Moral injury and suicide ideation among combat veterans: The moderating role of self-disclosure

Abstract

Introduction Modern warfare in a civilian setting may expose combatants to severe moral challenges. Whereas most of these challenges are handled effectively, some potentially morally injurious events (PMIEs) may have deleterious psychological effects on the combatants, such as suicide ideation (SI). Self-disclosure, which includes sharing distressing thoughts and emotions, has been recognized as a protective factor against SI in the aftermath of stressful events. Objectives The current study is the first to examine the moderating role of self-disclosure in the relationship between PMIEs exposure and SI among combat veterans. Methods A sample of 190 recently discharged Israeli combat veterans completed validated self-report questionnaires in a cross-sectional design study, tapping combat exposure, PMIEs, depressive symptoms, SI, and self-disclosure. Results PMIE dimensions, and self-disclosure significantly contributed to current SI. Importantly, the moderating model indicated that self-disclosure moderated the link between PMIE-Self and current SI , as PMIE-Self and current SI were more strongly associated among veterans with low levels of self-disclosure than among high self-disclosing veterans. Conclusions Self-disclosure, as a factor promoting a sense of belongingness, interpersonal bonding, and support, might reduce SI risk following PMIE exposure. Various mechanisms accounting for these associations are suggested, and clinical implications of these interactions are discussed. Disclosure of Interest Y. Levi-Belz Shareolder of: no, Grant / Research support from: no, Consultant of: no, Employee of: no, Paid Instructor of: no, Speakers bureau of: no