# Mindful Self Compassion for combat deployed Veterans with Moral Injury and co-occurring PTSD-SUD

> **NIH VA I21** · PROVIDENCE VA  MEDICAL CENTER · 2020 · —

## Abstract

PTSD-SUD is particularly common following combat exposure, affecting a rapidly increasing number of
U.S. military Veterans. The co-occurrence of these disorders presents added challenges to the VA treatment
delivery system, presently in need of effective integrated treatments. Veterans with PTSD-SUD experience
more severe symptomatology, increased risk of suicidality, poorer quality of life, and poorer response to
existing treatments than Veterans with either disorder alone. Furthermore, PTSD-SUD prevents Veterans from
reintegrating into society and is associated with occupational and social dysfunction. These findings
underscore the need to effectively and efficiently address comorbidity and the complex array of problems with
which Veterans present to treatment.
 One approach is to develop interventions that target mechanisms thought to underlie multiple highly
prevalent disorders, such as guilt related to traumatic experiences. Combat Veterans often report experiencing
moral injury defined as perpetrating, failing to prevent, or witnessing acts that violate the values they live by in
their civilian lives. Veterans who negatively appraise their actions or inaction during combat may experience
guilt, a common posttraumatic reaction. Moral injury suggests the inability to contextualize or justify actions and
the unsuccessful accommodation of those morally challenging experiences into pre-existing moral schemas,
resulting in guilt and shame. Posttraumatic guilt has been implicated as a risk factor for the development and
maintenance of several forms of psychopathology including PTSD, SUD, depression, and suicidality. However,
to date, treatments for posttraumatic psychological health issues have been primarily disorder specific, with a
focus largely on symptom reduction. Therefore, greater understanding of modifiable factors that influence
functional impairment and PTSD-SUD is needed to enhance treatment efforts.
 Mindful Self Compassion (MSC) combines the skills of mindfulness and self-compassion, providing
self-soothing skills to respond to difficult thoughts and feelings (including guilt) via meditation. Self-compassion
(SC) emphasizes kindness towards one's self, a feeling of connectedness with others, and mindful awareness
of distressing experiences. Furthermore, because SC is negatively associated with self-criticism, rumination,
thought suppression, anxiety, and depression, and positively associated with healthy psychological functioning,
it is well suited to addressing posttraumatic psychopathology, shame, and guilt.
 This proposal will begin to address a gap in the field's knowledge about MSC, and its role in the
treatment of co-occurring disorders in Veterans with moral injury. We will evaluate changes in self-compassion,
post-traumatic guilt, shame, PTSD and substance use symptom severity. In addition to symptom reduction, we
will focus on functional outcomes (e.g., quality of life, suicidality). Participants will complete assessments at...

## Key facts

- **NIH application ID:** 10174855
- **Project number:** 5I21RX002893-03
- **Recipient organization:** PROVIDENCE VA  MEDICAL CENTER
- **Principal Investigator:** Erica Eaton
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-10-01 → 2021-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10174855

## Citation

> US National Institutes of Health, RePORTER application 10174855, Mindful Self Compassion for combat deployed Veterans with Moral Injury and co-occurring PTSD-SUD (5I21RX002893-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10174855. Licensed CC0.

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