| Many Veterans experience traumatic and stressful events that are more common to wartime and combat settings than non-combat settings. Veterans may also experience potentially morally injurious events (PMIEs). Experiencing PMIEs may lead to moral injury (MI)which represents the impairment and distress from violations of moral values. A moral injury may meet the criteria for and be diagnosed as PTSD but it is not clear if Veterans with moral injury respond to currently used PTSD treatments such as cognitive processing therapy (CPT) or prolonged exposure (PE). This project investigated the association between symptoms of MI and treatment-initiation, treatment-adherence, and effectiveness of PE and CPT treatments. Data from 706 Veterans with a diagnosis of PTSD were used to examine these associations. Initial PTSD and MI symptoms were not associated with initiation to PE or CPT. For Veterans who initiated treatment, MI symptoms of transgression were associated with Veteran treatment-adherence for both PE and CPT, such that more severe MI transgression symptoms increased likelihood of treatment dropout. Among treatment completers, PTSD and MI symptoms were not associated with PTSD symptom reduction. Finally, PE evidenced greater PTSD symptom reduction than CPT for treatment completers. The results suggest that Veterans with PTSD who have high MI symptoms of transgression would benefit from supplementary treatment modules within PE and CPT or alternative treatments specific to their MI distress. Key Words: Veteran, PTSD, Moral Injury, PE, CPT |