TY  - JOUR
PY  - 2019//
TI  - Temporal associations between moral injury and posttraumatic stress disorder symptom clusters in military veterans
JO  - Journal of Traumatic Stress
A1  - Currier, Joseph M.
A1  - McDermott, Ryon C.
A1  - Farnsworth, Jacob K.
A1  - Borges, Lauren M.
SP  - 382
EP  - 392
VL  - 32
IS  - 3
N2  - War zone veterans who experience posttraumatic stress disorder (PTSD) symptoms might struggle with co-occurring cognitive, emotional, and behavioral expressions of suffering that align with conceptual definitions of moral injury (MI). However, given that PTSD is a multidimensional condition, disentangling the apparent interplay with MI may inform clinical practice and research. This study incorporated a cross-lagged design to explore temporal associations between self- and other-directed outcomes related to MI and severity of DSM-5 PTSD symptom clusters while accounting for depressive symptoms. Drawing on the Expressions of Moral Injury Scale-Military Version in a community sample of 182 previously deployed veterans, MI-related outcomes were linked with severity of PTSD symptom clusters at two assessments spaced apart by 6 months, rs =.58-.62. Of possible models for conceptualizing the temporal nature of these associations, structural equation modeling analyses revealed a cross-lagged primary MI model best fit veterans' responses. Within this model, veterans' self-directed MI at Time 1 predicted greater PTSD symptoms at the 6-month follow-up. However, an equivalent cross-lagged path also emerged between Time 1 PTSD Cluster D symptoms and self-directed MI at Time 2, suggesting the value of a reciprocal MI model for this symptom domain. In contrast, other-directed outcomes of MI were not linked with PTSD in the presence of other variables. Overall, these findings support the prognostic value of assessing for MI-related outcomes among veterans who might be struggling with PTSD symptomatology, particularly with respect to self-directed problems associated with enduring moral distress.<br><br>© 2019 International Society for Traumatic Stress Studies.<p />  <p>Language: en</p>
LA  - en
SN  - 0894-9867
UR  - http://dx.doi.org/10.1002/jts.22367
ID  - ref1
ER  -