Moral injury, PTSD, and intimate partner aggression: The roles of guilt-proneness and shame-proneness.

Abstract

Objective: Longitudinal research indicates a bidirectional relationship between posttraumatic stress disorder (PTSD) and perpetration of intimate partner aggression (IPA). Moral injury—a complex trauma-related syndrome encompassing biological, psychological, social, and spiritual dimensions—is consistently associated with PTSD and has recently been linked to IPA. Although guilt-proneness and shame-proneness have been explored in relation to both PTSD and perpetration of IPA, their connections to moral injury remain understudied. Method: The present study was designed to examine the relationships among IPA, PTSD, shame-related moral injury, trust-violation-related moral injury, guilt-proneness, and shame-proneness among adult participants recruited from Prolific ( N = 321) who completed validated measures. Results: Results of the structural equation model revealed that shame-proneness positively predicted IPA perpetration, while guilt-proneness negatively predicted IPA perpetration. Meanwhile, IPA perpetration significantly predicted both shame-related and trust-violation-related moral injury. IPA perpetration significantly mediated the relationships between (a) shame-proneness and both types of moral injury and (b) between guilt-proneness and shame-related moral injury. Trust-violation-related moral injury, but not shame-related moral injury, significantly predicted PTSD symptoms. However, the indirect effects of IPA perpetration on PTSD symptoms through either form of moral injury were not statistically significant. Conclusions: Our findings contribute to the sparse literature on moral injury in relation to IPA perpetration and highlight the need for interventions addressing moral injury among individuals who engage in IPA to combat the cyclical nature of partner violence. (PsycInfo Database Record (c) 2025 APA, all rights reserved) (Source: journal abstract) Impact statementOur findings highlight that some individuals who engage in aggression toward their intimate partner may experience significant moral distress, that proneness to feeling shame is associated with increased perpetration, and proneness to feeling guilt is related to decreased perpetration. These results suggest that interventions should assess for moral injury and focus on reducing shame-based responses while fostering appropriate guilt-based responses to help break cycles of intimate partner aggression. (PsycInfo Database Record (c) 2025 APA, all rights reserved)