Association Between Psychological Moral Injury and Delay Discounting in Military Veterans: A Behavioral Economic Perspective

Background/Objectives: In a recent meta-analysis of 1186 empirical studies, results showed that impulsivity may be one of the most important predictors of substance use. As such, the current study examined the association between an emerging psychological construct in the military veteran population, moral injury, and impulsivity—a construct found in high prevalence among military veterans. Methods: In this cross-sectional pilot study, 31 veterans completed the Moral Injury Purchase Task (MIPT), a behavioral economic assessment of sensitivity to moral injury–related relief, and the Monetary Choice Questionnaire. Demand indices for moral injury were derived, and delay discounting was quantified using area under the curve (AUC) and effective delay (ED50). Results: Participants were primarily White and male, with an average age of 38.55 years. Multivariable linear regression models adjusted for age, race, and sex. Higher moral injury intensity (b = 0.002, SE = 0.001, p = 0.04) and clinically significant moral injury (b = 0.17, SE = 0.07, p = 0.02) were associated with greater delay discounting AUCs, indicating increased preference for immediate outcomes. ED50 was not significantly associated with moral injury indices. Conclusions: Results suggest that moral injury may be linked to contextually driven shifts toward immediate reinforcement. Practitioners should consider including delay discounting in clinical settings.