Date of Award
5-1-2026
Degree Name
Doctor of Philosophy
Department
Population Health
First Advisor
McDaniel, Justin
Second Advisor
Dobie, Sarah
Abstract
Moral injury, the psychological distress arising from experiences that transgress deeply held moral beliefs or from betrayal by trusted authorities, remains understudied among women veterans despite evidence that their military experiences involve distinct moral stressors. This three-paper dissertation examined moral injury among women veterans through complementary psychometric, quantitative, and qualitative approaches.The first study evaluated the Moral Injury and Distress Scale (MIDS; Norman et al., 2023) in a pilot sample of 27 women veterans, yielding a trimmed 14-item structure with strong factor loadings and excellent internal consistency (α = .96; ω = .95). The second study found that trauma-related guilt (b = 2.41, p < .001) and psychosocial functioning impairments (b = 0.75, p = .04) were positively associated with moral injury severity, while perceived social support was inversely associated (b = −0.50, p = .03). The third study used reflexive thematic analysis with six women veterans, generating four themes: betrayal as the central moral wound, the gendered architecture of moral injury, psychological disruption and disruption of meaning, and resilience through agency, purpose, and relational anchors. These findings highlight the need for gender-responsive assessment and treatment and identify institutional betrayal and relational support as central features of moral injury in this understudied population.
Access
This dissertation is only available for download to the SIUC community. Current SIUC affiliates may also access this paper off campus by searching Dissertations & Theses @ Southern Illinois University Carbondale from ProQuest. Others should contact the interlibrary loan department of your local library or contact ProQuest's Dissertation Express service.