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Suicide and Self-Injury

Moral injury and suicidal ideation among female National Guard members: The mediating role of perceived burdensomeness and thwarted belongingness

(PS2-A17) Moral Injury and Suicidal Ideation Among Female National Guard Members: The Mediating Role of Perceived Burdensomeness and Thwarted Belongingness

Friday, November 18, 2022

10:30 AM – 11:30 AM EST

Location: Westside Ballroom, 5th Floor

Author(s)

MS

Mary O. Shapiro, Ph.D.

Clinical Investigator
Southeast Louisiana Veterans Health Care System
New Orleans, Louisiana

Co-Author(s)

Claire Houtsma, Ph.D.

Clinical Investigator and Suicide Prevention Coordinator
Southeast Louisiana Veterans Health Care System
New Orleans, Louisiana
KS

Katherine Schafer, M.S.

Psychology intern
Southeast Louisiana Veterans Health Care System
New Orleans, Louisiana
LM

Laura Miller, M.D.

Professor of Psychiatry
Loyola University Chicago
Evanston, Illinois
MA

Michael D. Anestis, Ph.D.

Executive Director
New Jersey Gun Violence Research Center
Milltown, New Jersey
GT

Gala True, Ph.D.

Associate Professor
US Department of Veterans Affairs
New Orleans, Louisiana

Moral injury, or an individual’s distress following a traumatic or morally unjust event, is common among service members and veterans as they are often exposed to stressful events that may violate their morals and beliefs. Numerous reports have linked moral injury with suicidal ideation and outcomes; however, little is known regarding mechanisms that may influence this association. According to empirically supported theories of suicide, thwarted belongingness (i.e., feeling disconnected from others) and perceived burdensomeness (i.e., feeling you are a burden to others) may lead to increased suicidal ideation. Further, nascent research has linked thwarted belongingness and perceived burdensomeness with moral injury. However, no work to date has examined whether thwarted belongingness and perceived burdensomeness explain the association between moral injury and suicidal ideation. The current sample consisted of 151 female National Guard members recruited as part of a larger research study. Results indicated a significant indirect effect of moral injury on suicidal ideation via thwarted belongingness (B = .002, 95% CI [.001, .007]). In addition, findings indicated a significant indirect effect of moral injury on suicidal ideation via perceived burdensomeness (B = .003, 95% CI [.001, .008]). Findings from the current study are important as they provide additional support for empirical theories of suicide and offer insight into potential mechanisms by which moral injury may indirectly confer increased risk for suicide. Given that previous research linking moral injury and suicide outcomes has primarily focused on men, our work extends the extant literature by examining these associations among a unique sample of female service members. In addition, the current findings have clinical implications. Specifically, previous intervention research has identified that thwarted belongingness and perceived burdensomeness are malleable via brief intervention. These results are promising and suggest that it is worth studying whether these interventions could reduce suicidality in women who have experienced moral injury. Limitations of the current study include the cross-sectional and concurrent nature of our data and future research should investigate the temporal sequence and causal relationships among these constructs.