Purpose in life and suicidality after military sexual assault: Gendered pathways through moral injury.

Psychology of Violence, Nov 03, 2025, No Pagination Specified; doi:10.1037/vio0000660

Objective: The present study tested the indirect effect of betrayal-based moral injury on the association between military sexual assault (MSA) and suicidality among male and female service members. We also tested whether the indirect effect was conditional on levels of purpose in life. Method: Participants were a community sample of former or current U.S. service members (N = 250, 173 men, M_age = 33.3 years, SD = 8.65 years). They completed an online survey assessing MSA, betrayal-based moral injury, suicidality, and purpose in life. Results: Across the full sample, MSA endorsement was associated with greater betrayal-based moral injury symptoms, which were in turn linked to greater suicidality. This indirect relationship was unexpectedly stronger at higher levels of purpose in life. When examined by gender, inclusion of purpose in life appears to weaken the direct relationship between MSA and suicidality for men but slightly intensified this link for women who endorsed MSA. Additionally, among women, MSA was strongly associated with betrayal-based moral injury, more so than for men and the full sample, and indirectly associated with greater suicidality; however, the conditional indirect effect was only present at high levels of purpose in life, suggesting purpose in life may play a complex role in the context of MSA and moral injury, especially for women. Conclusions: These findings have implications for those who work with MSA survivors such that greater perception of betrayal from the military institution/peers was associated with suicidality and provide support to betrayal trauma theory (Freyd, 1994). (PsycInfo Database Record (c) 2025 APA, all rights reserved)