436
Views
0
CrossRef citations to date
0
Altmetric
Basic Research Article

Potentially morally injurious experiences and associated factors among Dutch UN peacekeepers: a latent class analysis

Experiencias potencialmente dañinas para la moral y factores asociados entre el personal holandés de mantenimiento de la paz de la ONU: un análisis de clases latentes

ORCID Icon, ORCID Icon, ORCID Icon, ORCID Icon & ORCID Icon
Article: 2332105 | Received 26 Oct 2023, Accepted 11 Mar 2024, Published online: 05 Apr 2024

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
  • Asparouhov, T., & Muthén, B. (2014). Auxiliary variables in mixture modeling: Three-step approaches using M plus. Structural Equation Modeling: A Multidisciplinary Journal, 21(3), 329–341. https://doi.org/10.1080/10705511.2014.915181
  • Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059
  • Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20. https://doi.org/10.1037/0003-066X.59.1.20
  • Bovin, M. J., Marx, B. P., Weathers, F. W., Gallagher, M. W., Rodriguez, P., Schnurr, P. P., & Keane, T. M. (2016). Psychometric properties of the PTSD checklist for diagnostic and statistical manual of mental disorders–fifth edition (PCL-5) in veterans. Psychological Assessment, 28(11), 1379. https://doi.org/10.1037/pas0000254
  • Bowerman, B. L., & O'Connell, R. T. (1990). Linear statistical models: An applied approach (2nd ed.). Duxbury Press.
  • Bryan, C. J., Bryan, A. O., Anestis, M. D., Anestis, J. C., Green, B. A., Etienne, N., & Ray-Sannerud, B. (2016). Measuring moral injury: Psychometric properties of the moral injury events scale in two military samples. Assessment, 23(5), 557–570. https://doi.org/10.1177/1073191115590855
  • Celeux, G., & Soromenho, G. (1996). An entropy criterion for assessing the number of clusters in a mixture model. Journal of Classification, 13(2), 195–212. https://doi.org/10.1007/BF01246098
  • Crane, M. F., Phillips, J. K., & Karin, E. (2015). Trait perfectionism strengthens the negative effects of moral stressors occurring in veterinary practice. Australian Veterinary Journal, 93(10), 354–360. https://doi.org/10.1111/avj.12366
  • Currier, J. M., Drescher, K. D., & Nieuwsma, J. (2021). Addressing moral injury in clinical practice. American Psychological Association.
  • Currier, J. M., Holland, J. M., Drescher, K., & Foy, D. (2015). Initial psychometric evaluation of the Moral Injury Questionnaire—Military version. Clinical Psychology & Psychotherapy, 22(1), 54–63. https://doi.org/10.1002/cpp.1866
  • Dallaire, R., & Beardsley, B. (2003). Shake hands with the devil: The failure of humanity in Rwanda. Random House Canada.
  • Davis, J. P., Lee, D. S., Saba, S., Fitzke, R. E., Ring, C., Castro, C. C., & Pedersen, E. R. (2022). Applying polyvictimization theory to veterans: Associations with substance use and mental health. Psychology of Addictive Behaviors, 36(2), 144. https://doi.org/10.1037/adb0000781
  • Dirkzwager, A. J. E., Bramsen, I., & Van Der Ploeg, H. M. (2005). Factors associated with posttraumatic stress among peacekeeping soldiers. Anxiety, Stress & Coping, 18(1), 37–51. https://doi.org/10.1080/10615800412336418
  • Eid, M., Langeheine, R., & Diener, E. (2003). Comparing typological structures across cultures by multigroup latent class analysis: A primer. Journal of Cross-Cultural Psychology, 34(2), 195–210. https://doi.org/10.1177/0022022102250427
  • Evans, W. R., Szabo, Y. Z., Stanley, M. A., Barrera, T. L., Exline, J. J., Pargament, K. I., & Teng, E. J. (2018). Life satisfaction among veterans: Unique associations with morally injurious events and posttraumatic growth. Traumatology, 24(4), 263. https://doi.org/10.1037/trm0000157
  • Field, A. (2018). Discovering statistics using IBM SPSS statistics (5th ed.). SAGE Publications.
  • Fitzpatrick, J. J., Pignatiello, G., Kim, M., Jun, J., O'Mathúna, D. P., Duah, H. O., Taibl, J., & Tucker, S. (2022). Moral injury, nurse well-being, and resilience among nurses practicing during the COVID-19 pandemic. JONA: The Journal of Nursing Administration, 52(7/8), 392–398. https://doi.org/10.1097/NNA.0000000000001171
  • Geiser, C. (2013). Data analysis with Mplus. The Guilford press.
  • Hijazi, A. M., Keith, J. A., & O'Brien, C. (2015). Predictors of posttraumatic growth in a multiwar sample of US Combat veterans. Peace and Conflict: Journal of Peace Psychology, 21(3), 395–408. https://doi.org/10.1037/pac0000077
  • Jaarsma, T. A., Pool, G., Sanderman, R., & Ranchor, A. V. (2006). Psychometric properties of the Dutch version of the posttraumatic growth inventory among cancer patients. Psycho-Oncology, 15(10), 911–920. https://doi.org/10.1002/pon.1026
  • King, L. A., King, D. W., Fairbank, J. A., Keane, T. M., & Adams, G. A. (1998). Resilience–recovery factors in post-traumatic stress disorder among female and male Vietnam veterans: Hardiness, postwar social support, and additional stressful life events. Journal of Personality and Social Psychology, 74(2), 420–434. https://doi.org/10.1037/0022-3514.74.2.420
  • Klep, C. (2008). Somalië, Rwanda, Srebrenica. De nasleep van drie ontspoorde vredesmissies [Somalia, Rwanda, Srebrenica. The aftermath of three derailed peacekeeping missions]. Boom Uitgevers.
  • Lancaster, S. L., & Harris, J. I. (2018). Measures of morally injurious experiences: A quantitative comparison. Psychiatry Research, 264, 15–19. https://doi.org/10.1016/j.psychres.2018.03.057
  • Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706. https://doi.org/10.1016/j.cpr.2009.07.003
  • Macia, K. S., Moschetto, J. M., Wickham, R. E., Brown, L. M., & Waelde, L. C. (2020). Cumulative trauma exposure and chronic homelessness among veterans: The roles of responses to intrusions and emotion regulation. Journal of Traumatic Stress, 33(6), 1017–1028. https://doi.org/10.1002/jts.22569
  • Maguen, S., Lucenko, B. A., Reger, M. A., Gahm, G. A., Litz, B. T., Seal, K. H., Knight, S. J., & Marmar, C. R. (2010). The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans. Journal of Traumatic Stress, 23(1), 86–90. https://doi.org/10.1002/jts.20434
  • Maguen, S., Nichter, B., Norman, S. B., & Pietrzak, R. H. (2021). Moral injury and substance use disorders among US combat veterans: Results from the 2019–2020 National Health and Resilience in Veterans Study. Psychological Medicine, 53(4), 1364–1370. https://doi.org/10.1017/S0033291721001628
  • Molendijk, T. (2018). Toward an interdisciplinary conceptualization of moral injury: From unequivocal guilt and anger to moral conflict and disorientation. New Ideas in Psychology, 51, 1–8. https://doi.org/10.1016/j.newideapsych.2018.04.006
  • Molendijk, T. (2021). Moral injury and soldiers in conflict: Political practices and public perceptions. Routledge.
  • Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user's guide (8th ed.).
  • Nash, W. P., Marino Carper, T. L., Mills, M. A., Au, T., Goldsmith, A., & Litz, B. T. (2013). Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646–652. https://doi.org/10.7205/MILMED-D-13-00017
  • Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535–569. https://doi.org/10.1080/10705510701575396
  • Olff, M., Raaijmakers, I., Te Brake, H., Haagen, J., Mooren, T., Nauta, B., & Van Voorthuizen, M. (2020). Focus op Dutchbat III: Onderzoek naar het welzijn van Dutchbat III-veteranen en de behoefte aan zorg, erkenning en waardering [Focus on Dutchbat III: Research into the well-being of Dutchbat III veterans and the need for care, recognition and appreciation]. ARQ Nationaal Psychotrauma Centrum.
  • Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C., & Southwick, S. M. (2009). Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from operations enduring freedom and Iraqi Freedom. Depression and Anxiety, 26(8), 745–751. https://doi.org/10.1002/da.20558
  • Priebe, S., Huxley, P., Knight, S., & Evans, S. (1999). Application and results of the Manchester short assessment of quality of life (MANSA). International Journal of Social Psychiatry, 45(1), 7–12. https://doi.org/10.1177/002076409904500102
  • Reijnen, A., & Duel, J. (2019). Veteraan, hoe gaat het met u? Achtergrondrapport [Veteran, how are you doing? Background report]. Dutch Veterans Institute.
  • Rietveld, N. (2009). De gewetensvolle veteraan: Schuld- en schaamtebeleving bij veteranen van vredesmissies [The conscientious veteran: The experience of guilt and shame among veterans of peacekeeping missions]. BOXPress BV.
  • Rushton, C. H., Thomas, T. A., Antonsdottir, I. M., Nelson, K. E., Boyce, D., Vioral, A., Swavely, D., Ley, C. D., & Hanson, G. C. (2022). Moral injury and moral resilience in health care workers during COVID-19 pandemic. Journal of Palliative Medicine, 25(5), 712–719. https://doi.org/10.1089/jpm.2021.0076
  • Saba, S. K., Davis, J. P., Lee, D. S., Castro, C. A., & Pedersen, E. R. (2022). Moral injury events and behavioral health outcomes among American veterans. Journal of Anxiety Disorders, 90, 102605. https://doi.org/10.1016/j.janxdis.2022.102605
  • Schnurr, P. P., Lunney, C. A., Bovin, M. J., & Marx, B. P. (2009). Posttraumatic stress disorder and quality of life: Extension of findings to veterans of the wars in Iraq and Afghanistan. Clinical Psychology Review, 29(8), 727–735. https://doi.org/10.1016/j.cpr.2009.08.006
  • Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182–191. https://doi.org/10.1037/a0036090
  • Shigemura, J., & Nomura, S. (2002). Mental health issues of peacekeeping workers. Psychiatry and Clinical Neurosciences, 56(5), 483–491. https://doi.org/10.1046/j.1440-1819.2002.01043.x
  • Smigelsky, M. A., Malott, J. D., Veazey Morris, K., Berlin, K. S., & Neimeyer, R. A. (2019). Latent profile analysis exploring potential moral injury and posttraumatic stress disorder among military veterans. Journal of Clinical Psychology, 75(3), 499–519. https://doi.org/10.1002/jclp.22714
  • Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471. https://doi.org/10.1002/jts.2490090305
  • Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18. https://doi.org/10.1207/s15327965pli1501_01
  • Ter Heide, F. J. J. (2020). Empathy is key in the development of moral injury. European Journal of Psychotraumatology, 11(1), 1843261. https://doi.org/10.1080/20008198.2020.1843261
  • United Nations Department of Peacekeeping Operations. (2008). United Nations peacekeeping operations: Principles and guidelines. United Nations.
  • United Nations Security Council. (1993). Resolution 824 (1993). https://digitallibrary.un.org/record/166133/files/S_RES_824%281993%29-EN.pdf.
  • Van der Meer, C. A., Te Brake, H., Van der Aa, N., Dashtgard, P., Bakker, A., & Olff, M. (2018). Assessing psychological resilience: Development and psychometric properties of the English and Dutch version of the Resilience Evaluation Scale (RES). Frontiers in Psychiatry, 9, 169. https://doi.org/10.3389/fpsyt.2018.00169
  • Van Nieuwenhuizen, C., Janssen-de Ruijter, E. A. W., & Nugter, M. (2017). Handleiding Manchester Short Assessment of Quality of Life (MANSA). Stichting QoLM.
  • Van Praag, D. L., Fardzadeh, H. E., Covic, A., Maas, A. I., & von Steinbüchel, N. (2020). Preliminary validation of the Dutch version of the Posttraumatic stress disorder checklist for DSM-5 (PCL-5) after traumatic brain injury in a civilian population. PLoS One, 15(4), e0231857. https://doi.org/10.1371/journal.pone.0231857
  • Williamson, V., Stevelink, S. A., & Greenberg, N. (2018). Occupational moral injury and mental health: Systematic review and meta-analysis. The British Journal of Psychiatry, 212(6), 339–346. https://doi.org/10.1192/bjp.2018.55
  • Windle, G., Bennett, K. M., & Noyes, J. (2011). A methodological review of resilience measurement scales. Health and Quality of Life Outcomes, 9(1), 8–18. https://doi.org/10.1186/1477-7525-9-8
  • Zerach, G., Levi-Belz, Y., Griffin, B. J., & Maguen, S. (2021). Patterns of exposure to potentially morally injurious events among Israeli combat veterans: A latent class analysis approach. Journal of Anxiety Disorders, 79, 102378. https://doi.org/10.1016/j.janxdis.2021.102378