Body image and psychosocial well-being among UK military personnel and veterans who sustained appearance-altering conflict injuries.

A modest but significant number of military personnel sustained injuries during deployments resulting in an altered-appearance (e.g., limb loss and/or scarring). Civilian research indicates that appearance-altering injuries can affect psychosocial wellbeing, yet little is known about the impact of such injuries among injured personnel. This study aimed to understand the psychosocial impact of appearance-altering injuries and possible support needs among UK military personnel and veterans. Semi-structured interviews with 23 military participants who sustained appearance-altering injuries during deployments or training since 1969 were conducted. The interviews were analyzed using reflexive thematic analysis, identifying six master themes. These themes indicate that in the context of broader recovery experiences, military personnel and veterans experience a variety of psychosocial difficulties related to their changed appearance. While some of these are consistent with evidence from civilians, military-related nuances in the challenges, protective experiences, coping approaches, and preferences for support are evident. Personnel and veterans with appearance-altering injuries may require specific support for adjusting to their changed appearance and related difficulties. However, barriers to acknowledging appearance concerns were identified. Implications for support provision and future research are discussed.

Suicide attempts and mental health diagnoses in combat-injured service members: A retrospective cohort study.

INTRODUCTION: Examinations of risk factors for suicide attempt in United States service members at high risk of mental health diagnoses, such as those with combat injuries, are essential to guiding prevention and intervention efforts. METHODS: Retrospective cohort study of 8727 combat-injured patients matched to deployed, non-injured patients utilizing Department of Defense and Veterans Affairs administrative records. RESULTS: Combat injury was positively associated with suicide attempt in the univariate model (HR = 1.75, 95% CI 1.5-2.1), but lost significance after adjustment for mental health diagnoses. Utilizing Latent Transition Analysis in the combat-injured group, we identified five mental/behavioral health profiles: (1) Few mental health diagnoses, (2) PTSD and depressive disorders, (3) Adjustment disorder, (4) Multiple mental health comorbidities, and (5) Multiple mental health comorbidities with alcohol use disorder (AUD). Multiple mental health comorbidities with AUD had the highest suicide attempt rate throughout the study and more than four times that of Multiple mental health comorbidities in the first study year (23.4 vs. 5.1 per 1000 person years, respectively). CONCLUSION: Findings indicate that (1) combat injury's impact on suicide attempt is attenuated by mental health and (2) AUD with multiple mental health comorbidities confers heightened suicide attempt risk in combat-injured service members.

Longitudinal Changes in Posttraumatic Stress Disorder After Resettlement Among Yazidi Female Refugees Exposed to Violence.

Importance: Posttraumatic stress disorder (PTSD) is highly prevalent among refugees surviving mass atrocities, especially among women. Longitudinal studies investigating factors associated with PTSD course are essential to enable adequate treatment yet widely lacking. Objective: To identify longitudinal changes in PTSD severity and posttraumatic coping among severely traumatized female refugees as well as risk and protective factors for PTSD course. Design, Setting, and Participants: This prospective cohort study took place in 14 German cities in the context of a humanitarian admission program that resettled 1000 especially vulnerable women and children from northern Iraq to Germany. Approximately 400 adult beneficiaries of the humanitarian admission program were eligible for the study. At baseline, a total of 116 of the 400 beneficiaries (29.0%) participated, with 96 (82.8%) of these women participating in the follow-up assessment. The study included a baseline assessment conducted 2 years after resettlement (September 1, 2017, to January 12, 2018) and a 1-year follow-up (August 29, 2018, to January 15, 2019). Exposures: Violence and/or captivity during the 2014 genocide in northern Iraq by the so-called Islamic State. Main Outcomes and Measures: Posttraumatic stress disorder severity and coping strategies were assessed in interpreter-aided interviews using the Impact of Event Scale-Revised. Results: A total of 116 women (mean [SD] age, 32.2 [8.2] years; 115 [99.1%] Yazidi; 1 [0.9%] Christian) participated at baseline. According to the Impact of Event Scale-Revised, a high PTSD severity was found (mean [SD] raw sum score, 60.88 [15.75] of 88, with higher scores indicating greater distress), with no significant change over time. Helpful coping strategies included prayer, belief in collective strength, and belief in personal strength. Earlier symptoms of intrusions (ß = 0.389, P = .007) and longer captivity (ß = 0.218, P = .02) were identified as being associated with PTSD severity 1 year later. Longer captivity was associated with PTSD aggravation over time (ß = 0.227, P = .04). Posttraumatic strengthening in faith (ß = -0.206, P = .05) and in social relationships (ß = -0.221, P = .03) were associated with a reduction in PTSD symptoms. Conclusions and Relevance: These findings suggest that female refugee survivors of genocide are at high risk for severe and chronic PTSD beyond the initial years of resettlement. The findings provide suggestions for mental health care specialized for particularly vulnerable populations.

Association of Combat Experiences With Suicide Attempts Among Active-Duty US Service Members.

Importance: There is uncertainty about the role that military deployment experiences play in suicide-related outcomes. Most previous research has defined combat experiences broadly, and a limited number of cross-sectional studies have examined the association between specific combat exposure (eg, killing) and suicide-related outcomes. Objective: To prospectively examine combat exposures associated with suicide attempts among active-duty US service members while accounting for demographic, military-specific, and mental health factors. Design, Setting, and Participants: This cohort study analyzed data from the Millennium Cohort Study, an ongoing prospective longitudinal study of US service members from all military branches. Participants were enrolled in 4 phases from July 1, 2001, to April 4, 2013, and completed a self-administered survey at enrollment and every 3 to 5 years thereafter. The population for the present study was restricted to active-duty service members from the first 4 enrollment phases who deployed in support of the wars in Iraq and Afghanistan. Questionnaire data were linked with medical encounter data through September 30, 2015. Data analyses were conducted from January 10, 2017, to December 14, 2020. Exposures: Combat exposure was examined in 3 ways (any combat experience, overall combat severity, and 13 individual combat experiences) using a 13-item self-reported combat measure. Main Outcomes and Measures: Suicide attempts were identified from military electronic hospitalization and ambulatory medical encounter data using the International Classification of Diseases, Ninth Revision codes. Results: Among 57 841 participants, 44 062 were men (76.2%) and 42 095 were non-Hispanic White individuals (72.8%), and the mean (SD) age was 26.9 (5.3) years. During a mean (SD) follow-up period of 5.6 (4.0) years, 235 participants had a suicide attempt (0.4%). Combat exposure, defined broadly, was not associated with suicide attempts in Cox proportional hazards time-to-event regression models after adjustments for demographic and military-specific factors; high combat severity and certain individual combat experiences were associated with an increased risk for suicide attempts. However, these associations were mostly accounted for by mental disorders, especially posttraumatic stress disorder. After adjustment for mental disorders, combat experiences with significant association with suicide attempts included being attacked or ambushed (hazard ratio [HR], 1.55; 95% CI, 1.16-2.06), seeing dead bodies or human remains (HR, 1.34; 95% CI, 1.01-1.78), and being directly responsible for the death of a noncombatant (HR, 1.81; 95% CI, 1.04-3.16). Conclusions and Relevance: This study suggests that deployed service members who experience high levels of combat or are exposed to certain types of combat experiences (involving unexpected events or those that challenge moral or ethical norms) may be at an increased risk of a suicide attempt, either directly or mediated through a mental disorder.

Long-Term Outcomes of Service Women Injured on Combat Deployment.

Sex- and gender-based health disparities are well established and may be of particular concern for service women. Given that injured service members are at high risk of adverse mental and behavioral health outcomes, it is important to address any such disparities in this group, especially in regard to patient-reported outcomes, as much of the existing research has focused on objective medical records. The current study addressed physical and mental health-related quality of life, mental health symptoms, and health behaviors (i.e., alcohol use, sleep, and physical activity) among a sample of service women injured on deployment. Results indicate that about half of injured service women screened positive for a mental health condition, and also evidenced risky health behaviors including problematic drinking, poor sleep, and physical inactivity. Many of the mental and behavioral health variables demonstrated statistically significant associations with each other, supporting the relationships between psychological health and behaviors. Results provide additional evidence for the importance of access to integrated and effective mental healthcare treatment for injured service women and the need for screening in healthcare settings that address the multiple factors (e.g., mental health symptoms, alcohol use, poor sleep) that may lead to poor outcomes.

War Atrocities and Growing Up: Risks We Have to Think About.

The establishment of the United Nations after World War II raised hopes of a new era of peace. This was over-optimistic. Between 1945 and 1992, there were 149 major wars, killing more than 23 million people. Recent developments in warfare have significantly heightened the dangers for children. During the last decade child war victims have included: 2 million killed; 4-5 million disabled; 12 million left homeless; more than 1 million orphaned or separated from their parents; some 10 million psychologically traumatized. Researches indicate that children do develop PTSD after experiencing very stressful, life-threatening events such as happen in war. Wars of 21st century are often guerrilla-type civil wars in which women and children are not only the main victims, but are deliberately targeted. Thousands are displaced both internally and across borders. Wars at the end of nineties of 20th century in the region of ex Yugoslavian countries brought all the cruelty of war vivid again on European ground. Population were exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. During the War in Bosnia and Herzegovina 1992-1995 there were about 100 000 people killed (20% woman and 3.5% children) and about 18 000 children were orphaned because of war. Children are not capable to regulate their emotions and hyper-arousal on their own. It depends of the way how their parents (caretaker) regulate her/his own emotions. During the war weak child's ego is paralyzed with intensive stimuli and floating anxiety, it does not manage to make constructive solution for traumatic experiences in such a short time. Mothers with small children are especially vulnerable group during the war time: they are supposed to take care about children and feel happiness, what is almost impossible Severe war experiences could cause depressive symptoms in mothers, what reduce their emotional disposability and could lead in different form of the child's neglecting. PTSD symptoms were lasting longer in children if their mothers have had functioning problems. Traumatization of mothers is connected with different behavior problems in their children. Wars are continuing all over the world and there is a continuity of researches about their consequences on children. Any programs that intend to mitigate the psychological effects of such trauma need to adopt a public health approach aimed at reaching many thousands.

Barriers to managing and delivery of care to war-injured survivors or patients with non-communicable disease: a qualitative study of Palestinian patients' and policy-makers' perspectives.

BACKGROUND: Improving access to optimal quality of care is a core priority and ambitious health policy goal in spite of impediments, threats and challenges in Palestine. Understanding the factors that may impede quality of care is essential in developing an effective healthcare intervention for patient with non-communicable disease (NCD) or war-injured survivors. METHODS: Qualitative interviews were performed using a purposive sampling strategy of 18 political-key informants, 10 patients with NCD and 7 war-injured survivors from different health facilities in Gaza Strip. A semi-structured interview guide was developed for data collection. The interviews were audio recorded and transcribed verbatim. Important field notes of the individual interviews were also reported. Thematic-driven analytic approach was used to identify key themes and patterns. RESULTS: From the policy maker's perspective, the following important barriers to accessing optimal healthcare for patients with NCD or war-injured survivors' treatment were identified; 1) organizational/structural 2) availability 3) communication 4) personnel/lack of staff 5) financial and political barriers. Patient with NCD or war-injury had similar experiences of barriers as the policy makers. In addition, they also identified socioeconomic, physical and psychological barriers for accessing optimal healthcare and treatment. CONCLUSIONS: The main perceived barriers explored through this study will be very interesting and useful if they are considered seriously and handled carefully, in order to ensure efficient, productive, cost-effective intervention and delivery of a high-standard quality of care and better disease management.

Mothering very young children after wartime deployment: A case report.

Parenting very young children in the context of military service, deployment separations, and war-related trauma can be challenging for many families. Female active duty personnel represent one of the fastest growing segments of the military, and recent policy changes have led women to pursue serving in combat positions at much higher rates. While not much is known about service member mothers, some studies have shown that they experience significant symptoms of distress, depression, and anxiety during the deployment cycle, feelings of disconnection from family during reintegration, and higher rates of childhood trauma histories than their male counterparts. Service member mothers who experience the combined stressors of deployment separation, combat exposure, and adverse childhood experiences-a triple threat-may be at serious risk of posttraumatic stress and depressive symptomatology, which can negatively influence the quality and nature of their parenting and parent-child relationships. This case report describes the participation of a young single service member mother and her preschool-aged daughter in a home-based, reintegration program designed for military families with very young children (ages 0-5). The paper illustrates how this relationship-based, reflective parenting intervention was effective in increasing the mother's sense of competence in her parenting and strengthening the parent-child relationship.

Criar a niños muy pequeños en el contexto del servicio militar, las separaciones debido a asignaciones militares de trabajo y el trauma relacionado con la guerra pueden representar un reto para muchas familias. Las mujeres, como miembros del personal activo con asignaciones militares, representan uno de los segmentos que aumentan más rápidamente dentro del campo militar, y los cambios recientes en las regulaciones han llevado a las mujeres a dedicarse al servicio en posiciones de combate en porcentajes mucho más altos. Aunque no mucho se sabe acerca de las madres que son miembros del servicio militar, algunos estudios han mostrado que ellas experimentan síntomas significativos de angustia, depresión y ansiedad durante el ciclo de asignación militar de trabajo, sentimientos de desconexión de la familia durante la reintegración, y más altos porcentajes de historias de trauma en la niñez que sus compañeros varones. Las mujeres en el servicio militar que experimentan la combinación de factores de estrés por la separación debido a la asignación de trabajo, el estar expuestas al combate, y las adversas experiencias de la niñez - una triple amenaza - pudieran encontrarse bajo un serio riesgo de estrés postraumático y sintomatología depresiva lo cual puede influir negativamente la calidad y naturaleza de la crianza y las relaciones progenitor-niño. Este reporte de caso describe la participación de una madre joven soltera miembro del servicio militar y su hija de edad prescolar dentro de un programa de reintegración con base en el hogar diseñado para familias militares con niños muy pequeños (edad 0-5). El ensayo ilustra cómo esta intervención de crianza con reflexión con base en la relación afectiva fue eficaz en lograr aumentar el sentido de competencia de la madre en cuanto a la crianza y fortalecer la relación progenitor-niño.

Le parentage de très jeunes enfants dans le contexte du service militaire, des séparations de déploiement et du trauma lié à la guerre peut s'avérer difficile pour bien des familles. Les femmes des forces armées représentent l'une des segments à la croissance la plus rapide des forces armées américaines et des changements politiques récents aux Etats-Unis ont amené les femmes à s'intéresser aux positions de combat à des taux beaucoup plus élevés qu'auparavant. Bien qu'on sache peu de choses sur les mères dans les forces armées, certaines études ont montré qu'elles font l'expérience de symptômes importants de détresse, de dépression et d'anxiété durant leur cycle de déploiement ainsi que de sentiments de déconnexion de la famille durant leur réintégration, et font preuve d'une incidence d'histoire de trauma de l'enfance bien plus élevée que leurs contreparties hommes. Les mères dans les forces armées qui font l'expérience d'une combinaison de facteurs de stress comme la séparation du déploiement, l'exposition au combat, et des expériences adverses de l'enfance - une triple menace - peut être à risque sérieux de stress post traumatique et d'une symptomatologie dépressive qui peut influencer la qualité et la nature de leur parentage et des relations parent-enfant de manière négative. Cette étude de cas décrit la participation d'une mère des forces armées jeune et célibataire et sa fille d'âge préscolaire dans un programme de réintégration à domicile pour les familles de militaires avec de très jeunes enfants (âges 0-5). Cet article illustre la manière dont cette intervention réflective, basée sur le parentage, était efficace pour l'augmentation du sens de compétence et confiance en son parentage de la part de la mère ainsi que pour le renforcement de la relation parent-enfant.

Intrusions related to indirectly experienced events in clinical offspring of World War Two survivors.

Negative events may not only linger on in the form of intrusive memories in the minds of those directly exposed but also in those who are only indirectly confronted with these events. The aim of the present study was to investigate if intrusions referring to indirectly experienced traumatic events do indeed occur, and to compare their frequency and characteristics to intrusions about directly experienced negative events. Participants (N = 98) were adult postwar offspring of World War Two survivors currently in treatment in one of two clinics specialized in the treatment of war victims. We examined the frequency and characteristics of intrusions about indirectly experienced (i.e., parent war-related) events and two types of directly (self-) experienced events: Self-experienced traumatic events and negative events related to participants' upbringing. Intrusions referring to indirectly experienced traumatic events did indeed occur. The frequency as well as other characteristics of these intrusions did not differ from those of both types of intrusions about directly experienced events. The similarities between intrusions related to different types of events emphasize the (re)constructive nature of memory. Our findings indicate that traumatic events not only affect those directly involved but may also continue to plague the next generation.

War trauma exposed refugees and posttraumatic stress disorder: The moderating role of trait resilience.

OBJECTIVE: Examining how exposure to pre-migration war related trauma and duration of living in refugee camp can impact on PTSD and psychiatric morbidity, while assessing the moderating role of trait resilience and coping style. METHODS: In a cross-sectional study, exposure to war related trauma and duration of living in refugee camp was evaluated in a sample of 83 asylum seekers and refugees from the Middle East, together with an assessment of PTSD and psychiatric morbidity via self-rating instruments. Trait resilience and coping style were also measured. RESULTS: Eighty-three participants were included in the analysis, 96.4% reported having experienced more than one war related traumatic event while the mean duration of living in refugee camps was 23.6 (SD = 7.6) years. Of the entire sample, 32.5% reached the threshold for clinical presence of PTSD and 38.8% for psychiatric morbidity. Both pre-migration war related trauma (F(1,82) = 24.118, p < .001) and duration of living in refugee camp (F(2,81) = 2.511, p = .008) were significantly associated with PTSD. Trait resilience moderated effects of high-profile trauma exposure on PTSD severity, R2 = 0.26, MSE = 0.547, F(3,79) = 9.6357, p < .0001, with higher resilience levels weakening the effect of traumatic exposure on PTSD development. CONCLUSIONS: Our results shed light on the ways that resilience can influence the relationship between war trauma exposure and PTSD symptoms. Findings support the role of resilience-based interventions in order to bolster resilient functioning and optimize treatment of this disadvantaged and highly distressed population.

Associations Among Exposure to Potentially Morally Injurious Experiences, Spiritual Injury, and Alcohol Use Among Combat Veterans.

Potentially morally injurious experiences (PMIEs) are events that may violate deeply held values or belief systems. Combat engagement places service members at a heightened risk for PMIE exposure. Exposure to PMIEs may elicit internal conflict between moral beliefs and experiences and, if unresolved, conflict may manifest as feelings of guilt, shame, and spiritual or existential crisis. Further, distress caused by these experiences may promote harmful behaviors (e.g., excessive alcohol use), which may serve as attempts to cope with PMIEs veterans have witnessed or participated in. The present study examined a sequential mediation model in which combat exposure was associated with alcohol use (i.e., alcohol consumption, dependence symptoms, and alcohol-related problems) via PMIE exposure and spiritual injury (e.g., alienation from and/or anger towards respective higher power) in a community sample of 380 recent-era combat veterans. Multiple-group sequential mediation was then used to examine whether the model fit similarly across men and women. Exposure to PMIEs and spiritual injury sequentially mediated the association between combat and alcohol; higher levels of PMIE exposure and spiritual injury were associated with increased alcohol use, R2 = .17, f2 = 0.07. The multiple-group model showed that these associations significantly varied between genders such that the mediation was only significant among men. The results indicated that PMIEs and spiritual injury were associated with increased alcohol use, but these associations differed as a function of gender. Future research is needed to refine our understanding of moral and spiritual injury and explore possible risk and protective factors.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Las Asociaciones entre la Exposición a Experiencias Potencialmente Dañinas Moralmente, Daño Espiritual, y el Uso de Alcohol Entre Combatientes Veteranos EXPOSICION, DAÑO ESPIRITUAL, Y USO DE ALCOHOL Las experiencias potencialmente dañinas moralmente (PMIEs en su sigla en inglés) son eventos que pueden transgredir los valores profundamente arraigados o los sistemas de creencias. La participación en combates posiciona a los miembros en servicio en un más alto riesgo de exposición a las PMIEs. La exposición a las PMIEs puede provocar conflictos internos entre las creencias morales y las experiencias y, si no son resueltos, el conflicto puede manifestarse como sentimientos de culpa, vergüenza, y crisis espirituales o existenciales. Además, el malestar causado por estas experiencias puede promover conductas dañinas (por ej., uso excesivo de alcohol), las cuales pueden servir como intentos para lidiar con las PMIEs que los veteranos han observado o en las que ellos han participado. En el presente estudio, en una muestra comunitaria de 380 combatientes veteranos de la era reciente, se examinó un modelo de mediación secuencial en el cual la exposición al combate fue asociada con el uso de alcohol (por ej., consumo de alcohol, síntomas de dependencia, y problemas asociados al alcohol) por medio de la exposición a las PMIEs y el daño espiritual (por ej., alienación y enojo contra una deidad). Una mediación secuencial de grupos múltiples fue luego usada para examinar si el modelo se ajustaba similarmente entre hombres y mujeres. La exposición a las PMIEs y el daño espiritual mediaron secuencialmente la asociación entre el combate y el alcohol; niveles más altos de exposición a las PMIEs y el daño espiritual se asociaron con mayor uso de alcohol, R2 = .17, f2 = 0.07. El modelo de grupos múltiples mostró que estas asociaciones variaron significativamente entre los géneros, de manera tal que la mediación fue solamente significativa entre los hombres. Los resultados indican que las PMIEs y el daño espiritual se encuentran asociados con un mayor uso de alcohol, pero estas asociaciones son diferentes dependiendo del género. Las futuras investigaciones son necesarias para mejorar nuestro entendimiento del daño moral y espiritual y explorar posibles factores de riesgo y protectores.

Moral injury and suicidality among combat-wounded veterans: The moderating effects of social connectedness and self-compassion.

OBJECTIVE: Among combat veterans, moral injury (i.e., the guilt, shame, inability to forgive one's self and others, and social withdrawal associated with one's involvement in events that occurred during war or other missions) is associated with a host of negative mental health symptoms, including suicide. To better inform and tailor prevention and treatment efforts among veterans, the present study examined several potential risk (i.e., overidentification and self-judgment) and protective (i.e., self-kindness, mindfulness, common humanity, and social connectedness) variables that may moderate the association between moral injury and suicidality. METHOD: Participants were 189 combat wounded veterans (96.8% male; mean age = 43.14 years) who had experienced one or more deployments (defined as 90 days or more). Nearly all participants reported a service-connected disability (n = 176, 93.1%) and many had received a Purple Heart (n = 163, 86.2%). RESULTS: Within a series of moderation models, we found 3 statistically significant moderation effects. Specifically, the association between self-directed moral injury and suicidality strengthened at higher levels of overidentification, that is, a tendency to overidentify with one's failings and shortcomings. In addition, the association between other-directed moral injury and suicidality weakened at higher levels of mindfulness and social connectedness. CONCLUSIONS: These findings provide insight on risk and protective factors that strengthen (risk factor) or weaken (protective factor) the association between moral injury and suicidality in combat-wounded veterans. Taken together, mindfulness, social connectedness, and overidentification are relevant to understand the increased/decreased vulnerability of veterans to exhibit suicidality when experiencing moral injury. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Moral Injury and Spiritual Struggles in Military Veterans: A Latent Profile Analysis.

War-related traumas can lead to emotional, relational, and spiritual suffering. Drawing on two community samples of war zone veterans from diverse military eras (Study 1, N = 616 and Study 2, N = 300), the purpose of this study was to examine patterns of constellations between outcomes related to moral injury (MI) and common ways in which veterans may struggle with religion or spirituality, defined as divine, morality, meaning, interpersonal, and doubt. Results from latent profile analyses revealed three distinct classes across the samples, based on psychometrically validated instruments: (a) no MI-related outcomes or spiritual struggles (nondistressed group; Study 1 = 72.7%, Study 2 = 75.0%); (b) MI-related outcomes and equivalent or lower degrees of spiritual struggles relative to MI-related outcomes (psychological MI group; Study 1 = 19.2%, Study 2 = 17.0%); and (c) MI-related outcomes and salient struggles with religious faith or spirituality, both within their own profiles and compared to other groups (spiritual MI group; 8.1% and 8.0% in the two samples). When we compared severity of spiritual struggles within MI groups, turmoil with God or a higher power emerged as a defining feature of the spiritual MI group in both samples. In addition, secondary analyses revealed membership in this third group was linked with greater importance of religion or spirituality before military service, χ2 (1, N = 616 and 300) = 4.468-8.273. Overall, although more research is needed, these findings highlight the possible utility of differentiating between psychological and spiritual subtypes of MI according to war zone veterans' religious or spiritual backgrounds.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Daño moral y luchas espirituales en veteranos de guerra: Un análisis de perfil latente DAÑO MORAL Y LUCHAS ESPIRITUALES Los traumas relacionados con la guerra pueden llevar al sufrimiento emocional, relacional, y espiritual. Basado en dos muestras comunitarias de veteranos de la zona de guerra de diversas épocas militares (Estudio 1, N = 616 y Estudio 2, N = 300), el objetivo de este estudio fue examinar los patrones de las constelaciones entre los resultados relacionados con el daño moral (DM) y las formas comunes en las que los veteranos pueden lidiar con la religión y/o la espiritualidad, definidas como divinas, moralidad, significado, interpersonal, y duda. Los resultados de los análisis de perfiles latentes revelaron tres clases distintas, basadas en instrumentos validados psicométricamente, en todas las muestras, aquellas con: (a) Los resultados no relacionados con el DM o luchas espirituales (grupo sin malestar psicológico, Estudio 1 = 72.7%, Estudio 2 = 75.0); (b) Los resultados relacionados con el DM y grados equivalentes o más bajos de luchas espirituales en relación con los resultados relacionados con el DM (grupo de DM psicológico; Estudio 1 = 19.2%, Estudio 2 = 17.0); y (c) Los resultados relacionados con el DM y las luchas salientes con la fe religiosa y/o la espiritualidad, tanto dentro de sus propios perfiles como en comparación con otros grupos (grupo de DM espiritual; 8.1 y 8.0% en las dos muestras). Cuando comparamos la severidad de las luchas espirituales dentro de los grupos DM, la confusión con Dios o un poder superior emergió como una característica definitoria del grupo espiritual DM en ambas muestras. Además, los análisis secundarios revelaron que la pertenencia a este tercer grupo se relacionaba con una mayor importancia de la religión y/o la espiritualidad antes del servicio militar, χ2 (1, N = 616 y 300) = 4.468-8.273. En general, aunque se necesita más investigación, estos hallazgos resaltan la posible utilidad de diferenciar entre los subtipos psicológicos y espirituales de DM según los antecedentes religiosos y/o espirituales de los veteranos de la zona de guerra.

Morally injurious experiences and mental health: The moderating role of self-compassion.

INTRODUCTION: Military veterans are at heightened risk for developing mental and behavioral health problems. Morally injurious combat experiences have recently gained empirical and clinical attention following the increased rates of mental and behavioral health problems observed in this population. OBJECTIVE: Extending extant research, the current investigation assessed the relationship between morally injurious experiences and mental and behavioral health outcomes. Furthermore, it examined the potential protective role of self-compassion in these relationships. METHOD: Participants were 203 military veterans (M age = 35.08 years, 77.30% male) who completed online questionnaires. RESULTS: Analyses indicated that self-compassion significantly moderated the relationship between exposure to morally injurious experiences and posttraumatic stress disorder, depression severity, and deliberate self-harm versatility. CONCLUSIONS: These results highlight the potential clinical utility of self-compassion in military mental health, particularly in the context of morally injurious experiences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).