Outside the realm of combat: The relationship of cumulative trauma with perceived military betrayal and military-related posttraumatic stress disorder symptoms

Abstract: The relationship between lifetime trauma history and posttraumatic stress disorder (PTSD) severity has been established, though the relationship between lifetime trauma history and military-related PTSD symptoms (M-PTSS) has been predominantly studied in reference to childhood trauma alone. The current study was designed to assess the contribution of lifetime trauma history and conflictual military experiences (potentially morally injurious events [PMIEs]) to the experience of M-PTSS and whether the relationship between lifetime trauma history and M-PTSS was mediated by the experience of moral injury during military service. Around 357 Israeli, male, combat veterans completed questionnaires concerning their lifetime trauma history, M-PTSS, and PMIEs as part of a wider study on veteran transition. A regression analysis indicated that higher exposure to PMIEs predicted higher M-PTSS, with betrayal demonstrating the strongest relationship. Furthermore, lifetime traumas predicted M-PTSS, which was partially mediated by betrayal-based PMIEs. Cumulative lifetime trauma history is a potential risk factor for military-related PTSD, in part via an enhanced tendency to appraise betrayal. The current study suggests that adapting commanding doctrines may be beneficial for military-related PTSD prevention and that screening for lifetime trauma exposure may offer an opportunity for targeted support during service. Additionally, viewing betrayal in the military in relation to lifetime trauma history offers an opportunity for integration in therapy.

Read the full article
Report a problem with this article

Related articles

  • More for Researchers

    Outcomes from a posttraumatic growth-oriented program among Veterans: A quasi-experimental retrospective study

    Abstract: Objective: The present study is a retrospective quasi-experimental study to evaluate the effectiveness of the Warrior PATHH (WP) program at improving posttraumatic growth (PTG) outcomes and reducing PTSD symptoms compared to a waitlist control among a sample of Veterans. Method: Participants (n = 164) were U.S. military Veterans with a history of trauma. Participants were either undergoing the Warrior PATHH program or a waitlist. Primary outcome measures were administered at baseline and at 90-day follow-up and consisted of the Posttraumatic Growth Inventory – Expanded (PTGI-X) and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). Secondary outcome measures assessed psychosocial functioning and included measures of depression and anxiety symptoms, sleep, wellbeing, and social support. Results: Significant differences were observed between groups on the PTGI-X (F(1, 205) = 23.667, p < .001, partial η2 = 0.103), and the PCL-5 (F(1, 205) = 262.460, p < .001, partial η2 = 0.561) with the WP group showing significant positive psychological change following a traumatic event as measured by the PTGI-X and decreased PTSD symptoms as measured by the PCL-5 compared to those in the waitlist condition. Those in the treatment arm also demonstrated gains to psychosocial functioning. Conclusions: Consistent with previous research, participants in the Warrior PATHH program exhibited significant increases in PTG outcomes, decreased PTSD symptoms, and broad improvements to psychosocial functioning. These findings suggest it is an effective training program to foster PTG outcomes among Veterans. This study is unique as it is the first to compare the effects of WP programming with a sample of waitlisted Veterans.