Lives in Transition: returning to civilian life with a physical injury or condition. Final report.
Executive Summary: This report presents the final findings of a project funded by Forces in Mind Trust (FiMT) called Understanding the transition to civilian life for ex-service personnel with physical conditions as a direct result of service or acquired whilst in service. Running from April 2019to October 2021, this project was the #rst substantive qualitative longitudinal research (QLR) to explore how service leavers experience the transition to civilian life when they have left the Armed Forces with a physical injury or condition. Despite the prevalence of physical conditions and injuries as a factor in leaving service, there is limited research that provides a holistic view of the experiences of this cohort. Our project was therefore structured to provide an exploration of the various stages of people’s journeys from injury/condition within service through to accessing civilian systems, support and employment.
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.