Morally Injurious Experiences of Combat Exposed Veterans of Iraq and Afghanistan: Moderating Effects of Self-Forgiveness on Feelings of Shame and Guilt

Abstract

Moral injury is a construct developed to explain a unique symptom profile of individuals who may have perpetrated, witnessed, or learned about events that transgress their held moral beliefs. Among combat exposed Veterans, particular attention has been focused on the ambiguous nature of recent military conflicts and the increased moral conflicts associated with more recent, unconventional combat tactics and strategies. This study examined the relationship between moral injury and feelings of shame and guilt among a large sample (n=198) of Veterans who deployed in support of conflicts in Iraq and/or Afghanistan. Additionally, this study sought to examine self-forgiveness as a moderator of the well-studied and empirically supported association of moral injury and shame and guilt. This study considered demographic and exposure variables and found moral injury was positively correlated with feelings of shame, guilt, and with the combination of these two affective experiences. Also, self-forgiveness was found to moderate the relationship between shame and guilt. The results of this study further support the relationship between moral injury and feelings of shame and guilt, as identified in the past decade of moral injury literature. The results also suggest that self-forgiveness does significantly impact the strength of the relationship between moral injury and feelings of shame and guilt, which supports Litz et al.'s (2009) conceptual model. This study demonstrates a need for more research to examine self-forgiveness as a principle factor in moral injury treatment, which could improve the efficacy of moral injury treatments such as Adaptive Disclosure. MORAL INJURY, SHAME, GUILT, AND SELF-FORGIVENESS iii DEDICATION This study is dedicated to those who I had the distinct pleasure of serving with in the United States military and who paid the ultimate sacrifice in defend our Freedoms. This study is also dedicated to those who survived combat but succumbed to their internal battles, as their war never ended. The following names, listed by rank, are true American heroes: