Morale as a Moderator of the Combat Exposure-PTSD Symptom Relationship

Journal of Traumatic StressFebruary 2013, 26, 94–101

Morale as a Moderator of the Combat Exposure-PTSD SymptomRelationship

Thomas W. Britt,1,2,3 Amy B. Adler,2 Paul D. Bliese,1 and DeWayne Moore3

1Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA2U.S. Army Medical Research Unit-Europe, Walter Reed Army Institute of Research, Heidelberg, Germany

3Clemson University, Clemson, South Carolina, USA

We examined morale as a moderator of the relationship between combat exposure and posttraumatic stress disorder (PTSD) symptoms ina longitudinal study of U.S. soldiers who had participated in a deployment to Iraq. Soldiers (N = 636) completed assessments at 4 (Time1) and 10 (Time 2) months following their combat deployment. Combat exposure (both breadth and perceived stressfulness), morale, andPTSD symptoms were assessed at Time 1, and PTSD symptoms were assessed again at Time 2. Results of multivariate multiple regressionsrevealed that morale at Time 1 interacted with both the breadth and stressfulness of combat exposure to predict PTSD symptoms at bothTime 1 and Time 2, even when partialling out the effect of unit support. The slope of the given combat exposure and PTSD symptomsrelationship was weaker when reports of morale were higher (with the effect size of the interaction ranging from .01 to .04). The resultssuggest that morale may buffer soldiers from the negative consequences of combat stressors.

Many military personnel returning from recent operationsin Iraq and Afghanistan develop mental health problems suchas posttraumatic stress disorder (PTSD) as a result of expo-sure to traumatic events during combat (Hoge, Auchterline,& Milliken, 2006; Hoge et al., 2004). The relationship be-tween combat exposure and symptoms of PTSD has been re-peatedly demonstrated following multiple combat operations(Adler et al., 2009; Hoge et al., 2004). Furthermore, exposureto combat has been related to mental health symptoms such asPTSD long after combat is over (Bliese, Wright, Adler, Cabrera,Castro, & Hoge, 2008). Therefore, researchers have been ac-tive in examining factors that may buffer military veterans fromthe negative effects of exposure to combat (see Glass, 1970;Iverson et al. 2008; Silsby & Jones, 1985; Solomon, Mikulincer,& Hobfoll, 1986). In the present study, we examined postde-

We thank MAJ Dennis McGurk, Angela Salvi, Rachel Eckford, Dr. CharlesHoge, MAJ Oscar Cabrera, Dr. Kathleen Wright, SFC Shawn Abrahamson,SGT Lisa Williams, SPC Matthew McGinnis, Allison Whitt, Paul Kim, RobertKlocko, Steven Terry, Lance Rahey and Dr. James Pennebaker.

The findings described in this article were collected under a Walter Reed ArmyInstitute of Research (WRAIR) Protocol. The views expressed in this articleare those of the authors and do not necessarily represent the official policy orposition of the U.S. Army Medical Command or the Department of Defense.

Correspondence concerning this article should be addressed to Thomas W.Britt, Department of Psychology, Clemson University, Clemson, SC 29634.E-mail: [email protected]

Published 2013. This article is a US Government work and is in the publicdomain in the USA. View this article online at wileyonlinelibrary.comDOI: 10.1002/jts.21775

ployment morale as a moderator of the combat exposure-PTSDsymptoms relationship. In the remainder of the introduction,we address why morale should be expected to moderate thecombat exposure-PTSD symptom relationship.

The construct of morale has been used by both military andcivilian researchers to describe an important psychological re-source that presumably causes employees to persevere underdifficult conditions (Manning, 1991; Vandenberg, Richardson,& Eastman, 1999). Within military settings, some researchershave provided multidimensional definitions of morale that in-clude concepts such as unit cohesion and esprit de corps(Baynes, 1967; Motowidlo & Borman, 1978). Other researchershave defined morale more narrowly, with Ingraham andManning (1981) referring to morale as “a psychological stateof mind, characterized by a sense of well-being based on confi-dence in the self and in primary groups” (p. 6). Within civiliancontexts, morale has also been referred to in different ways,with Vandenberg et al. (1999) commenting on the definition ofmorale “ . . . when pressed for a definition, they have difficultynarrowing it down to a single entity and often find it easierto describe morale in many ways (e.g., employees are happy,committed, motivated, and will stick around” (p. 311).

Britt and Dickinson (2006) noted that one common elementin both civilian and military definitions of morale has been em-ployees possessing a sense of energy and enthusiasm in theirparticular work context. For example, when applying morale toa teacher context, Hart (1994) defined morale as “the energy, en-thusiasm, team spirit, and pride that teachers experience in theirschool” (p. 113), and in a military context, Britt and Dickinson

94

Morale as a Moderator 95

(2006) defined morale as a positive psychological variable re-flecting “a service member’s level of motivation and enthusiasmfor achieving mission success” (p. 162).

Defining morale in this manner places it within a familyof motivational constructs combining energy with a positivemotivational state of mind, such as subjective vitality (Ryan& Frederick, 1997) and vigor (McNair, Lorr, & Droppelman,1971; Shirom, 2010). Although there are some distinctions be-tween morale and these related constructs, we would arguethey all represent positive energy as a personal psychologicalresource that should allow individuals to accomplish tasks anddeal with environmental demands (see Hobfoll, 1998; Shirom,2010).

Similar to Shirom’s (2010) concept of vigor, we see moraleas a type of positive affect that combines feelings of energywith feelings of enthusiasm for accomplishing salient tasks.Therefore, morale is presumed to positively influence adapta-tion under stressful conditions through mechanisms similar toother positive affective states. For example, Frederickson andher colleagues have argued that positive affect increases therange of thought-action repertoires, so that individuals expe-riencing more positive affect should think of more potentialsolutions for dealing with current life problems (Fredrickson,1998; Fredrickson & Losada, 2005). Individuals high in moralemay be similarly likely to generate a greater range of optionsfor approaching work demands, which should enable them tofunction better when dealing with the consequences of stressfulevents. Morale may also provide a respite from dealing withthe symptoms resulting from combat exposure, provide energyto cope with the consequences of combat exposure, or enablemilitary personnel to change their interpretation of their com-bat experiences (Folkman & Moskowitz, 2000). The theoreticalmodel illustrating how morale is related to fewer PTSD symp-toms following combat exposure is provided in Figure 1.

To strengthen the argument that morale is a novel bufferof the negative effects of combat exposure on PTSD symp-

Combat experiences

Energy for

coping

PTSD symptomsMorale

Unit support

Greater range of coping

responses

Positive interpretation

of combat experiences

Figure 1. Overall model of how morale is hypothesized to moderate the combatexperiences—posttraumatic stress disorder (PTSD) symptoms relationship,controlling for unit support.

toms, we examined morale as a moderator after controlling forunit support (see Figure 1). Like morale, unit support providesa resource to help individuals manage stressful experiences.High levels of unit support provide military personnel with theknowledge there are other people they can turn to when copingwith their postcombat experiences, which is a different pro-cess than we are proposing for morale. Indeed, studies havefound unit support is predictive of well-being among servicemembers following combat (Siebold, 2006; Solomon, et al.,1986).

In the present study we assessed unit support with a modi-fied version of the perceived organizational support scale (POS;Eisenberger, Huntington, Hutchison, & Sowa, 1986). The POShas been defined as the extent to which an employee believesthe organization values his or her contributions and cares abouthis or her well-being, and has been found to predict variousmental health outcomes (see Rhodes & Eisenberger, 2002).Thus, to establish whether morale provides a unique resourcefor individuals who experienced high levels of combat stres-sors, we first accounted for the influence of unit support beforeexamining the impact of morale on the combat exposure-PTSDsymptom relationship.

It is particularly important to assess the impact of modera-tors for individuals in those occupations where environmentaldemands are high and employees are at risk for exposure to trau-matic events (Bacharach & Bamberger, 2007). Service mem-bers deployed to combat can certainly be included as a high-riskoccupational category. Exposure to combat creates long-termdemands that must be coped with to reduce future mental healthproblems (Bliese et al., 2009). Under such demanding occupa-tional conditions, morale represents one valuable resource thatmay disrupt the cumulative negative effects of being exposedto high levels of combat, and may provide military person-nel with the necessary energy and outlook to better deal withthe consequences of combat exposure (Folkman & Moskowitz,2000).

Therefore, the purpose of the present research was to ex-amine morale as a psychological resource for soldiers whorecently returned from a combat deployment by assessingwhether higher levels of morale would be associated withlower levels of PTSD symptoms under high levels of com-bat exposure, even when controlling for the effects of an-other work-related resource, unit support. We examined moraleas a buffer against the negative effects of combat exposureduring two different periods following a combat deployment:4 months (Time 1) and 10 months (Time 2). Mental healthproblems such as PTSD tend to increase in the months fol-lowing a soldier’s return from a deployment (Bliese, Wright,Adler, Thomas, & Hoge, 2007), indicating the effects of com-bat exposure continue after soldiers return home (supportiveof a sleeper-effect model; see Garst, Frese, & Molenar, 2000).We therefore hypothesized that morale at Time 1 would inter-act with combat exposure to predict PTSD symptoms at bothTime 1 and Time 2, even when controlling for unit support atTime 1.

Journal of Traumatic Stress DOI 10.1002/jts. Published on behalf of the International Society for Traumatic Stress Studies.

96 Britt et al.

The hypotheses were examined with two different measuresof combat exposure, one reflecting a sum of the combat expe-riences participants reported, and a second reflecting the meanstressfulness rating of the combat experiences that were re-ported. These two measures address the breadth of exposure(Bendixen, Endresen, & Olweus, 2003) as well as the degree towhich combat experiences were perceived as stressful. We hy-pothesized that morale would buffer soldiers from both indicesof combat at both time periods through the processes identifiedin Figure 1.

Method

Participants and Procedure

Participants were active-duty U.S. soldiers (N = 641) in abrigade combat team (BCT) who had returned from a 15-monthcombat deployment to Iraq. Participants were assessed 4 monthsafter their return and again 6 months later. Participants wereonly included if they completed both assessments. There were1,658 veterans who completed the first assessment, resulting inresponse rate of 38% who completed the second assessment.Such a response rate is not unusual in military samples (Adleret al., 2009; Britt, Adler, & Bartone, 2001), as service membersfrequently move to new duty stations or may not be present onthe dates of testing due to numerous obligations (i.e., trainingand other mission-related travel). Surveys were administered ina classroom (Time 1) and theater (Time 2) on U.S. Army baseslocated in Germany.

No significant differences were obtained between those par-ticipants in the Time 1 sample who completed the Time 2 as-sessment in gender or ethnicity compared to those who did notcomplete the Time 2 assessment. Slight differences, however,did emerge in terms of rank. The Time 1 sample who completedthe Time 2 assessment contained a slightly higher percentageof junior enlisted soldiers (63%) than those who did not (56%),and a slightly lower percentage of noncommissioned officers(32% vs. 38%, respectively), χ2(2, N = 1652) = 8.86, p = .012.In terms of the continuous measures, those who completed theTime 2 assessment did not differ from those who did not com-plete the Time 2 assessment in PTSD symptoms at Time 1,F(1, 1655) = 2.21, p = .14, combat exposure breadth, F(1,1613) = .92, p = .339, or combat exposure stressfulness, F(1,1649) = .18, p = .67. Those completing the Time 2 assessmentdid report slightly higher levels of morale (M = 2.89 vs. M =2.78), F(1, 1644) = 6.23, p = .013, and unit support (M = 4.11vs. M = 3.83), F(1, 1643) = 19.67, p < .001, than those notcompleting the Time 2 assessment.

The analytic sample (those who completed both Time 1and Time 2 assessments) was 96% male and 4% female. Interms of rank, the sample was 63% junior-enlisted (privateto corporal), 32% senior-enlisted (sergeant to sergeant major),and 5% officers. In terms of ethnicity, the sample was 64%Caucasian/White, 13% African American, 12% Hispanic, and4% Asian/Pacific Islander. The measures used in the present

study were part of a survey that was administered as partof a larger study on postdeployment transitions (Adler, Britt,Castro, McGurk, & Bliese, 2011). This study was approved byan institutional review board (IRB) at the Walter Reed Army In-stitute of Research. Participation was voluntary, and after beingbriefed on the study, 90.1% of potential participants providedtheir informed consent by indicating their responses could beused for research purposes on the survey and took part in thestudy.

Measures

Morale. Morale at Time 1 was assessed by a 5-item scalewhere soldiers rated, on a 5-point response format from verylow to very high, their level of “personal morale,” “energy,”“drive,” “enthusiasm,” and “eagerness.” This scale was a mod-ified version of that used by Britt, Dickinson, Moore, Castro,and Adler (2007). The adjectives “enthusiasm” and “eager-ness” were added to this version of the scale to better captureour conceptualization of morale as the positive energy an in-dividual possesses in the service of future action. Collectively,the five items assess the components of morale representingenergy/motivation combined with a positive orientation to thework environment. Britt et al. (2007) reported a Cronbach’s α

of .89 for a similar version of the measure. The Cronbach’s α

in the present study was .93.

Unit support. Unit support was assessed at Time 1 usinga modified version of the Eisenberger et al. (1986) 8-item sur-vey of perceived organizational support (POS). The modifieditems replaced the word “employer” with “unit.” Sample itemsincluded “My unit strongly considers my goals and values”and “My unit really cares about my well-being.” The responseswere assessed on a 5-point Likert scale anchored by Stronglydisagree and Strongly agree. The measure of POS used in civil-ian samples has been positively related to performance andnegatively related to turnover, and the version of the POS scaledeveloped by Eisenberger has been used in dozens of studiesand has demonstrated reliability and validity (see Rhoades &Eisenberger, 2002). The present study is the first to use thePOS to assess unit support. Prior studies, however, have foundsimilar measures of unit support to be positively related to thewell-being of military personnel (see Solomon et al., 1986).The Cronbach’s α in the present study was .90.

Combat exposure. At Time 1 soldiers completed a 33-item measure of combat exposure regarding their most recentdeployment to Iraq that was a modification of the instrumentused by Hoge et al. (2004) and Adler et al. (2009). Sampleitems were “Being attacked or ambushed,” “Handling or recov-ering human remains,” and “Shooting or directing fire at theenemy.” For each item soldiers were asked whether they hadexperienced the event, and if so, to rate the stressfulness of theevent. Combat exposure breadth was assessed by summing thenumber of “yes” responses, and combat exposure stressfulness



was assessed by taking the mean of the stress ratings that wereprovided. Participants rated how stressful each event was on ascale from 1 = Not at all to 5 = Extremely. Note these twomeasures assess different constructs, as soldiers could reporta relatively small variety of combat experiences, but considerthese experiences quite stressful. The Cronbach’s α for com-bat exposure breadth was .90, and the for combat exposurestressfulness was .97.

PTSD symptoms. Posttraumatic stress disorder symptomsat Time 1 and 2 were assessed using the PTSD Checklist-Military Version (PCL; Blanchard, Jones-Alexander, Buckley,& Forneris, 1996; Weathers, Litz, Herman, Huska, & Keane,1993). This well-validated measure (see Bliese, Wright, Adler,Thomas, & Hoge, 2008) includes 17 items that correspond tothe diagnostic criteria for PTSD in the Diagnostic and Statis-tical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000). The items areresponded to on a 5-point scale (1 = Not at all to 5 = Ex-tremely). Sample items include “Repeated, disturbing dreamsof the stressful experiences” and “Feeling irritable or havingangry outbursts.” The same measure was administered at Time2. The Cronbach’s α in the present study was .94 for Time 1and .95 for Time 2.

Data Analysis

Missing data were infrequent. Therefore, scale scores formorale, unit support, combat exposure stressfulness, and PTSDsymptoms were calculated based upon the responses provided.Combat exposure breadth was calculated based upon the num-ber of yes responses, with missing values treated as participantsnot experiencing the event. Correlations among all the continu-ous variables were examined to assess the associations amongthe variables. A principal axis factor analysis was conductedto assess whether the items assessing morale and unit supportformed two different factors. The results of the scree plot andan eigenvalue > 1 suggested retaining two factors for rotation.These factors were submitted to a varimax rotation, and thefactor loadings revealed that all items from the morale scaleloaded on one factor (with loadings ranging from .70 to .87),and all the items for the unit support scale loaded on a secondfactor (with loadings ranging from .53 to .83). No item loaded> .40 on the opposite factor.

We examined the moderating effects of morale in two dif-ferent ways, one involving the prediction of absolute levels ofPTSD symptoms at Time 1 and Time 2, and one involvingthe prediction of change in PTSD symptoms from Time 1 toTime 2. We first conducted a multivariate multiple regressionwith morale, combat exposure breadth, unit support, and theinteraction between morale and combat exposure breadth aspredictors, and PTSD symptoms at Time 1 and Time 2 as thedependent variables. Predictors were mean-centered prior to en-try in the regression (Cohen, Cohen, West, & Aiken, 2003). Thesame multivariate multiple regression was conducted for com-

bat exposure stressfulness as a predictor. Most prior researchinvestigating combat exposure and other factors as predictors ofPTSD symptoms has examined the prediction of absolute lev-els of PTSD symptoms (Bacharach & Bamberger, 2007; Blieseet al., 2008; Iverson et al., 2008), as opposed to changes inPTSD symptoms from one time period to another. When wemodeled the moderating effects of morale on the relationshipbetween combat exposure and change in PTSD symptoms fromTime 1 to Time 2, the results were not significant (details onthese analyses are available from the first author). Althoughmental health problems tend to increase in the months follow-ing deployment for soldiers in general (Bliese et al., 2007), thestability of individual scores in terms of their rank order withina given sample is relatively strong (Wright, Britt, Bliese, Adler,Picchioni, & Moore, 2011).

Given both the theoretical and methodological challengessurrounding modeling changes in PTSD, the main analyticframework relied on multivariate multiple regression to exam-ine whether morale interacted with combat exposure breadthand combat exposure stressfulness to predict absolute levelsof PTSD symptoms at Time 1 and Time 2. The approach wasalso used to assess whether the interactions remained significantwhen for unit support was included in the model. We conductedall analyses with the demographic variables of rank and gender.All of the significant interactions reported below remained sig-nificant when these demographic variables were in the model,and the results are presented without the demographics includedin the model.

Results

Table 1 provides the means, standard deviations, and correla-tions among the continuous measures. As seen in the table,morale was related to PTSD symptoms at both Time 1 andTime 2, as was unit support. Supporting the argument thatmorale and unit support are linked theoretically, there was afairly strong relationship between the variables.

In addition, morale and unit support were slightly related tocombat breadth and stressfulness. The two combat measureswere related to PTSD symptoms at both periods. Interestingly,the relationship between breadth of combat exposure and per-ceived stressfulness of combat exposure was only moderate.The Time 1–Time 2 correlation for PTSD symptoms showedrelatively strong stability of symptoms across the 6-monthperiod.

Morale as a Moderator of the Combat ExposureBreadth-PTSD Symptom Relationship

The results of the multivariate regression revealed significantmultivariate effects for morale, F(2, 635) = 21.97, p < .001,R2 = .07, unit support, F(2, 635) = 6.33, p = .002, R2 = .02,combat exposure breadth, F(2, 635) = 92.54, p < .001, R2 =.27, and the interaction between morale and combat exposurebreadth, F(2, 635) = 13.44, p < .001, change in R2 = .04. Given


98 Britt et al.

Table 1Means, Standard Deviations, and Correlations for Continuous Measures at Time 1 and Time 2

Variable Mean SD 1 2 3 4 5

1. Morale (T1) 2.88 0.92 –2. Unit support (T1) 4.11 1.23 .58*** –3. Exposure-breadth (T1) 13.30 8.19 -.16*** -.11* –4. Exposure-stress (T1) 2.77 .91 -.23*** -.15*** .34*** –5. PTSD (T1) 30.94 13.33 -.41*** -.31*** .48*** .45*** –6. PTSD (T2) 31.59 14.66 -.32*** -.28*** .40*** .37*** .69***

Note. ns range from 625–641. PTSD (T1) and PTSD (T2) refer to PTSD symptoms at Time 1 and Time 2. Exposure-Breadth (T1) refers to combat exposure breadth atTime 1. Exposure-Stress (T1) refers to combat exposure stressfulness at Time 1. PTSD = posttraumatic stress disorder.

*p < .05. ***p < .001.

the significant multivariate effects, Table 2 provides the resultsfor the separate outcome variables of PTSD symptoms at Time1 and Time 2. The results show the hypothesized interactionbetween morale and combat exposure breadth in the predictionof PTSD symptoms at Time 1 and Time 2 after controlling forunit support. Figure 2 provides a graph of the interaction as apredictor of PTSD symptoms at Time 1. As seen in Figure 2,when combat exposure breadth was high, those reporting highmorale were much less likely to report symptoms of PTSD. Thesame form of interaction was obtained for PTSD symptoms atTime 2.

Morale as a Moderator of the Combat ExposureStressfulness–PTSD Symptom Relationship. The results ofthe multivariate regression revealed significant multivariate ef-fects for morale, F(2, 619) = 21.72, p < .001, R2 = .07, unitsupport, F(2, 619) = 5.26, p = .017, R2 = .02, combat exposurestressfulness, F(2, 619) = 60.64, p < .001, R2 = .16, and theinteraction between morale and combat exposure breadth, F(2,619) = 4.93, p = .006, change in R2 = .02. Given the signif-icant multivariate effects, Table 3 provides the results for theseparate outcome variables of PTSD symptoms at Time 1 andTime 2. The results show the hypothesized interaction betweenmorale and combat exposure stressfulness in the prediction ofPTSD symptoms at Time 1 and Time 2 after controlling for unit

support. Figure 3 provides a graph of the interaction as a pre-dictor of PTSD symptoms at Time 1. As seen in Figure 2, whencombat exposure stressfulness was high, those reporting highmorale were much less likely to report symptoms of PTSD. Thesame form of interaction was obtained for PTSD symptoms atTime 2.

Discussion

The results of the present study provide support for morale asa buffer against the negative psychological consequences ofcombat. Although the effect sizes were relatively small, moraleemerged as a moderator of the relationship between two differ-ent indices of combat exposure (breadth and perceived stress-fulness) and PTSD symptoms at two different periods after sol-diers returned home from a deployment, and these moderatingeffects were obtained even when controlling for unit support.

Individuals reporting high levels of morale were less likelyto report PTSD symptoms under high combat exposure breadthand perceived stressfulness, both when PTSD symptoms wereassessed concurrently with the other variables (at 4 months fol-lowing deployment), as well as when PTSD symptoms wereassessed 6 months later. Importantly, the moderating effects ofmorale were obtained even after controlling for unit support, avariable that has been found to be related to indices of strain in

Table 2Multiple Regression of Morale, Unit Support, and Combat Exposure Breadth on PTSD Symptoms

PTSD Symptoms T1 PTSD Symptoms T2

Predictor B SE B β R2 B SE B β R2

Unit support (T1) -1.25** 0.42 -.12 .038** -1.68** 0.51 -.14 .24**Morale (T1) -3.78** 0.57 -.26 -2.73** 0.69 -.17Combat breath 0.69** 0.05 .42 0.63** 0.06 .35Combat breadth × Morale -0.28** 0.06 -.16 -0.18** 0.07 -.10

Note. N = 641. PTSD = posttraumatic stress disorder; T1 = time 1; T2 = time 2.

** p < .01.



31.58

47.14

28.93

35.97

20.0

25.0

30.0

35.0

40.0

45.0

50.0

HighLow

PT

SD

sy

mp

tom

s

Combat exposure breadth

Low morale High morale

Figure 2. Morale at Time 1 as a moderator of the relationship between combatexposure breadth and postraumatic stress disorder symptoms at Time 1 (N =641).

combat veterans in prior research (see Solomon et al., 1986).Iverson et al. (2008) found that high levels of unit morale werelinked to a lower incidence of PTSD among United Kingdompersonnel who had been deployed to Iraq. The present resultsreveal that individual-level morale also attenuates the relation-ship between combat exposure and symptoms of PTSD.

This raises the question of the process responsible for themoderating effects of morale. Bacharach and Bamberger (2007)noted that when employees are exposed to highly stressfulevents, their resources become depleted through dealing withtheir initial response to the events and coping with the symptomscreated by their exposure. Morale may provide military person-nel with additional resources needed to cope adequately withthe effects of combat. In addition, as a type of positive affect,morale may broaden the range of solutions soldiers come upwith to address the consequences of combat exposure, providea respite from dealing with the symptoms resulting from com-bat exposure, or perhaps enable military personnel to changetheir interpretation of their combat experiences (Folkman &Moskowitz, 2000; Fredrickson, 1998; Fredrickson & Losada,2005).

32.78

45.33

28.17

35.29

20.0

25.0

30.0

35.0

40.0

45.0

50.0

hgiH woL

PT

SD

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s

Combat exposure stressfulness

Low morale High morale

Figure 3. Morale at Time 1 as a moderator of the relationship between combatexposure stressfulness and postraumatic stress disorder symptoms at Time 1.

In the present study morale interacted with combat exposureto predict PTSD symptoms concurrently and 6 months later,but did not predict a change in PTSD symptoms from 4 to10 months postdeployment. This pattern of findings suggeststhe moderating influence of morale was constant across the6-month period, rather than morale exerting an influence at4 months postdeployment that resulted in a reduction of PTSDsymptoms 6 months later.

The biggest limitation of the present research was the useof self-report as the only measurement strategy for assessingthe variables that were examined. This raises the concern ofa same-source measurement bias influencing the strength ofthe relationships examined. This concern is more problematicfor cross-sectional than longitudinal analyses (Spector, Zapf,Chen, & Frese, 2000). Although most of the variables are bestaddressed in the subjective manner of self-report (Jex, 1998;McGrath, 1976), indicators of PTSD symptoms could havebeen addressed by structured interviews.

A second limitation was that our assessment of combatexposure occurred 4 months after soldiers returned from a15-month deployment. This necessitated soldiers responding

Table 3Multiple Regression of Morale, Unit Support, and Combat Exposure Stressfulness on PTSD Symptoms

PTSD Symptoms T1 PTSD Symptoms T2

Predictor B SE B β R2 B SE B β R2

Unit Support (T1) -1.08 0.44 -.10 .32** -1.66 0.52 -.14 .22**Morale (T1) -4.00** 0.61 -.27 -2.91** 0.71 -.18Combat Stress 5.42** 0.51 .37 4.98** 0.60 .31Combat Stress × Morale -1.63** 0.54 -.10 -1.61** 0.64 -.09

Note. N = 625. PTSD = posttraumatic stress disorder; T1 = Time 1; T2 = Time 2.

** p ≤ .01.


100 Britt et al.

to the measure retrospectively rather than shortly after thecombat exposure occurred. Ideally, combat experiences shouldbe assessed as close to the deployment as possible. Prior re-search, however, has demonstrated the reliability of veteran re-ports of traumatic events (Krinsley, Gallagher, Weathers, Kutter,& Kaloupek, 2003). Furthermore, as discussed earlier, the ef-fects of exposure to combat continue long after the deploymentis over.

A third limitation was that, like many studies examining thepsychological effects of traumatic events, our study did notinclude a baseline (predeployment) assessment of PTSD symp-toms and morale. Combat exposure was also related to morale,indicating the predictor may have influenced the moderator inthe present study.

Finally, as mentioned above, the effect sizes for the interac-tion terms in the present study were relatively small. It is worthnoting that detecting interactions between continuous variablesin field settings is notoriously difficult (see Cohen et al., 2003),and the effects sizes that are detected tend to be small (Chaplin,1991; Frazier, Tix, & Barron, 2004). Interaction effect sizes inthe 1% realm are therefore not atypical in applied research. Thepractical importance of small effects can be seen in Figure 2,which shows a fairly large difference in reports of PTSD symp-toms for soldiers reporting low versus high morale under highlevels of combat exposure.

Future research should examine the specific processes re-sponsible for morale’s moderating effects. In addition, researchis needed on how morale can be enhanced by the organization.Even though morale accounted for a relatively small amountof variance in PTSD symptoms in comparison to combat expo-sure, it may be possible to enhance morale following militaryoperations, whereas not much can be done to address combatexposure that has already occurred. Although morale is typi-cally conceptualized as an individual psychological resource,it is also likely that this individual resource can be affected bythe organizational context or small group (Britt et al., 2007).Thus, intervention studies can be developed that would focuson enhancing morale as an additional mechanism for reducingthe negative impact of combat experiences on mental health.

Specifically, interventions could enhance the motivationcomponent of morale through targeted leadership training, goalsetting, or reinforcing the meaning of a unit’s contributions toa larger mission (Britt & Dickinson, 2006). Interventions couldalso enhance the energy and drive component of morale throughthe use of energy management techniques (Tennenbaum,Edmonds, & Eccles, 2008). Such techniques are used in perfor-mance psychology and could be adapted for implementation atpostdeployment. Studies examining the impact of these kindsof interventions can also help to explain the processes by whichmorale moderates the impact of negative combat experienceson mental health.

The combat exposure-PTSD symptoms relationship is oneof the most robust in studies of combat veterans (see Adleret al., 2009; Hoge et al., 2004), so finding moderators of thisrelationship indicative of a buffering effect is important (Glass,

1970; Iverson et al. 2008; Silsby & Jones, 1985). Given thegrowing number of combat veterans, research on factors thatmight protect soldiers from the adverse effects of combat andtheir transition into practice should be a priority.

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Morale as a Moderator of the Combat Exposure-PTSD Symptom Relationship