The Relationship Between Adverse Childhood Experiences and Moral Injury in the Canadian Armed Forces
Bibliographic record
Abstract
Background: There is increasing evidence that moral injuries (MIs) may affect the mental health of Canadian Armed Forces (CAF) members and veterans.Despite knowledge suggesting that MIs are related to multiple negative mental health outcomes, including the onset of post-traumatic stress disorder (PTSD), it is unknown whether pre-traumatic variables, including the presence of childhood abuse, are related to MIs.Objective: This study seeks to investigate the potential relationship between adverse childhood experiences and later onset MI in military members.Methods: Thirty-three patients newly admitted to an inpatient unit for treatment of traumarelated disorders received a standardized self-assessment package, including the PTSD Checklist for DSM-5 (PCL-5), the Moral Injury Events Scale (MIES; adapted for the Canadian context), and the Adverse Childhood Experiences Questionnaire (ACE-Q), which is a retrospective measure of childhood abuse.Results: Analyses revealed a significant relation between childhood emotional abuse and the presence of MI in adulthood.Specifically, emotional abuse during childhood was correlated with total score on the MIES (p = 0.006) and with its two subscales, perceived betrayals (p = 0.022) and perceived transgressions (p = 0.016).These correlations remained significant when controlling for age and gender.Conclusions: Among CAF members and veterans, childhood events are related to the presence of MI during adulthood.These preliminary data are provocative in suggesting that emotional abuse during childhood may increase the likelihood of endorsing MI during adult military service.Further work is needed to identify pre-traumatic variables that may serve to increase risk or enhance resilience to the development of MI in military members.La relación entre experiencias adversas en la infancia y daño moral en las Fuerzas Armadas Canadienses Antecedentes: Existe un aumento de la evidencia que los daños morales (MIs, por sus siglas en inglés) pueden afectar la salud mental de los miembros de las Fuerzas Armadas Canadienses (FAC) y veteranos.A pesar que el conocimiento sugiere que las MIs están relacionadas con múltiples consecuencias negativas en la salud mental, incluyendo el inicio del trastorno de estrés postraumático (TEPT), se desconoce si variables pre-traumáticas, incluyendo la presencia de abuso en la infancia, están relacionadas con MIs.Objetivo: Este estudio busca investigar la relación potencial entre experiencias infantiles adversas y el posterior inicio de MIs entre los miembros militares.Método: Treinta y tres pacientes nuevos admitidos a una unidad hospitalaria para tratamiento de los trastornos relacionados con trauma, recibieron un paquete estandarizado de auto-evaluación, incluyendo la lista de chequeo para TEPT del DSM-5 (PCL-5), la Escala de Eventos de Daño Moral (MIES por sus siglas en inglés, adaptada para el contexto canadiense) y el Cuestionario de Experiencias Adversas Condiciones Infantiles (ACE-Q por sus siglas en inglés).Resultados: Los análisis revelaron una relación significativa entre abuso emocional en la infancia y la presencia de MI en la adultez.Específicamente, el abuso emocional durante la infancia estuvo correlacionado con el puntaje total del MIES (p= 0.006) y con sus dos subescalas, percepción de traición (p=0.022)y percepción de transgresiones (p= 0.016).Estas correlaciones permanecen significativas cuando se controlan por edad y sexo.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.016 | 0.005 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".