Trajectories of functioning in a population-based sample of veterans: contributions of moral injury, PTSD, and depression.
Psychol Med
; 52(12): 2332-2341, 2022 09.
Article
em En
| MEDLINE
| ID: mdl-33234177
ABSTRACT
BACKGROUND:
Although research has shown that exposure to potentially traumatic and morally injurious events is associated with psychological symptoms among veterans, knowledge regarding functioning impacts remains limited.METHODS:
A population-based sample of post-9/11 veterans completed measures of intimate relationship, health, and work functioning at approximately 9, 15, 21, and 27 months after leaving service. Moral injury, posttraumatic stress, and depression were assessed at ~9 months post-separation. We used Latent Growth Mixture Models to identify discrete classes characterized by unique trajectories of change in functioning over time and to examine predictors of class membership.RESULTS:
Veterans were assigned to one of four functioning trajectories high and stable, high and decreasing, moderate and increasing, and moderate and stable. Whereas posttraumatic stress, depression, and moral injury associated with perpetration and betrayal predicted worse outcomes at baseline across multiple functioning domains, moral injury associated with perpetration and depression most reliably predicted assignment to trajectories characterized by relatively poor or declining functioning.CONCLUSIONS:
Moral injury contributes to functional problems beyond what is explained by posttraumatic stress and depression, and moral injury due to perpetration and depression most reliably predicted assignment to trajectories characterized by functional impairment over time.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos de Estresse Pós-Traumáticos
/
Veteranos
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Psychol Med
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos