Rates of potentially morally injurious events, combat, and lifetime traumas among Black/African American, White, Hispanic/Latino/a/e and non-Hispanic/Latino/a/e U.S. combat veterans

Abstract

Objective: Potentially morally injurious events (PMIEs) involve transgressions of one’s deeply held sense of right and wrong. Race-related stress may be a source of PMIEs, but no studies have investigated how PMIE exposures differ by racial or ethnic identity. This study explored variations in reported rates of PMIEs among Black/African American, White, Hispanic/Latino/a/e, and non-Hispanic/Latino/a/e United States post-9/11 combat veterans. Methods: Secondary data analysis were conducted using observational cohort data from a repository on post-deployment functioning among combat veterans ($n = 487$). Participants completed two measures of PMIEs (Moral Injury Questionnaire – Military Version [MIQ-M], Currier et al., 2015; Moral Injury Events Scale [MIES], Nash et al., 2013) and measures of combat exposure and trauma exposure. Participants self-identified as White (57 %), Black or African American (31 %), Hispanic/Latino/a/e (20 %), and non-Hispanic/Latino/a/e (80.5 %). Racial/ethnic differences were analyzed at the item level using item response theory models. Results: All latent mean differences between racial and ethnic groups on the PMIE measures were small. The largest difference was between Black/African American and White veterans on the MIES ($d = 0.38$) and the smallest difference was between Hispanic/Latino/a/e and non-Hispanic/Latino/a/e veterans on trauma exposure ($d = −0.01$). Conclusions: Possible reasons for results include that: 1) between-group differences are negligible; 2) differences are greater within groups than between groups; 3) the MIES and MIQ-M do not assess race-based PMIEs. Future studies should use mixed methods to investigate cultural processes operative in PMIEs with an emphasis on the perspectives of people from diverse racial and ethnic identities.

@article{harrisRates2026,
  title = {Rates of potentially morally injurious events, combat, and lifetime traumas among {Black/African American}, {White}, {Hispanic/Latino/a/e} and non-{Hispanic/Latino/a/e} {U.S.} combat veterans},
  author = {Emma Harris and Sheila F. O'Brien and A. Solomon Kurz and Alison Krauss and Lance Roehl and Marcus G. Wild},
  journal = {Journal of Psychiatric Research},
  year = 2026,
  volume = 192,
  page = 59-68,
  doi = {https://doi.org/10.1016/j.jpsychires.2025.10.029}
}