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Research Article

The moderating role of emotion dysregulation in the relation between potentially morally injurious experiences and alcohol misuse among military Veterans

, ORCID Icon, , , ORCID Icon & ORCID Icon
Pages 41-49 | Received 06 Apr 2020, Accepted 09 Oct 2020, Published online: 05 Jan 2021

References

  • American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  • Baker, T. B., Piper, M. E., McCarthy, D. E., Majeskie, M. R., & Fiore, M. C. (2004). Addiction motivation reformulated: An affective processing model of negative reinforcement. Psychological Review, 111(1), 33–51. doi:10.1037/0033-295X.111.1.33
  • Battles, A. R., Kelley, M. L., Jinkerson, J. D., Hamrick, H. C., & Hollis, B. F. (2019). Associations among exposure to potentially morally injurious experiences, spiritual injury, and alcohol use among combat veterans. Journal of Traumatic Stress, 32(3), 405–413. doi:10.1002/jts.22404
  • Benda, B. B., Rodell, D. E., & Rodell, L. (2003). Crime among homeless military veterans who abuse substances. Psychiatric Rehabilitation Journal, 26(4), 332–345. doi:10.2975/26.2003.332.345
  • Bjureberg, J., Ljótsson, B., Tull, M. T., Hedman, E., Sahlin, H., Lundh, L.-G., … Gumpert, C. H. (2016). Development and validation of a brief version of the difficulties in emotion regulation scale: The DERS-16. Journal of Psychopathology and Behavioral Assessment, 38(2), 284–296. doi:10.1007/s10862-015-9514-x
  • Bray, R. M., Brown, J. M., & Williams, J. (2013). Trends in binge and heavy drinking, alcohol-related problems, and combat exposure in the US military. Substance Use & Misuse, 48(10), 799–810. doi:10.3109/10826084.2013.796990
  • 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.
  • Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s Mechanical Turk: A new source of inexpensive, yet highquality, data? Perspectives on Psychological Science, 6, 3–5.
  • Cavicchioli, M., Movalli, M., & Maffei, C. (2018). The clinical efficacy of mindfulness-based treatments for alcohol and drugs use disorders: A meta-analytic review of randomized and nonrandomized controlled trials. European Addiction Research, 24(1), 137–162. doi:10.1159/000490762
  • da Silva, A. N., Vasco, A. B., & Watson, J. C. (2017). Alexithymia and emotional processing: A mediation model. Journal of Clinical Psychology, 73(9), 1196–1205. doi:10.1002/jclp.22422
  • Dvorak, R. D., Sargent, E. M., Kilwein, T. M., Stevenson, B. L., Kuvaas, N. J., & Williams, T. J. (2014). Alcohol use and alcohol-related consequences: Associations with emotion regulation difficulties. The American Journal of Drug and Alcohol Abuse, 40(2), 125–130. doi:10.3109/00952990.2013.877920
  • Fillo, J., Heavey, S. C., Homish, D. L., & Homish, G. G. (2018). Deployment‐related military sexual trauma predicts heavy drinking and alcohol problems among male reserve and national guard soldiers. Alcoholism: Clinical and Experimental Research, 42(1), 111–119. doi:10.1111/acer.13528
  • Forkus, S. R., Breines, J. G., & Weiss, N. H. (2019). Morally injurious experiences and mental health: The moderating role of self-compassion. Psychological Trauma: Theory, Research, Practice, and Policy, 11(6), 630–638. doi:10.1037/tra0000446
  • Frewen, P. A., Dean, J. A., & Lanius, R. A. (2012). Assessment of anhedonia in psychological trauma: Development of the hedonic deficit and interference scale. European Journal of Psychotraumatology, 3(1), 8585. doi:10.3402/ejpt.v3i0.8585
  • Fuehrlein, B. S., Mota, N., Arias, A. J., Trevisan, L. A., Kachadourian, L. K., Krystal, J. H., … Pietrzak, R. H. (2016). The burden of alcohol use disorders in US military veterans: Results from the national health and resilience in veterans study. Addiction, 111(10), 1786–1794. doi:10.1111/add.13423
  • Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. doi:10.1023/B:JOBA.0000007455.08539.94
  • Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C., & Gunderson, J. G. (2006). An experimental investigation of emotion dysregulation in borderline personality disorder. Journal of Abnormal Psychology, 115(4), 850–855. doi:10.1037/1949-2715.S.1.18
  • Greenberg, N. (2018). Occupational moral injury and mental health: Systematic review and meta-analysis. The British Journal of Psychiatry, 212(6), 339–346. doi:10.1192/bjp.2018.55
  • Hartz, S. M., Oehlert, M., Horton, A., Grucza, R. A., Fisher, S. L., Culverhouse, R. C., … Regnier, P. (2018). Daily drinking is associated with increased mortality. Alcoholism: Clinical and Experimental Research, 42(11), 2246–2255. doi:10.1111/acer.13886
  • Hayes, A. F. (2015). Hacking PROCESS for estimation and probing of linear moderation of quadratic effects and quadratic moderation of linear effects [ Unpublished White Paper]. Ohio State University.
  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2009). Acceptance and commitment therapy. Washington, DC: American Psychological Association.
  • Held, P., Klassen, B. J., Hall, J. M., Friese, T. R., Bertsch-Gout, M. M., Zalta, A. K., & Pollack, M. H. (2019). “I knew it was wrong the moment I got the order”: A narrative thematic analysis of moral injury in combat veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 11(4), 396–405. doi:10.1037/tra0000364
  • Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244. doi:10.3109/10673229709030550
  • Linehan, M. M. (1987). Dialectical behavior therapy for borderline personality disorder: Theory and method. Bulletin of the Menninger Clinic, 51(3), 261–276.
  • Litz, B. T., Orsillo, S. M., Kaloupek, D., & Weathers, F. (2000). Emotional processing in posttraumatic stress disorder. Journal of Abnormal Psychology, 109(1), 26–39. doi:10.1037/0021-843X.109.1.26
  • 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. doi:10.1016/j.cpr.2009.07.003
  • Lorber, W., & Garcia, H. A. (2010). Not supposed to feel this: Traditional masculinity in psychotherapy with male veterans returning from Afghanistan and Iraq. Psychotherapy: Theory, Research, Practice, Training, 47(3), 296–305. doi:10.1037/a0021161
  • Lynn, B. M. D., & Morgan, J. K. (2016). Using Amazon’s Mechanical Turk (MTurk) to recruit military veterans: Issues and suggestions. The Military Psychologist, 31(3), 8–14.
  • Meade, A. W., & Craig, S. B. (2012). Identifying careless responses in survey data. Psychological Methods, 17(3), 437. doi:10.1037/a0028085
  • Messman-Moore, T. L., & Ward, R. M. (2014). Emotion dysregulation and coping drinking motives in college women. American Journal of Health Behavior, 38(4), 553–559. doi:10.5993/AJHB.38.4.8
  • Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA, 298(18), 2141–2148. doi:10.1001/jama.298.18.2141
  • 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. doi:10.7205/MILMED-D-13-00017
  • Nieuwsma, J. A., Walser, R. D., Farnsworth, J. K., Drescher, K. D., Meador, K. G., & Nash, W. (2015). Possibilities within acceptance and commitment therapy for approaching moral injury. Current Psychiatry Reviews, 11(3), 193–206. doi:10.2174/1573400511666150629105234
  • Roemer, L., Litz, B. T., Orsillo, S. M., & Wagner, A. W. (2001). A preliminary investigation of the role of strategic withholding of emotions in PTSD. Journal of Traumatic Stress, 14(1), 149–156. doi:10.1023/A:1007895817502
  • Saunders, J. B., Aasland, O. G., Babor, T. F., De la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption‐II. Addiction, 88(6), 791–804.
  • Searle, A. K., Van Hooff, M., McFarlane, A. C., Davies, C. E., Fairweather‐Schmidt, A. K., Hodson, S. E., … Steele, N. (2015). The validity of military screening for mental health problems: Diagnostic accuracy of the PCL, K10 and AUDIT scales in an entire military population. International Journal of Methods in Psychiatric Research, 24(1), 32–45. doi:10.1002/mpr.1460
  • Shapiro, D. N., Chandler, J., & Mueller, P. A. (2013). Using mechanical turk to study clinical populations. Clinical Psychological Science, 1(2), 213–220. doi:10.1177/2167702612469015
  • Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182–191. doi:10.1037/a0036090
  • Shishido, H., Gaher, R. M., & Simons, J. S. (2013). I don’t know how I feel, therefore I act: Alexithymia, urgency, and alcohol problems. Addictive Behaviors, 38(4), 2014–2017. doi:10.1016/j.addbeh.2012.12.014
  • Stacy, M. A., Stefanovics, E., & Rosenheck, R. (2017). Reasons for job loss among homeless veterans in supported employment. American Journal of Psychiatric Rehabilitation, 20(1), 16–33. doi:10.1080/15487768.2016.1267049
  • Taylor, G. J. (2000). Recent developments in alexithymia theory and research. The Canadian. Journal of Psychiatry, 45(2), 134–142.
  • Taylor, S. (2003). Anxiety sensitivity and its implications for understanding and treating PTSD. Journal of Cognitive Psychotherapy, 17(2), 179–186. doi:10.1891/jcop.17.2.179.57431
  • Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). The Life Events Checklist for DSM-5 (LEC-5). Instrument available from the National Center for PTSD at www.ptsd.va.gov
  • Weiss, N. H., Darosh, A. G., Contractor, A. A., Schick, M. M., & Dixon‐Gordon, K. L. (2019). Confirmatory validation of the factor structure and psychometric properties of the difficulties in emotion regulation scale‐positive. Journal of Clinical Psychology, 75(7), 1267–1287. doi:10.1002/jclp.22768
  • Weiss, N. H., Gratz, K. L., & Lavender, J. M. (2015). Factor structure and initial validation of a multidimensional measure of difficulties in the regulation of positive emotions: The DERS-positive. Behavior Modification, 39(3), 431–453. doi:10.1177/0145445514566504
  • Williamson, V., Stevelink, S. A. M., & Greenberg, N. (2018). Occupational moral injury and mental health: systematic review and meta-analysis. The British Journal of Psychiatry, 212(6), 339–346.
  • Wisco, B. E., Marx, B. P., May, C. L., Martini, B., Krystal, J. H., Southwick, S. M., & Pietrzak, R. H. (2017). Moral injury in U.S. combat veterans: Results from the national health and resilience in veterans study. Depression and Anxiety, 34(4), 340–347. doi:10.1002/da.2017.34.issue-4
  • Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., ... & Mintz, J. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28(11), 1392.

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