Family and occupational functioning following military trauma exposure and moral injury

Victoria Williamson*, Dominic Murphy, Sharon A.M. Stevelink, Edgar Jones, Shannon Allen, Neil Greenberg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction Evidence is growing regarding the impact of potentially morally injurious events (PMIEs) on mental health; yet how moral injury may affect an individual’s occupational and familial functioning remains poorly understood.

Method Thirty male veterans who reported exposure to either traumatic or morally injurious events and 15 clinicians were recruited for semi-structured qualitative interviews.

Results While many veterans experienced psychological distress postevent, those who experienced PMIEs especially reported social withdrawal and engagement in aggressive, risk-taking behaviours. This was highly distressing for family members and created a tense, volatile home and workplace environment that was difficult for others to navigate. Following PMIEs, employment could be used as a cognitive avoidance strategy or as a means to atone for transgressive acts. In cases of moral injury, clinicians considered that targeted support for spouses and accessible guidance to help children to better understand how their military parent may be feeling would be beneficial.

Conclusions This study provides some of the first evidence of the pervasive negative impact of PMIEs on veterans’ familial and occupational functioning. These findings highlight the need to comprehensively screen for the impact of moral injury on daily functioning in future studies that goes beyond just an assessment of psychological symptoms.
Original languageEnglish
Pages (from-to)205-211
JournalBMJ Military Health
Issue number3
Early online date8 Mar 2021
Publication statusPublished - 1 Jun 2023
Externally publishedYes

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