Exploratory Testing of Treatment Effects on Moral Injury
Bivariate correlations and descriptive statistics of all study variables
across time points are presented in Table 2. There were no statistically
significant differences on demographic characteristics (except for age,
participants were significantly older in the MMMI condition [M= 45.81 years; SD = 10.51] than the ES condition [M =
39.26 years; SD = 8.57]) and baseline scores on all outcomes
across treatment conditions, thus ensuring the two analytic treatment
groups (MMMI and ES) were largely similar. All results of our repeated
measures ANCOVA models are found in Table 3.
Exploratory testing of effects on MMMI on moral injury
outcomes. We generally found medium-large effect sizes (.08
< η2 > .26). Regarding those that were
statistically significant, we found significant decreases in EMIS-M
other-directed (betrayal-based) moral injury collapsing across
conditions (η2 = .195); however, this finding was qualified by a
significant interaction (p = .023; η2 = .129), such that there
was a larger decrease in the MMMI condition (T1: M = 28.57, SE =
1.53; T2: M = 24.71, SE = 1.41; M difference = -3.86, SE =
0.98, p < .001) compared to the ES condition (T1:M = 28.37, SE = 1.61; T2: M = 27.90, SE = 1.48; Mdifference = -0.47, SE = 1.04, p = .650). While no significant
interaction was found for EMIS-M self-directed scores (p = .071,
η2 = .083), significant decreases in EMIS-M self-directed scores emerged
when collapsing across the MMMI and ES conditions (η2 = .100; T1:M = 25.17, SE = 1.29; T2: M = 23.04, SE = 1.10; Mdifference = -2.13, SE = 1.03, p = .046). Similarly, while no
significant interaction was found for MISS scores (p = .061, η2 =
.089), we found significant decreases in MISS total scores collapsing
across the MMMI and ES conditions (η2 = .216; T1: M = 54.83, SE =
2.35; T2: M = 48.69, SE = 2.01; M difference = -6.14, SE =
1.90, p = .003).
Regarding the MIOS measure, we found significant decreases in MIOS total
scores collapsing across the MMMI and ES conditions (η2 = .132);
however, this outcome was also qualified by a significant interaction
(p = .028; η2 = .121), such that there was a larger decrease in
the MMMI condition (T1: M = 26.86, SE = 2.15; T2: M =
20.29, SE = 2.10; M difference = -6.57, SE = 1.93, p =
.002) compared to the ES condition (T1: M = 28.68, SE = 2.26; T2:M = 28.53, SE = 2.21; M difference = -0.16, SE = 2.03,p = .938). We also found a significant interaction for MIOS –
shame-related experiences (p = .042; η2 = .105), such that there
was a significant decrease in the MMMI condition (T1: M = 12.24,
SE = 1.41; T2: M = 9.57, SE = 1.29; M difference = -2.67,
SE = 1.18, p = .030) compared to a marginal increase in the ES
condition (T1: M = 12.84, SE = 1.48; T2: M = 13.79, SE =
1.36; M difference = 0.95, SE = 1.24, p = .451).
While no significant interaction was found for MIOS –
trust-violation-related scores (p = .050, η2 = .097), significant
decreases in MIOS – trust-violation-related scores emerged when
collapsing across the MMMI and ES conditions (η2 = .256; T1: M =
15.23, SE = 0.82; T2: M = 12.73, SE = 0.79; M difference =
-2.51, SE = 0.69, p = <.001). Finally, we also found
significant decreases in MIOS impaired functioning due to moral injury
scores collapsing across conditions (η2 = .167); however, this was
qualified by a significant interaction (p = .023; η2 = .129),
such that there was a larger decrease in the MMMI condition (T1:M = 42.94, SE = 3.74; T2: M = 28.96, SE = 3.53; Mdifference = -13.98, SE = 3.76, p < .001) compared to
the ES condition (T1: M = 40.45, SE = 3.74; T2: M = 39.40,
SE = 3.72; M difference = -1.05, SE = 3.95, p = .791).