Award Date

August 2025

Degree Type

Thesis

Degree Name

Master of Arts (MA)

Department

Psychology

First Committee Member

Stephen Benning

Second Committee Member

Shane Kraus

Third Committee Member

Nicole Short

Fourth Committee Member

Robert Pietrzak

Fifth Committee Member

Nicholas Barr

Number of Pages

130

Abstract

Moral injury is an experience of psychological distress that occurs when a person’s morals are violated by themselves or others, including institutions and organizations. Such violations of morality can be impairing and have high rates of comorbidity with internalizing disorders (posttraumatic stress, depression, anxiety, suicidality), which may indicate that moral injury is a transdiagnostic construct. This study had four aims, which were accomplished using from a nationally representative, probability-based sample of 1,353 US military veterans. In the first aim, we created structural models of moral injury using the Moral Injury Events Scale (for which a bifactor structure with a specific factor of perceived betrayals fit best) and posttraumatic stress using the PTSD checklist for DSM-5 (for which a seven correlated factors model fit best). The second aim created a bifactor structural model of disinhibited externalizing with symptoms of alcohol use, drug use, and gambling disorders as markers of the general factor alone, with a specific second-order normal-range inhibitory personality factor comprising traits of conscientiousness, cognitive impulsivity, and grit. In the third aim, we found that the general factor of moral injury was associated with the unique variance in the reexperiencing factor of PTSD along with disinhibited personality traits and drug and gambling use disorder symptoms.The perceived betrayals factor was associated with the unique variance in the anhedonia factor of PTSD. In the fourth aim, we verified that these relationships remained after adjusting for lifetime trauma and combat exposure. These results highlight the importance of examining these constructs at multiple levels to understand their relationships and formulate treatments targeted at the appropriate level of symptom presentation.

Keywords

alcohol use disorder; at-risk problem gambling; drug use disorder; grit; moral injury; posttraumatic stress disorder

Disciplines

Clinical Psychology | Personality and Social Contexts | Statistics and Probability

File Format

pdf

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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