Relationship between combat exposure, potentially morally injurious events, and mental health outcomes in ex-combat fighters during the Lebanese civil war

Abstract

The Lebanese civil war was considered an example of one of the most traumatic experience the Lebanese went through. In addition, owing to the brutality, which existed at the time, the Lebanese Civil war caused a substantial number of casualties. This study examined the association between exposure to combat experiences and potentially morally injurious events with the mental health of ex-fighters during the Lebanese civil war. The study utilized a quantitative research method, based on a survey method design and a deductive approach to analyzing the collected data from respondents who were involved in the civil war in Lebanon. The participants were recruited through non-probability sampling. Convenient sampling was used since the population we are recruiting is difficult to approach, snowball sampling was also used. The total number of participants was 40 from various locations in Lebanon with the majority in Mount Lebanon. Combat experiences was measured using the Combat experiences subscales of the Deployment Resiliency Risk Inventory-2 (DDRI-2), exposure to morally injurious events was measured using the Moral Injury Event Scale (MIES), and the mental health conditions was measured using the Depression, Anxiety and Stress Scale - 21 Items (DASS-21). Participants were recruited through snowball sampling. Analysis of the collected data indicated that the combination of the two independent variables, the higher exposure to combat experiences and potentially morally injurious events, has a significant influence on the mental health of ex-combat fighters in the civil war (r2 = 0.17, p-value = 0.032). The analysis indicated that potentially morally injurious events have a moderate positive correlation with mental health outcomes (r2 =0.169, p-value = 0.009) and exposure to combat experiences indicated a weak positive correlation with mental health of ex-combat fighters (r2 = 0.018, p-value = 0.422). In addition, the higher exposure to combat experiences has a weak positive correlation to potentially morally injurious events (r2 = 0.001, p-value = 0.818. It is suggested that addressing moral injury is crucial in reducing mental health problems in ex-combat fighters. This study emphasizes the need to provide appropriate services and therapies to ex-combat fighters suffering from mental health issues. All these initiations are crucial for limiting or reducing the mental health problems of those ex-combats.