# Moral Injury and Post‐Traumatic Stress Disorder in War: The Effect of Marital Status and Previous Genocidal Trauma

**Authors:** Larysa Zasiekina, Serhii Zasiekin, Victor Kuperman

PMC · DOI: 10.1002/ijop.70204 · 2026-03-20

## TL;DR

This study explores how the trauma of the Holodomor genocide affects descendants and how being married influences moral injury during the Russia-Ukraine war.

## Contribution

The study expands moral injury research to third and fourth-generation descendants of genocide survivors and examines the role of marital status.

## Key findings

- Married descendants of Holodomor survivors show significantly higher moral injury when familial trauma is present.
- Non-married individuals do not show significant differences in moral injury related to genocidal trauma.
- The interaction of genocidal trauma and marital status does not affect PTSD levels.

## Abstract

This study examines the intergenerational transfer of the genocidal trauma of the Holodomor (1932–33) and explores how marital status moderates its impact on moral injury and post‐traumatic stress disorder (PTSD) in the context of the ongoing Russia‐Ukraine war. Moral injury, distinct from PTSD, arises from the violation of moral beliefs, leading to emotional distress characterised by guilt, shame, anger, disgust and a sense of betrayal. While previous research predominantly focused on direct survivors of genocide, this study expands the understanding of moral injury to their descendants, particularly the third and fourth generations, highlighting the often‐overlooked familial dynamics involved. Through a sample of 1857 participants, our findings reveal that married descendants of Holodomor survivors exhibit significantly higher levels of moral injury when familial genocidal trauma is present, contrasting with non‐married individuals who show no significant difference. This suggests that marital status plays a vital role in shaping the emotional burden of inherited moral injury, as these individuals grapple with the dual responsibilities of familial protection and the distress of genocidal trauma. Our results indicate that the interaction of genocidal trauma and marital status does not extend to PTSD. These findings emphasise the need for targeted family‐based interventions to address the complexities of intergenerational moral injury.

## Linked entities

- **Diseases:** post‐traumatic stress disorder (MONDO:0005146)

## Full-text entities

- **Diseases:** mental (MESH:D008607), creep (MESH:D007815), mental disorder (MESH:D001523), emotional distress (MESH:D012128), inherited trauma (MESH:D030342), emotional dysregulation (MESH:D021081), mass violence (MESH:C536030), Genocidal trauma (MESH:D014947), Moral Injury (MESH:D013313), death (MESH:D003643), depression (MESH:D003866)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13004653/full.md

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Source: https://tomesphere.com/paper/PMC13004653