.1037/tra0000347
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发表时间：
2018-05-01
影响因子：
6.3
通讯作者：
Teng, Ellen J.
中科院分区：
文献类型：
--
作者：
Evans, Wyatt R.;Stanley, Melinda A.;Teng, Ellen J.
目的：潜在道德伤害事件（PMIE）--侵犯（实施或目睹）一个人根深蒂固的信仰或价值观--与多种形式的心理困扰有关。被PMIE侵犯的价值观往往受到一个人的宗教/精神信仰的影响。与一个人的r/s信仰和/或实践的斗争也可能导致心理困扰的加剧。为了进一步发展一个框架，了解和治疗PMIE暴露的后遗症，我们研究了R/S斗争的作用PMIE暴露和心理困扰之间的关系。方法：一个大型退伍军人事务医疗中心的155名退伍军人完成了评估PMIE暴露，r/s斗争和心理困扰的问卷调查。结果如下：研究结果显示，PMIE暴露越大，r/s挣扎越高，焦虑和创伤后应激障碍（PTSD）症状也越高。同样，更大的r/s挣扎预示着焦虑、创伤后应激障碍和抑郁症状的增加。回归分析显示r/s挣扎完全介导PMIE暴露与焦虑以及PTSD之间的关系，并且观察到PMIE暴露通过r/s挣扎对抑郁症状的显着间接影响。后续分析表明，没有特定的域的r/s的斗争占PMIE曝光和心理困扰之间的关系，而是，总体结构的r/s的斗争占这种关系。结论：这些研究结果推进了不断发展的理论框架的精神伤害，阐明了显着的r/s的斗争发展的困扰。道德伤害干预的影响要求注意潜在的不和谐行为（目睹或犯下）和R/S的个人的道德框架的基础之间。
Objective: Potentially morally injurious events (PMIEs)-violations (perpetrated or witnessed) of one's deeply held beliefs or values-have been associated with several forms of psychological distress. The values violated by PMIEs are often influenced by one's religion/spirituality (r/s). Struggles with one's r/s beliefs and/or practices may also contribute to elevated psychological distress. To further develop a framework for understanding and treating the sequelae of PMIE exposure, we examined the role of r/s struggles in the relation between PMIE exposure and psychological distress. Method: A diverse sample of 155 veterans at a large Veterans Affairs medical center completed questionnaires assessing PMIE exposure, r/s struggles, and psychological distress. Results: Findings revealed greater PMIE exposure predicted elevated r/s struggles as well as elevated symptoms of anxiety and posttraumatic stress disorder (PTSD). Likewise, greater r/s struggles predicted elevated anxiety, PTSD, and depression symptoms. Regression analyses revealed r/s struggles fully mediated the relation between PMIE exposure and anxiety as well as PTSD, and a significant indirect effect of PMIE exposure on depression symptoms through r/s struggles was observed. Follow-up analyses revealed that no specific domain of r/s struggles accounted for the relation between PMIE exposure and psychological distress; rather, the overarching construct of r/s struggles accounted for this relation. Conclusion: These findings advance the evolving theoretical framework of moral injury, elucidating the salience of r/s struggles in the development of distress. Implications for moral injury intervention call for attention to potential dissonance between actions (witnessed or perpetrated) and r/s underpinnings of the individual's moral framework.