Moral Injury and Suicidal Ideation Among Female National Guard Members: Indirect Effects of Perceived Burdensomeness and Thwarted Belongingness

Numerous reports have linked moral injury (i.e., experience or perpetration of a morally unjust event) 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 and perceived burdensomeness may lead to increased suicidal ideation. Furthermore, 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 association between moral injury and suicidal ideation that was indirect through thwarted belongingness and perceived burdensomeness. These findings highlight important and malleable mechanisms that may lead to increased suicide risk among women exposed to morally injurious events. Furthermore, this work extends our current understanding of moral injury and suicide by examining these constructs among a sample of female service members.