Institutional Betrayal in Military and Veteran Populations: A Systematic Scoping Review.

Abstract

BACKGROUND: Institutional betrayal (IB) refers to the wrongdoings, encompassing both action and inaction, committed by institutions against their affiliated individuals. Military members are particularly vulnerable to IB due to strong social identification with the military, values of loyalty and self-sacrifice, dependence on the institution, the military power structure and legal system, and the complexity of morality in an occupation centered around war. AIMS: This review examines the state of IB literature within the military/Veteran population, identifying research gaps and implications for future policy and clinical care. METHODS: Conducting a systematic scoping literature review across seven databases resulted in 16 eligible publications out of 44 found. RESULTS: Findings indicate a high prevalence of IB experiences within the studied population, correlating with increased psychiatric symptoms and clinical features. The existing literature primarily focuses on military sexual trauma, with limited exploration of IB in the context of combat, politics, return from deployment, illness, military exposures, and moral injury. CONCLUSIONS: Future research should expand on IB in other military experiences, evaluate intervention efficacy and policies, and validate a standardized IB measure. These insights highlight the need for provider education, revised assessments, and interventions tailored to address the complex impact of IB on military and Veteran populations.