Examining the Impact of Moral Injury on Relationship Satisfaction and Intimacy in Combat Veterans
No Thumbnail Available
Authors
Sapp, Deena
Issue Date
2026-03
Type
Dissertation
Language
en
Keywords
Military Learners & Veteran Transition , Moral Injury , Combat Veterans , Relationship Satisfaction , Intimacy
Alternative Title
Abstract
The purpose of this quantitative cross-sectional study was to examine the impact of moral injury on relationship satisfaction and intimacy in combat veterans. Attachment theory served as the foundational theoretical framework in understanding moral injury as it relates to combat veteran relational dynamics. Three research questions were designed to examine whether moral injury severity was associated with relationship satisfaction and/or intimacy and explored the association between satisfaction and intimacy when accounting for moral injury. Participants included 81 combat veterans currently in an intimate partner relationship. Participants completed self-report measures including the Expressions of Moral Injury Scale-Military Version (EMIS-M), Couples Satisfaction Inventory (CSI), and Personal Assessment of Intimacy in Relationships (PAIR). Multivariate and univariate regression analyses were conducted to evaluate the relationships between moral injury and relational outcomes. Pearson zero-order and partial correlations were used to examine the association between relationship satisfaction and intimacy while controlling for moral injury. Missing data were managed using multiple imputation procedures. Results indicated that moral injury severity was not significantly associated with relationship satisfaction. Greater moral injury severity was significantly associated with lower reported intimacy. Relationship satisfaction and intimacy remained positively and significantly related even when accounting for moral injury severity. These findings suggest that moral injury may impede emotional closeness without necessarily undermining perceived relationship satisfaction. Conclusions from this study highlight the importance of distinguishing between relationship satisfaction and intimacy when considering relational outcomes associated with moral injury. Findings support attachment-informed conceptualizations of moral injury as a relational concept and emphasize intimacy as a critical focal point for clinical intervention. Implications for practice include the use of attachment-informed, systemic treatment approaches. Recommendations for future research include longitudinal studies with dyadic reporting to further examine relational dynamics impacted by moral injury.