UNIVERSITY PARK, Pa. — A recent study, led by researchers at the Clearinghouse for Military Family Readiness at Penn State, is the first to examine the relationship between moral injury and social well-being over a long period of time. The study included nearly 10,000 veterans who were followed for three years.

Moral injury (MI) occurs when one engages in self-directed MI, witnesses it, or is the victim of someone else’s (other-directed MI) transgressions that violate deep-seated beliefs concerning right and wrong (e.g., harming or killing civilians, witnessing atrocities of war, experiencing sexual violence). Moral injury is associated with a number of psychological symptoms. Social well-being (SWB) includes social support, social functioning (i.e., being able to fulfill social roles and obligations), social activity (i.e., actively connecting with others and the community), and satisfaction with one’s social network.

“Research is beginning to show that MI can have a significant impact on veterans,” stated Ryan Chesnut, assistant research professor at the Clearinghouse. “Unfortunately, these impacts can last for a very long time and little is known about how MI is experienced by people over time.”

Unique to this study was the examination of two types of MI: self-directed and other-directed. Self-directed and other-directed MI had different effects on veterans’ SWB.

“First, MI was associated with poorer SWB and significantly declining SWB at both baseline and over the course of the nearly three-year timeframe,” indicated Daniel F. Perkins, professor and principal scientist of the Clearinghouse. “Those who experienced other-directed MI had lower levels of all SWB domains at baseline, and they experienced declines in social functioning and social satisfaction across time.”

Moreover, veterans who experienced self-directed MI had significantly lower levels of social functioning but higher levels of social activity at baseline. However, self-directed MI was related to a decline in social activity across the study’s timeframe.

“Our work demonstrated that MI has a negative impact on post-9/11 veterans and that different types of MI had somewhat different impacts on SWB,” said Chesnut. “One implication of the study results is that MI needs to be identified and treated among veterans. The second is that professionals treating those with MI should specifically identify the type of MI the veteran has.”

The study, titled “Exploring Moral Injury: Theory, Measurement, and Applications,” appears in the journal Military Behavioral Health.

The Clearinghouse for Military Family Readiness is an applied research center committed to advancing health and well-being of service members, veterans, and their families. The Clearinghouse takes a solution-oriented approach that includes writing research reports, conducting applied research studies, building workforce expertise through training and resource provision, implementing and evaluating evidence-informed programs and practices, and delivering objective data and policy-relevant findings so that decisions are based on the best science and evidence available. The Clearinghouse is located within Penn State’s Social Science Research Institute.

The Veterans Metrics Initiative research was managed by the Henry M. Jackson Foundation for the Advancement of Military Medicine Inc. (HJF); and collaboratively sponsored by the Bob Woodruff Foundation, Health Net Federal Services, The Heinz Endowments, HJF, Lockheed Martin Corporation, May and Stanley Smith Charitable Trust, National Endowment for the Humanities, Northrop Grumman, Philip and Marge Odeen, Prudential, Robert R. McCormick Foundation, Rumsfeld Foundation, Schultz Family Foundation, Walmart Foundation, Wounded Warrior Project Inc., and the Veterans Health Administration Health Services Research and Development Service.