Profiles of moral distress and associated outcomes among student veterans.

Griffin BJ, Williams CL, Shaler L, Dees RF, Cowden RG, Bryan CJ, Litz B, Purcell N, Burkman K, Maguen S. Profiles of moral distress and associated outcomes among student veterans. Psychological trauma : theory, research, practice and policy. 2020 Oct 1; 12(7):669-677.

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Abstract:

OBJECTIVE: Military veterans who interpret their own or others' actions as moral transgressions are theorized to experience moral distress. The purpose of this study was to explore patterns of moral distress and associated psychological, social, and religious or spiritual problems among student veterans. METHOD: Student veterans ( = 498) retrospectively reported experiences of moral distress associated with deployment-related events in which they felt (a) troubled by what they witnessed, (b) troubled by what they did, (c) troubled by what they failed to do, (d) betrayed by military leaders, or (e) betrayed by fellow service members. RESULTS: Latent profile analysis revealed 5 response patterns: No Moral Distress (42%), Witnessing-Only (16%), Moral Distress-Other (19%; encompassing distress mostly from being betrayed by others), Moral Distress-Self (8%; encompassing distress mostly from one's own actions or inactions), and Moral Distress-Self and Other (15%). We compared scores on measures of posttraumatic stress, familial or social functioning, and religious or spiritual struggles between profiles and observed moderate to large differences. CONCLUSIONS: Whereas participants reported some problems (e.g., interpersonal conflict) regardless of whether they were exposed to a morally injurious event by witnessing, perpetrating, or being betrayed, in comparison to those reporting no moral distress, those who felt responsible for the event reported greater guilt and lack of purpose and those who held others responsible for the event reported greater posttraumatic stress. Participants who endorsed feeling betrayed by others' and troubled by their own actions reported multiple problems including posttraumatic stress, interpersonal difficulties, and religious or spiritual struggles. (PsycInfo Database Record (c) 2020 APA, all rights reserved).