Military sexual trauma (MST) comprises a range of harmful experiences, including rape, sexual coercion, attempts at forcible sexual contact, and sexual harassment (Conrad et al., 2014). Estimates vary across studies and the definitions that the Veterans Administration (VA) has used over the years have changed, as well as the Department of Defense’s reporting requirements. Conservative estimates state that 20% of women veterans have experienced military sexual trauma, but that does not fully account for the 80-90% of assaults that go unreported (Conrad et al., 2014). In the moral injury study for women veterans I am co-leading, 80% of participants interviewed so far experienced some form of sexual trauma. One participant, who works to help other veteran women said that pretty much everyone she knows is a sexual assault survivor.
MST is so prevalent among women who served that it is common for people to equate moral injury in women to MST. They are not synonymous terms. Moral injury refers to the psychological injury that occurs when a traumatic event clashes with a person’s deeply held moral values (Nash et al., 2013). Moral injury research is still in its early stages and there is no agreed-upon list of potentially moral injurious events (MIEs). Currier et al. (2015) identified 20 MIEs in six categories: acts of betrayal, acts of disproportionate violence inflicted on others, incidents involving death or harm to civilians, violence within military ranks, inability to prevent death or suffering, and ethical dilemmas/moral conflicts. Nash et al. (2013) developed a scale that included nine items — six of which involved perceived transgressions by self or others and three items related to betrayal by others. Currier et al.’s (2015) scale included the item, “I was sexually assaulted,” but the instrument by Nash et al. (2013) stuck to more general categories.
The point is that while many women experience moral injury as a result of a sexual assault, MST is not the only event that causes psychological harm. Our research is generating a new theory of moral injury as it relates to women veterans. We encourage all women who meet the study qualifications to apply. More information can be found on our study website. To participate, you must be a woman between the age of 25 and 70; a retired or discharged uniformed service member with at least five years of service; of the grade of E-5 or above as an enlisted person, W-2 or above as a warrant officer, or O-3 or above as an officer at the time you left the service; not currently working for the Department of Defense as a civilian or contractor; and a witness to, participant in, or the target of any activities by military personnel that created inner conflict or violated your personal moral values.
To generate a complete theory, we need to interview a broad spectrum of women who have experienced a wide array of emotional and psychological traumas. In operations that the U.S. has been involved in in the last 20 years, women have been involved in direct combat action, so we need to gather data from those women who have killed in combat or witnessed combat death or injury. We need to find women who were not sexually assaulted but were the subject of other types of humiliation or attacks by fellow service members. Many women have been outright rejected and disrespected by colleagues or treated as pariahs in their units. I do not know the full extent of the injuries that are out there in the woman veteran population, but that is why we are conducting this study. We need to fill in many gaps in the knowledge base of the moral injury field. If you think you qualify, or know someone who does, please contact me at 910-690-5964 or firstname.lastname@example.org. Sharing your experiences can be difficult, but many women find that the act of sharing is cathartic.
Dr. Daniel Roberts is an author, consultant, and teacher who conducts world-class education and research in military chaplaincy. He has over 15 years of experience in providing emotional and spiritual support to the men and women in the armed forces. Daniel also provides training and mentorship to thousands of military chaplains through conferences, classroom instruction, and one-on-one coaching. His students include chaplains from the US Army, Air Force, and Canadian Armed Forces (CAF). Dr. Roberts also helped the CAF develop military doctrine for the deployment of chaplains as religious advisers.
Conrad, P. L., Young, C., Hogan, L., Armstrong, M. (2014). Encountering women veterans with military sexual trauma. Perspectives in Psychiatric Care, 50(4), 280-286.
Currier, J. M., Holland, J. M., Drescher, K., & Foy, D. (2013). Initial Psychometric Evaluation of the Moral Injury Questionnaire-Military Version. Clinical Psychology & Psychotherapy, 22(1), 54–63.
Nash, William 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.