Gender differences in reported potentially morally injurious events among post-9/11 U.S. combat veterans, using two measures

Abstract

Objective: Military experiences that violate one’s sense of right and wrong (i.e., potentially morally injurious events [PMIEs]) may result in moral injury, characterized by shame, guilt, demoralization, self-condemnation, and social withdrawal. The objective of this study was to examine gender-related differences in the rate of reporting PMIEs. Method: Secondary analyses were conducted on a previously collected longitudinal cohort study of postdeployment functioning among U.S. post-9/11 combat veterans in Central Texas (N = 406). As part of the parent study, participants completed two measures of PMIEs—the Moral Injury Events Scale (MIES; Nash et al., 2013) and the Moral Injury Questionnaire–Military Version (MIQ-M; Currier et al., 2015). Gender differences at the item response level were analyzed in a series of Bayesian multilevel item response theory models. Results: The most frequently endorsed responses on both the MIES and MIQ-M for both men and women were never or strongly disagree. On the MIQ-M, more veteran men endorsed experiencing PMIEs to some degree. On the MIES, more veteran wom betrayal items. Conclusions: Veteran men and women reported anyan men and women reported any PMIE occurring at relatively high rates. Gender differences at the item response level were found for most items on both the MIES and MIQ-M, albeit of small magnitude. Awareness of gender differences in the likelihood of experiencing a given PMIE may help in case conceptualizations.

Clinical Impact Statement: Veteran men and women both report potentially morally injurious military experiences; men and women may report slightly different types of potentially morally injurious events. However, the method of assessment—asking about specific combat experiences versus appraisals of morally wrong or betrayal events—may account for some gender-based differences in rates of moral injury events. Veteran men and women’s history of potentially morally injurious events should be assessed using multiple methods.

@article{myersGender2025,
  title = {Gender differences in reported potentially morally injurious events among post-9/11 {U.S.} combat veterans, using two measures},
  author = {Morgan N. Myers and A. Solomon Kurz and Jasmyn Paul and Marcus G. Wild and Sheila Frankfurt O'Brien},
  journal = {Psychological Trauma: Theory, Research, Practice, and Policy},
  year = 2025,
  volume = 17,
  issue = 8,
  page = 1751-1761,
  doi = {https://doi.org/10.1037/tra0001782}
}