Psychological resilience and valued living as mediators in the relation between moral injury and attitudes toward future among Turkish adults

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BACKGROUND: Moral injury exacerbates poor outcomes, such as negative attitudes toward the future; however, the potential underlying mechanisms of this association remain unknown. This present study aimed to disentangle the pathways linking moral injury to confidence toward the future through the serial mediation effect of psychological resilience and valued living in a Turkish population. METHODS: The data analyzed were collected from representative samples of adult aged 18-65 years living in Gaziantep Province, Turkey. A total of 681 participants (77.7% female, mean age = 25.05) were included in this study. Structural equation modeling (SEM) was used to analyze the relationships among the variables. RESULTS: Indirect effects of moral injury on confidence toward the future were found. The direct effect of moral injury on attitudes toward the future in the presence of mediators was not significant (b = 0.014, p > 0.05). Thus, we concluded that there was a fully serial mediation by psychological resilience and valued living in the relationship between moral injury and attitudes toward the future (b = -0.077, 95% bootstrap CI: -0.115 to -0.048). LIMITATIONS: The main constraint of this study was its cross-sectional design, which restricted the capacity for causal inference. CONCLUSIONS: These findings highlight the role of psychological resilience and valued living as serial mediators in the relationship between moral injury and confidence toward the future. Therefore, mental health professionals or clinicians incorporating intervention programs aimed at enhancing psychological resilience and promoting valued living could be beneficial, especially for individuals who have experienced moral injuries. Employing a multifaceted therapeutic approach may be advantageous in addressing these concerns.