Meaning in life moderates the association between morally injurious experiences and suicide ideation among U.S. combat veterans: Results from the National Health and Resilience in Veterans Study.

Abstract

Objective: Effectively responding to suicide risk among veterans involves further developing understanding of reactions to combat experiences, including life-threatening events, traumatic losses, and morally injurious experiences. An important determinant of whether stressors lead to poor mental health outcomes is the perception of meaning. The current study aimed to determine whether global meaning (i.e., general beliefs, goals, and sense of purpose in life) moderates the relationship between morally injurious experiences and suicide ideation among combat veterans. Method: This analysis examined 564 participants in the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of U.S. military veterans, who reported a history of deployment to a combat zone. Multivariable logistic regressions examined interactions between morally injurious experiences and global meaning as predictors of the likelihood of current suicide ideation. Results: There were significant interactions between global meaning and 2 morally injurious experience subtypes-transgressions by others and betrayal experiences. Higher global meaning was associated with significantly lower likelihood of experiencing suicide ideation at higher levels of transgression by others and betrayal experiences. Conclusions: Veterans who report higher levels of morally injurious experiences involving transgressions by others and betrayal experiences in the presence of higher levels of global meaning are significantly less likely to experience suicide ideation. Continued research is needed to determine whether interventions aimed at cultivating global meaning may help mitigate suicide risk in combat veterans with high exposure to certain potentially morally injurious experiences. Clinical Impact StatementThe current study provides evidence that having a greater sense of global meaning in life (i.e., general beliefs, goals, and sense of purpose in life) is associated with lower likelihood of reporting suicide ideation among U.S. combat veterans with exposure to morally injurious experiences involving witnessing transgressions by others and betrayal. This information may be of use to those who seek to further understand experiences that place combat veterans at increased risk for suicide, and to develop interventions aimed at reducing suicide risk in this population.

Own soul's warning: Moral injury, suicidal ideation, and meaning in life.

“…Our results are consistent with previous studies that have demonstrated that meaning in life moderates the association between morally injurious events and suicidal ideation (Bryan et al, 2013; Corona et al, 2019). More globally, our findings also support research demonstrating that a higher presence of meaning in life is associated with psychological growth after traumatic events (e.g., Calhoun & Tedeschi, 2006; Janoff-Bulman, 2006; Park, 2010).…”

“…Studies have shown that meaning in life moderates the association between morally injurious events and suicidal ideation in service members (e.g., Bryan et al, 2013; Corona et al, 2019). In general, individuals who can make meaning from traumatic events report a higher presence of meaning in life and greater growth and psychological well-being (Calhoun & Tedeschi, 2006; Janoff-Bulman, 2006; Park, 2010).…”

Invisible wounds and suicide: Moral injury and veteran mental health

“…Transgressions, acts, or behaviours undertaken in military service can incite deep feelings of distrust, anger, shame, and guilt (Litz et al 2009;Tangney et al 2007;Vargas et al 2013). The transgressive act or behaviour may be intrapersonally evaluated as a threat to the integrity of one's moral schema, or a moral disorientation (Molendijk 2018) resulting in negative psychological and emotional consequences that can heighten the risk of suicide in veterans (Bryan et al 2014;Corona et al 2019;Kelley et al 2019;Koenig et al 2019b).…”

Post‐9/11 military veterans' adjustment to civilian life over time following separation from service

“…Meaning in life in the context of distress may be a protective factor in preventing worsening mental health among veterans. Higher meaning in life is associated with lower suicidal ideation after morally injurious events (Corona et al, 2019) and is also associated with improvement in depression and hopelessness among previously depressed veterans (Braden et al, 2017). Curiously, we saw no differences in meaning in life across demographic characteristics.…”