Determinants of successful transition literature review
Abstract:Â Introduction: To understand the current Canadian research on transition from military to civilian life, the Office of the Veterans Ombudsman (OVO) initiated a literature review of peer-reviewed work from both academic and government sources, to help identify which factors contribute to a successful transition to civilian life for medically-released Canadian Armed Forces (CAF) Veterans. Methods: A scoping review was conducted by searching Embase, MEDLINE, PsycINFO, Google Scholar and the Veterans Affairs Canada (VAC) Research Directorate website for Canadian articles that described transition facilitators in any of the domains identified by the OVO. Results: In total, 94 relevant studies were identified and most of these focused on all Veterans without identifying a medical or non-medical release. Only 18 addressed the determinants of successful transition and only 2 focused on investigating transition issues for medically-released CAF Veterans compared to their non-medically-released peers. Discussion: The largest limitation found in the literature is the scarcity of articles related to identifying the factors that facilitate a successful transition for medically-released CAF Veterans. A further limitation is that the majority of surveys conducted were based on cohorts that had not experienced transition under the New Veterans Charter (NVC), implemented in 2006, or had only a small number of NVC subjects in their cohort. Given the significant policy and program changes implemented with the NVC, this is a compelling rationale for the requirement of more Canadian research to determine the effectiveness of the NVC policy and programs on transition outcomes for Canadian Veterans.
Abstract: Background: Exposure to potentially morally injurious events (PMIEs) during military service can lead to moral injury (MI) outcomes and posttraumatic stress symptoms (PTSS). This longitudinal study examined the relationships between PMIE exposure, MI outcomes, and PTSS among Israeli combat veterans, and the potential protective role of dispositional forgiveness in these associations. Method: Participants were 169 Israeli combat veterans who participated in a six-year longitudinal study with four measurement points (T1: 12 months before enlistment, T2: Six months following enlistment- pre-deployment, T3: 18 months following enlistment- post-deployment, and T4: 28 months following discharge). Participants’ characteristics were assessed via semi-structured interviews (T1) and validated self-report measures (T2-T4) between 2019-2024. Results: Approximately 36% of participants reported exposure to PMIEs during service, with 13% exceeding the clinical threshold for probable PTSD at T4. PMIE-Betrayal at T3 was positively associated with MI outcomes of shame and trust violation at T4. The indirect effect of PMIEs on PTSS through MI outcome-Shame depended on forgiveness levels. Among veterans with low forgiveness, higher exposure to PMIE-Betrayal was associated with increased MI shame, which was linked to more severe PTSS. Conversely, for those with high forgiveness, exposure to PMIE-Self and Other was associated with decreased MI shame and subsequently reduced PTSS. Conclusion: Dispositional forgiveness moderates the relationship between PMIE exposure and MI outcomes, particularly shame, which mediates the development of PTSS. These findings highlight forgiveness as a potential target for intervention in treating moral injury and preventing PTSS among combat veterans.