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Moral Injury and Suicide Ideation Among Combat Veterans.

Authors
  • Levi-Belz, Yossi1
  • Shemesh, Sharon1, 2
  • Zerach, Gadi3
  • 1 The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel. , (Israel)
  • 2 Department of Clinical Psychology, Ruppin Academic Center, Emek Hefer, Israel. , (Israel)
  • 3 Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel. , (Israel)
Type
Published Article
Journal
Crisis
Publication Date
May 01, 2023
Volume
44
Issue
3
Pages
198–208
Identifiers
DOI: 10.1027/0227-5910/a000849
PMID: 35138155
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Background: Modern warfare in a civilian setting may expose combatants to severe moral challenges. Whereas most of these challenges are handled effectively, some potentially morally injurious events (PMIEs) may have deleterious psychological effects on the combatants, such as suicide ideation (SI). Self-disclosure, which includes sharing distressing thoughts and emotions, has been recognized as a protective factor against SI in the aftermath of stressful events. The current study is the first to examine the moderating role of self-disclosure in the relationship between PMIE exposure and SI among combat veterans. Method: A sample of 190 recently discharged Israeli combat veterans completed validated self-report questionnaires measuring combat exposure, PMIEs, depressive symptoms, SI, and self-disclosure in a cross-sectional design study. Results: PMIE dimensions and self-disclosure significantly contributed to current SI. Notably, the moderating model indicated that self-disclosure moderated the link between PMIE-Self and current SI, as PMIE-Self and current SI demonstrated a stronger association among veterans with low self-disclosure than among those with high self-disclosure. Limitations: Cross-sectional design of volunteers, the findings may not be directly generalizable to veterans' population. Conclusion: Self-disclosure, as a factor promoting a sense of belongingness, interpersonal bonding, and support, might diminish SI risk following PMIE exposure. Various mechanisms accounting for these associations are suggested, and the clinical implications of these interactions are discussed.

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