Moral injury appraisals and posttraumatic stress symptoms in trauma-exposed police officers : a latent class analysis

Background: Police officers encounter various potentially traumatic events (PTEs) and may becompelled to engage in actions that contradict their moral codes. Consequently, they are at riskto develop symptoms of Posttraumatic Stress Disorder (PTSD), but also moral stress or moralinjury (MI). To date, MI in police officers has received limited attention.

Objective: The present study sought to identify classes of MI appraisals and PTSD symptomsamong police officers exposed to PTEs, while also investigating potential clinical differencesbetween these classes.

Method: For this study, 421 trauma-exposed police officers were assessed on demographicsand several clinical measurements including MI appraisals (self-directed and other-directed),PTSD severity, and general psychopathology. Latent class and regression analyses wereconducted to examine the presence of different classes among trauma-exposed policeofficers and class differentiation in terms of demographics, general psychopathology, PTSDseverity, mistrust, guilt, self-punishment, and feelings of worthlessness.

Results: The following five classes were identified: (1) a ‘Low MI, high PTSD class’ (28%), (2) a‘High MI, low PTSD class’ (11%), (3) a ‘High MI, high PTSD class’ (17%), (4) a ‘Low MI, low PTSDclass’ (16%), and (5) a ‘High MI-other, high PTSD class’ (27%). There were significant differencesbetween the classes in terms of age, general psychopathology, PTSD severity, mistrust, guilt,and self-punishment but no differences for gender and feelings of worthlessness.

Conclusion: In conclusion, we identified five classes, each exhibiting unique patterns ofcognitive MI appraisals and PTSD symptoms. This underscores the criticality of measuringand identifying MI in this particular group, as it allows for tailored treatment interventions.

HIGHLIGHTS

• This study identifiedclasses differing in terms ofendorsement of MIappraisals andposttraumatic stressdisorder (PTSD) symptomsamong police officersexposed to potentiallytraumatic events.
• Five classes wereidentified, each exhibitingunique patterns of MIappraisals and PTSDsymptoms.
• It is important to measurethe presence of MIappraisals in addition toPTSD symptoms intraumatized police officersas it can inform treatmentinterventions.