PE+ER for Moral Injury

Recruiting · 18+ · Female · Charleston, SC

This study is evaluating whether integrating evidence-based emotion regulation skills training with a scientifically validated treatment for PTSD called Prolonged Exposure (PE), will enhance PTSD treatment retention and 'dose received'

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About the trial for Moral Injury

Eligible Conditions
Sexual Trauma · Anxiety Disorders · Mental Disorders · Disease · Stress Disorders, Traumatic · Stress Disorders, Post-Traumatic · Psychiatric Disorder NOS

Treatment Groups

This trial involves 2 different treatments. PE+ER is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Main TreatmentA portion of participants receive this new treatment to see if it outperforms the control.
Control TreatmentAnother portion of participants receive the standard treatment to act as a baseline.


This trial is for female patients aged 18 and older. There are 3 eligibility criteria to participate in this trial as listed below.

Inclusion & Exclusion Checklist
Mark “yes” if the following statements are true for you:
If an individual has been sexually assaulted or experiences some other form of trauma, they may develop posttraumatic stress disorder (PTSD) show original
This scale measures difficulties with emotion regulation, which is defined as the ability to manage one's emotions in a flexible and adaptive way show original
The MST-related index event is a measure of the severity of a migraine show original
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Odds of Eligibility
Be sure to apply to 2-3 other trials, as you have a low likelihood of qualifying for this one.Apply To This Trial
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Approximate Timelines

Please note that timelines for treatment and screening will vary by patient
Screening: ~3 weeks
Treatment: varies
Reporting: 13 weeks
Screening: ~3 weeks
Treatment: Varies
Reporting: 13 weeks
This trial has approximate timelines as follows: 3 weeks for initial screening, variable treatment timelines, and reporting: 13 weeks.
View detailed reporting requirements
Trial Expert
Connect with the researchersHop on a 15 minute call & ask questions about:
- What options you have available- The pros & cons of this trial
- Whether you're likely to qualify- What the enrollment process looks like

Measurement Requirements

This trial is evaluating whether PE+ER will improve 1 primary outcome and 1 secondary outcome in patients with Moral Injury. Measurement will happen over the course of 13 weeks.

PTSD Checklist, 5th Version (PCL-5)
The PCL-5 is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. The PCL-5 has a variety of purposes, including, monitoring symptom change during and after treatment, screening individuals for PTSD, and making a provisional PTSD diagnosis. Description information provided by the National Center for PTSD.
Clinical Administrated PTSD Scale (CAPS)
The Clinician Administered PTSD (Posttraumatic stress disorder) Scale (CAPS) is a 30-item structured interview that corresponds to the Diagnostic and Statistical Manual of Mental Disorders, 5th Version (DSM-V) criteria for PTSD. The CAPS can be used to make a current (past month) or lifetime diagnosis of PTSD or to assesses symptoms over the past week. CAPS-5 symptom cluster severity scores are calculated by summing the individual item severity scores for symptoms corresponding to a given DSM-5 cluster: Criterion B (items 1-5); Criterion C (items 6-7); Criterion D (items 8-14); and, Criterion E (items 15-20). A symptom cluster score may also be calculated for dissociation by summing items 19 and 20. Scores range from 0 to 80.

Patient Q & A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

Can moral injury be cured?

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.

Anonymous Patient Answer

What causes moral injury?

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.

Anonymous Patient Answer

What are the signs of moral injury?

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.

Anonymous Patient Answer

How many people get moral injury a year in the United States?

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.

Anonymous Patient Answer

What are common treatments for moral injury?

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

Anonymous Patient Answer

What is moral injury?

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.

Anonymous Patient Answer

What is pe+er?

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.

Anonymous Patient Answer

Is pe+er safe for people?

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.

Anonymous Patient Answer

What is the average age someone gets moral injury?

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.

Anonymous Patient Answer

What is the primary cause of moral injury?

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.

Anonymous Patient Answer

Does pe+er improve quality of life for those with moral injury?

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.

Anonymous Patient Answer

What is the latest research for moral injury?

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.

Anonymous Patient Answer
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