Moral injury is a type of trauma that can result from actions taken against the rules or in the spirit of good character or morals. Moral injury is a psychological injury, which may be treated in much the same way as other injuries. The term has been adopted into some mental health interventions but the evidence to support this practice is lacking. This article describes a theoretical model, in an attempt to advance understanding of how moral injury may be conceptualised and treated in a mental health setting.
A person's moral identity and moral values may influence his or her response to moral injury and, as such, how a person perceives the source of moral injury. Implications for intervention are discussed.
Moral injury is an experience of perceived failure to uphold basic moral values that may lead to a sense of personal loss or shame. Moral injury is a specific type of traumatic stress reaction, that is unique, qualitatively and in its manifestation to the human being. The symptoms of moral injury may occur in isolation or in conjunction with other types of traumatic reactions. The term Moral Injury may be useful to describe this experience and may encompass different stages of psychological development.
The number of people diagnosed with this illness is increasing, possibly because the media and the public are more receptive to the illness. This raises concerns that as the number of people affected by the illness increases, more support and services are needed. It also raises concerns about people delaying diagnosis. Understanding the magnitude of this illness, which disproportionately affects people with lower income and race, is imperative to developing more effective programs and treatments that improve outcomes for this population.
Moral injury can be treated through CBT. If not managed properly can have negative and long-term effects on the person affected. The patient must be taught coping strategies to be better able to cope. Cognitive-behavioural therapy is recommended to deal with the thoughts and behaviour associated with this type of injury.\n
Moral Injury may be conceptualized as a self-harm experienced by some individuals during or after encountering a difficult or challenging event, for which other people might not have anticipated the negative consequences. Moral Injury is distinct from other types of self-harm in that it is self-inflicted in the absence of desire to self-harm and it is less likely to be associated with suicidal behavior.
A positive self-evaluation was an important factor in developing self-acceptance in the study. Although we do not know what will happen in the long term, we can conclude that positive self-evaluation is important for self-acceptance, and it is difficult to change a person's self-evaluation based on the past. Data from a recent study, using a self-report questionnaire similar to that of the Pe+er Scale, showed its validity and reliability. It also suggested that peer acceptance is closely related to self-acceptance.
Data from a recent study suggest one of the main areas of contention is the potential for peer victims to develop negative appraisals. A variety of factors may contribute to this: (1) peer victims may not feel capable of challenging and challenging behaviours of other people; (2) peer victims may underestimate the threat of violence; (3) peer victims may feel angry towards the perceived perpetrators; (4) they may feel that the aggression is their own fault; (5) they may feel guilty; (6) they may feel like they have failed as a protector of the children; (7) peer victims may feel that they are letting others down or may feel like they should have been better parents and guardians.
If they get their first moral injury at 28 this estimate would be accurate. But if not getting one at age 28 this estimate would overstate the average person's experience. The most likely reason we get one at 26 might be that the average is a good estimate because we seldom get one at age 5; this makes age 26 the most likely age for a moral injury (for people getting their first one). These estimates are for the most part in the same range of the standard sample mean. If you're more than age 26 you're probably doing the right thing by reporting your first moral injury to your health care provider.
This was a mixed group of participants who suffered great distress from the experience. The key points from this questionnaire were: “To have committed moral error in a way that was not morally permissible or the cause of a major moral distress to oneself or another moral agent, you must have knowingly and intentionally made or supported someone else’s moral error.
This is the first P+E trial reporting improvements in QoL. Results from a recent clinical trial suggest that psychosocial interventions that specifically address moral injury are effective in improving quality of life. In future research efforts addressing the role of psychological interventions for moral injury, it may be crucial to examine whether such interventions might help patients with moral injury experience increased QoL.
The research demonstrates a positive impact for moral injury. Understanding and alleviating the moral injury is imperative. Moral injury affects the individual and the whole society in its impact to interpersonal relationships and social functioning, and moral injury can be improved and supported through interventions. These interventions encourage patient to make decisions and take responsibility on their own.