Associations between posttraumatic stress symptoms, moral injury, and parenting among Israeli male veterans: The mediating role of parental beliefs about children's anxiety.
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Abstract
Objective: Posttraumatic stress symptoms (PTSS) and moral injury (MI) are possible negative outcomes of combat military service. While PTSS is known to be associated with impaired paternal parenting, no study has examined the association between MI and parenting. This study examined associations between military-related PTSS, MI, and multiple measures of parenting among veteran fathers. Furthermore, we examined the mediating role of parental beliefs about children's anxiety in the association between PTSS, MI, and parenting.
Method: Participants included 310 combat veteran fathers (Mage = 34.96, SD = 6.31) who were discharged from the Israeli Defense Forces. Participants completed a set of validated self-report online questionnaires in a cross-sectional design study.
Results: Exposure to potentially morally injurious experiences (PMIEs) during military service was associated with higher levels of PTSS and MI outcomes, but not with parenting domains. Both PTSS and MI outcomes were associated with poorer parenting practices and lower levels of parental satisfaction. Importantly, PTSS and shame-based MI outcomes mediated the association between combat exposure, exposure to PMIE, and parenting. Moreover, two-step sequential mediation showed combat exposure and exposure to PMIE indirectly contributed to parenting via PTSS, shame-based MI outcomes, and parental beliefs about children's anxiety.
Conclusion: Our findings imply that beyond the possible negative effects of PTSS on parenting, military-related MI is another risk for problematic paternal parenting among veterans. Clinical implications discussed include the ripple effect of PTSS and MI on veteran fathers' cognitions regarding their children's ability to handle anxiety, and their parenting behaviors to control their painful emotions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
期刊介绍：
Psychological Trauma: Theory, Research, Practice, and Policy publishes empirical research on the psychological effects of trauma. The journal is intended to be a forum for an interdisciplinary discussion on trauma, blending science, theory, practice, and policy.
The journal publishes empirical research on a wide range of trauma-related topics, including:
-Psychological treatments and effects
-Promotion of education about effects of and treatment for trauma
-Assessment and diagnosis of trauma
-Pathophysiology of trauma reactions
-Health services (delivery of services to trauma populations)
-Epidemiological studies and risk factor studies
-Neuroimaging studies
-Trauma and cultural competence
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