Moral struggles involve internal conflict regarding inconsistencies between one's higher values and the actions of the self and may include guilt, shame, contempt, disgust, and anger. Previous research in civilian populations revealed several factors that might predispose people to moral struggles. The current study sought to replicate and extend this research in a sample of 178 U.S. veterans (83% male) receiving care at a Veterans Affairs hospital and affiliated outpatient clinics. Regression analyses identified several concurrent predictors of moral struggles: higher religiousness, lower self-esteem, and attributing one's religious/spiritual struggles to oneself and the military. Moral struggles also showed a modest, positive association with a scale assessing morally injurious events and inner conflicts that arose from such events. Exploratory, longitudinal path analyses showed that, at a 6-month follow-up, lower self-esteem predicted increased moral struggles. Path analyses also showed that increases in religiousness, increases in attribution of one's religious/spiritual struggles to oneself, and increases in scores on a measure of potentially morally injurious experiences were related to increases in moral struggles. Taken together, these results point to a constellation of religious/spiritual, psychosocial, and military factors that play unique roles in the development and maintenance of moral struggles in a veteran sample.
- Moral struggles
- Morally injurious events
- Religious/spiritual struggles
ASJC Scopus subject areas
- General Nursing
- Emergency Medicine
- Public Health, Environmental and Occupational Health