The Health and Wellbeing of Armed Forces Veterans in Northern Ireland: The Results of a Cross-sectional Psychological Wellbeing Survey
Abstract: Overview: This report details the findings of the Northern Ireland Veteran Health and Wellbeing Study (NIVHWS) psychological wellbeing survey; a cross-sectional survey designed to collect data directly from veterans of the UK Armed Forces residing in Northern Ireland (NI). The report provides a methodological overview of study procedures and the resultant sociodemographic profile of the 1267 respondents. In addition, the report presents headline results on respondents’ favourable and unfavourable military experiences, physical and mental health and mental health service utilisation and help-seeking. Methods: The NIVHWS is a large-scale cross-sectional survey of the adult (18+) veteran population within NI (N= 1267; 88% were male). The survey was administered using online survey methods, via the survey software platform ‘Qualtrics’ and via traditional pen and paper format. Participants were recruited via (1) a large-scale social media campaign, (2) newspaper advertising, (3) veteran service providers and (4) engagements with veterans at Armed Forces events such as Armed Forces Day. This is a valuable data source and is the first of its kind concerning the health and wellbeing of military veterans in NI. The sociodemographic profile has similarities to that of veterans residing in Great Britain (male [89% vs 88% in the current study], older ([60% were over 65 vs 20% over 65 and 53% over at least 55 in the current study], married or in a civil partnership [62% vs 72% in the current sample] and had at attained at least one educational qualification [92% vs 80% in the current sample], however it is pertinent to be clear that we do not know if the data is representative of all veterans residing in NI as the total population size and characteristic remain unknown. Taken together these initial findings highlight the importance of developing a concrete evidence base around the health and wellbeing of veterans residing in NI. The NIVHWS survey has collected vast amounts of quantitative date which over time will solidify a concrete evidence base upon which appropriate services can be developed and implemented to support veterans residing in NI. These results can therefore be used as a locally focused resource by clinicians, policy makers, and funders of key services which aim to support veterans residing in NI.
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.