Moral injury, suicidal ideation, and suicide attempts in a military sample

Moral injury entails emotional distress associated with perceived violations of one’s moral code and has been proposed to be a possible contributor to self-injurious thoughts and behaviors (SITB) among military personnel. Three dimensions of moral injury have previously been empirically derived: transgressions committed by others (Transgressions-Others), transgressions committed by oneself (Transgressions-Self), and perceived betrayal by others (Betrayal). The current study examined the relationship of these dimensions of moral injury with SITB in a clinical sample of 151 active duty military personnel. Transgressions-Other and Transgressions-Self were significantly higher among personnel with a history of suicide attempt relative to history of suicidal ideation and no suicidality (Hedge’s g’s > .64). Transgressions-Self was associated with significantly more severe suicidal ideation during the past week (p = .018).