ArticleTraumatology2020
Rumination as a Mediator of the Associations Between Moral Injury and Mental Health Problems in Combat-Wounded Veterans.
Article in Traumatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Evaluating the association between potentially morally injurious events (PMIEs) and types of psychological distress. A systematic review.European journal of psychotraumatology · 2026Pooled it
- Using Mindfulness to Manage Moral Injury in Veterans: Feasibility and Satisfaction of a Pilot Randomized Controlled Trial.Journal of clinical psychology · 2025Trial
- Moving Forward from Moral Injury: A Mixed Methods Study Investigating the Use of 3MDR for Treatment-Resistant PTSD.International journal of environmental research and public health · 2023Trial
- Resting-State Neural Signatures of Moral Injury: Associations With Rumination.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2026Article
- Rumination and depressive symptoms among aging Veterans: The moderating role of social support.Journal of military, veteran and family health · 2026Article
- The therapeutic role of self-transcendence in moral injury recovery:Frontiers in psychiatry · 2026Article
- Psychometric properties of the Arabic version of the 10-item State Shame and Guilt Scale.Frontiers in psychology · 2026Article
- Morally Injurious Events and Depression: Examining the Role of Rumination Among Combat-Deployed Military Veterans in the Community.International journal of stress management · 2024Article
- The Effects of a Single-Session Virtual Rumination Intervention to Enhance Cognitive Functioning in Veterans With Subjective Cognitive Symptoms: Multimethod Pilot Study.JMIR formative research · 2024Article
- The Association Between Intolerance of Uncertainty and Mobile Phone Addiction Among Overseas Chinese Students During COVID-19: The Mediating Roles of Perceived Stress and Rumination.Psychology research and behavior management · 2024Article
- Moral Injury is a Risk Factor for Substance Use and Suicidality Among US Military Veterans with and without Traumatic Brain Injury.Journal of religion and health · 2023Article
- To Trust is to Survive: Toward a Developmental Model of Moral Injury.Journal of child & adolescent trauma · 2023Article
- Conceptualization of moral injury: A socio-cognitive perspective.Journal of military, veteran and family health · 2023Article
- The traumatic impact of the COVID-19 pandemic: the possible role of rumination and uncertainty.Current psychology (New Brunswick, N.J.) · 2023Article
- Morally injurious events among aid workers: examining the indirect effect of negative cognitions and self-care in associations with mental health indicators.Frontiers in psychology · 2023Article
- Mindfulness to Manage Moral Injury: Rationale and development of a live online 7-week group intervention for veterans with moral injury.Contemporary clinical trials communications · 2022Review
- Mediating role of self-compassion in the association between moral injury and depression among Korean youths.Heliyon · 2022Article
- Moral Injury Among Frontline Long-Term Care Staff and Management During the COVID-19 Pandemic.Frontiers in health services · 2022Article
- Emotional exhaustion and unhealthy eating among COVID-19 front-line healthcare workers during recuperation: A cross-sectional study.Frontiers in public health · 2022Article
- Intolerance of uncertainty, rumination, post-traumatic stress symptoms and aggression during COVID-19: a serial mediation model.European journal of psychotraumatologyArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
Moral injury is hypothesized to develop from witnessing or engaging in events that violate one's beliefs about themselves and has been shown to be associated with negative mental health symptoms. Although there has been an increase in research examining moral injury among military veterans, mechanisms that link moral injury to mental health outcomes are not well understood. The present study examined rumination subcomponents (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) as possible mediators of the associations between moral injury (both self-directed and other-directed symptoms) and negative mental health symptoms (i.e., depression, anxiety, suicidality, sleep disturbance, memory problems, and posttraumatic stress disorder symptoms). Participants were 189 combat wounded veterans (180 men; Mean age = 43.14 years) who had experienced one or more deployments (defined as 90 days or more). Nearly all participants reported a service-connected disability (
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.