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Journal of Religion and Health

Erschienen in:

10.07.2021 | Psychological Exploration

Moral Injury: An Increasingly Recognized and Widespread Syndrome

verfasst von: Harold G. Koenig, Faten Al Zaben

Erschienen in: Journal of Religion and Health | Ausgabe 5/2021

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Abstract

Moral injury (MI), originally discussed in relationship to transgressing moral beliefs and values during wartime among military personnel, has expanded beyond this context to include similar emotions experienced by healthcare professionals, first responders, and others experiencing moral emotions resulting from actions taken or observations made during traumatic events or circumstances. In this article, we review the history, definition, measurement, prevalence, distinctiveness, psychological consequences, manifestations (in and outside of military settings), and correlates of MI in different settings. We also review secular psychological treatments, spiritually integrated therapies, and pastoral care approaches (specific for clergy and chaplains) used to treat MI and the evidence documenting their efficacy. Finally, we examine directions for future research needed to fill the many gaps in our knowledge about MI, how it develops, and how to help those suffering from it.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425596CrossRef

Ames, D., Erickson, Z., Geise, C., Tiwari, S., Sakhno, S., Sones, A., & Koenig, H. G. (2018a). Spiritually-integrated cognitive processing therapy (SICPT) for the treatment of moral injury in U.S. Veterans with PTSD: 3-arm randomized controlled trial. Los Angeles, CA: Greater Los Angeles VA Health System, IRB approval # PCC 2018–050499 (VA Project #0059).

Ames, D., Erickson, Z., Geise, C., Tiwari, S., Sakhno, S., Sones, A., Tyrrell, C. G., Mackay, C. R. B., Steele, C. W., Van Hoof, T., & Koenig, H. G. (2021). Treatment of moral injury in U.S. Veterans with PTSD utilizing a structured chaplain intervention. Journal of Religion and Health. https://doi.org/10.1007/s10943-021-01312-8 in press.CrossRefPubMed

Ames, D., Erickson, Z., Youssef, N. A., Arnold, I., Adamson, C. S., Sones, A. C., Yin, J., Haynes, K., Volk, F., Teng, E. J., & Oliver, J. P. (2019). Moral injury, religiosity, and suicide risk in US veterans and active duty military with PTSD symptoms. Military Medicine, 184(3–4), e271–e278. https://doi.org/10.1093/milmed/usy148CrossRefPubMed

Ames, D., Haynes, K., Adamson, S.F., Bruce, L.E., Chacko, B.K., Button, L., & Koenig, H. G. (2018b). A structured chaplain intervention for Veterans with moral injury in the setting of PTSD. Durham, NC: Duke University Center for Spirituality, Theology and Health (Christian, Buddhist, Hindu, Jewish, and Muslim versions available; contact Harold.Koenig@duke.edu)

Barnes, H. A., Hurley, R. A., & Taber, K. H. (2019). Moral injury and PTSD: Often co-occurring yet mechanistically different. Journal of Neuropsychiatry and Clinical Neurosciences, 31(2), A4-103. https://doi.org/10.1176/appi.neuropsych.19020036CrossRef

Battaglia, A. M., Protopopescu, A., Boyd, J. E., Lloyd, C., Jetly, R., O’Connor, C., Hood, H. K., Nazarov, A., Rhind, S. G., Lanius, R. A., & McKinnon, M. C. (2019). The relation between adverse childhood experiences and moral injury in the Canadian Armed Forces. European Journal of Psychotraumatology. https://doi.org/10.1080/20008198.2018.1546084CrossRefPubMedPubMedCentral

Bernstein, C. Z., & Manata, P. (2019). Moral responsibility and the wrongness of abortion. Journal of Medicine and Philosophy, 44(2), 243–262. https://doi.org/10.1093/jmp/jhy039CrossRef

Brock, R. N., & Lettini, G. (2012). Soul repair: Recovering from moral injury after war. Beacon Press.

Bryan, A. O., Bryan, C. J., Morrow, C. E., Etienne, N., & Ray-Sannerud, B. (2014). Moral injury, suicidal ideation, and suicide attempts in a military sample. Traumatology, 20(3), 154. https://doi.org/10.1037/h0099852CrossRef

Bryan, A. O., Theriault, J. L., & Bryan, C. J. (2015). Self-forgiveness, posttraumatic stress, and suicide attempts among military personnel and veterans. Traumatology, 21(1), 40. https://doi.org/10.1037/trm0000017CrossRef

Bryan, C. J., Bryan, A. O., Anestis, M. D., Anestis, J. C., Green, B. A., Etienne, N., Morrow, C. E., & Ray-Sannerud, B. (2016). Measuring moral injury: Psychometric properties of the moral injury events scale in two military samples. Assessment, 23(5), 557–570. https://doi.org/10.1177/1073191115590855CrossRefPubMed

Bryan, C. J., Morrow, C. E., Etienne, N., & Ray-Sannerud, B. (2013). Guilt, shame, and suicidal ideation in a military outpatient clinical sample. Depression and Anxiety, 30(1), 55–60. https://doi.org/10.1002/da.22002CrossRefPubMed

Carey, L. B., & Hodgson, T. J. (2018). Chaplaincy, spiritual care and moral injury: Considerations regarding screening and treatment. Frontiers in Psychiatry, 9, 619. https://doi.org/10.3389/fpsyt.2018.00619CrossRefPubMedPubMedCentral

Carey, L. B., Hodgson, T. J., Krikheli, L., Soh, R. Y., Armour, A. R., Singh, T. K., & Impiombato, C. G. (2016). Moral injury, spiritual care and the role of chaplains: An exploratory scoping review of literature and resources. Journal of Religion and Health, 55(4), 1218–1245. https://doi.org/10.1007/s10943-016-0231-xCrossRefPubMed

Cenkner, D. P., Yeomans, P. D., Antal, C. J., & Scott, J. C. (2021). A pilot study of a moral injury group intervention co-facilitated by a chaplain and psychologist. Journal of Traumatic Stress, 34(2), 367–374. https://doi.org/10.1002/jts.22642CrossRefPubMed

CSTH. (2021). Religiously-integrated CBT manuals and workbooks for depression. Durham, NC: Duke University Center for Spirituality, Theology, and Health. Retrieved June 7, 2021, from https://spiritualityandhealth.duke.edu/index.php/religious-cbt-study/therapy-manuals

Curlin, F. A. (2005). After harm: Medical error and the ethics of forgiveness. British Medical Journal, 331(7528), 1343. https://doi.org/10.1136/bmj.331.7528.1343

Currier, J. M., Farnsworth, J. K., Drescher, K. D., McDermott, R. C., Sims, B. M., & Albright, D. L. (2018). Development and evaluation of the Expressions of Moral Injury Scale—Military Version. Clinical Psychology & Psychotherapy, 25(3), 474–488. https://doi.org/10.1002/cpp.2407CrossRef

Currier, J. M., Holland, J. M., Drescher, K., & Foy, D. (2015a). Initial psychometric evaluation of the Moral Injury Questionnaire—Military version. Clinical Psychology & Psychotherapy, 22(1), 54–63. https://doi.org/10.1002/cpp.1866CrossRef

Currier, J. M., Holland, J. M., Rojas-Flores, L., Herrera, S., & Foy, D. (2015b). Morally injurious experiences and meaning in Salvadorian teachers exposed to violence. Psychological Trauma: Theory, Research, Practice, and Policy, 7(1), 24. https://doi.org/10.1037/a0034092CrossRef

Currier, J. M., Isaak, S. L., & McDermott, R. C. (2020). Validation of the expressions of moral injury scale-military version-short form. Clinical Psychology & Psychotherapy, 27(1), 61–68. https://doi.org/10.1002/cpp.2407CrossRef

Currier, J. M., Smith, P. N., & Kuhlman, S. (2017). Assessing the unique role of religious coping in suicidal behavior among US Iraq and Afghanistan veterans. Psychology of Religion and Spirituality, 9(1), 118. https://doi.org/10.1037/rel0000055CrossRef

Drescher, K. D., Foy, D. W., Kelly, C., Leshner, A., Schutz, K., & Litz, B. (2011). An exploration of the viability and usefulness of the construct of moral injury in war veterans. Traumatology, 17(1), 8–13. https://doi.org/10.1177/1534765610395615CrossRef

Euripides (416 BCE; translated by Thomas Sleigh). Euripides’ Herakles. New York, NY: Oxford University Press.

Evans, W. R., Stanley, M. A., Barrera, T. L., Exline, J. J., Pargament, K. I., & Teng, E. J. (2018). Morally injurious events and psychological distress among veterans: Examining the mediating role of religious and spiritual struggles. Psychological Trauma: Theory, Research, Practice, and Policy, 10(3), 360. https://doi.org/10.1037/tra0000347CrossRef

Evans, W. R., Walser, R. D., Drescher, K. D., & Farnsworth, J. K. (2020). The moral injury workbook: Acceptance and commitment therapy skills for moving beyond shame, anger, and trauma to reclaim your values. New Harbinger Publications.

Feinstein, A., Pavisian, B., & Storm, H. (2018). Journalists covering the refugee and migration crisis are affected by moral injury not PTSD. Journal of the Royal Society of Medicine Open, 9(3), 1–7. https://doi.org/10.1177/2054270418759010CrossRef

Ferrajão, P. C., & Aragão Oliveira, R. (2016). Portuguese war veterans: Moral injury and factors related to recovery from PTSD. Qualitative Health Research, 26(2), 204–214. https://doi.org/10.1177/1049732315573012CrossRefPubMed

Frankfurt, S., & Frazier, P. (2016). A review of research on moral injury in combat veterans. Military Psychology, 28(5), 318–330. https://doi.org/10.1037/mil0000132CrossRef

Greene, T., Bloomfield, M. A., & Billings, J. (2020). Psychological trauma and moral injury in religious leaders during COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S143–S145. https://doi.org/10.1037/tra0000641CrossRef

Grimsley, C. W., & Grimsley, G. (2017). PTSD & moral injury: The journey to healing through forgiveness. Exulon Press.

Haight, W., Korang-Okrah, R., Black, J. E., Gibson, P., & Nashandi, N. J. (2020). Moral injury among Akan women: Lessons for culturally sensitive child welfare interventions. Children and Youth Services Review. https://doi.org/10.1016/j.childyouth.2020.104768 in press.CrossRef

Haight, W., Sugrue, E., Calhoun, M., & Black, J. (2016). A scoping study of moral injury: Identifying directions for social work research. Children and Youth Services Review, 70, 190–200. https://doi.org/10.1016/j.childyouth.2016.09.026CrossRef

Harris, J. I., Erbes, C. R., Engdahl, B. E., Thuras, P., Murray-Swank, N., Grace, D., Ogden, H., Olson, R. H., Winskowski, A. M., Bacon, R., & Malec, C. (2011). The effectiveness of a trauma focused spiritually integrated intervention for veterans exposed to trauma. Journal of Clinical Psychology, 67(4), 425–438. https://doi.org/10.1002/jclp.20777CrossRefPubMed

Harris, J. I., Usset, T., Voecks, C., Thuras, P., Currier, J., & Erbes, C. (2018). Spiritually integrated care for PTSD: A randomized controlled trial of “Building Spiritual Strength.” Psychiatry Research, 267, 420–428. https://doi.org/10.1016/j.psychres.2018.06.045CrossRefPubMed

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. NY, NY: Guilford Press

Held, P., Klassen, B. J., Brennan, M. B., & Zalta, A. K. (2018). Using prolonged exposure and cognitive processing therapy to treat veterans with moral injury-based PTSD: Two case examples. Cognitive and Behavioral Practice, 25(3), 377–390. https://doi.org/10.1016/j.cbpra.2017.09.003CrossRefPubMed

Hodgson, T. J., & Carey, L. B. (2017). Moral injury and definitional clarity: Betrayal, spirituality and the role of chaplains. Journal of Religion and Health, 56(4), 1212–1228. https://doi.org/10.1007/s10943-017-0407-zCrossRefPubMed

Hodgson, T. J., Carey, L. B., & Koenig, H. G. (2021). Moral injury, Australian veterans and the role of chaplains: An exploratory qualitative study. (forthcoming).

Hoffman, J., & Nickerson, A. (2021). The impact of moral-based appraisals on psychological outcomes in response to analogue trauma: An experimental paradigm of moral injury. Cognitive Therapy and Research, 45, 494–507. https://doi.org/10.1007/s10608-020-10172-7CrossRef

Hoge, C. W., & Chard, K. M. (2018). A window into the evolution of trauma focused psychotherapies for posttraumatic stress disorder. Journal of the American Medical Association, 319(4), 343–345. https://doi.org/10.1001/jama.2017.21880CrossRefPubMed

Hurley, E. C. (2018). Effective treatment of veterans with PTSD: Comparison between intensive daily and weekly EMDR approaches. Frontiers in Psychology, 9, 1458. https://doi.org/10.3389/fpsyg.2018.01458CrossRefPubMedPubMedCentral

Jinkerson, J. D. (2016). Defining and assessing moral injury: A syndrome perspective. Traumatology, 22(2), 122–130. https://doi.org/10.1037/trm0000069

Joannou, M., Besemann, M., & Kriellaars, D. (2017). Project trauma support: Addressing moral injury in first responders. Mental Health in Family Medicine, 13, 418–422.

Koenig, H., Ames, D., & Pearce, M. (2019b). Religion and recovery from PTSD. Jessica Kingsley Publishers.

Koenig, H. G., Ames, D., Youssef, N. A., Oliver, J. P., Volk, F., Teng, E. J., Haynes, K., Erickson, Z. D., Arnold, I., O’Garo, K., & Pearce, M. (2018a). The moral injury symptom scale-military version. Journal of Religion and Health, 57(1), 249–265. https://doi.org/10.1007/s10943-017-0531-9CrossRefPubMed

Koenig, H. G., Ames, D., Youssef, N. A., Oliver, J. P., Volk, F., Teng, E. J., Haynes, K., Erickson, Z. D., Arnold, I., O’Garo, K., & Pearce, M. (2018b). Screening for moral injury: the moral injury symptom scale–military version short form. Military Medicine, 183(11–12), e659–e665. https://doi.org/10.1093/milmed/usy017CrossRefPubMed

Koenig, H. G., Boucher, N. A., Oliver, R. J. P., Youssef, N., Mooney, S. R., Currier, J. M., & Pearce, M. (2017). Rationale for spiritually oriented cognitive processing therapy for moral injury in active duty military and veterans with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 205(2), 147–153. https://doi.org/10.1097/NMD.0000000000000554CrossRef

Koenig, H. G., Pearce, M. J., Nelson, B., Shaw, S. F., Robins, C. J., Daher, N. S., Cohen, H. J., Berk, L. S., Bellinger, D. L., Pargament, K. I., & King, M. B. (2015). Religious vs. conventional cognitive behavioral therapy for major depression in persons with chronic medical illness: A pilot randomized trial. Journal of Nervous and Mental Disease, 203(4), 243–251. https://doi.org/10.1097/NMD.0000000000000273CrossRef

Koenig, H. G., Youssef, N. A., Ames, D., Oliver, J. P., Teng, E. J., Haynes, K., Erickson, Z. D., Arnold, I., Currier, J. M., O’Garo, K., & Pearce, M. (2018c). Moral injury and religiosity in US veterans with posttraumatic stress disorder symptoms. Journal of Nervous and Mental Disease, 206(5), 325–331. https://doi.org/10.1097/NMD.0000000000000798CrossRef

Koenig, H. G., Youssef, N. A., Ames, D., Teng, E. J., & Hill, T. D. (2020). Examining the overlap between moral injury and PTSD in US veterans and active duty military. Journal of Nervous and Mental Disease, 208(1), 7–12. https://doi.org/10.1097/NMD.0000000000001077CrossRef

Koenig, H. G., Youssef, N. A., & Pearce, M. (2019a). Assessment of moral injury in veterans and active duty military personnel with PTSD: A review. Frontiers in Psychiatry, 10, 443. https://doi.org/10.3389/fpsyt.2019.00443CrossRefPubMedPubMedCentral

Kopacz, M. S., Ames, D., & Koenig, H. G. (2019). It’s time to talk about physician burnout and moral injury. Lancet Psychiatry, 6(11), e28. https://doi.org/10.1016/S2215-0366(19)30385-2CrossRefPubMed

Kopacz, M. S., Connery, A. L., Bishop, T. M., Bryan, C. J., Drescher, K. D., Currier, J. M., & Pigeon, W. R. (2016). Moral injury: A new challenge for complementary and alternative medicine. Complementary Therapies in Medicine, 24, 29–33. https://doi.org/10.1016/j.ctim.2015.11.003CrossRefPubMed

Lee, L. J. (2018). Moral injury reconciliation. A practitioner’s guide for treating moral injury, PTSD, grief and military sexual trauma through spiritual formation. Jessica Kingsley Publishers.

Lentz, L. M., Smith-MacDonald, L., Malloy, D., Carleton, R. N., & Brémault-Phillips, S. (2021). Compromised conscience: A scoping review of moral injury among firefighters, paramedics, and police officers. Frontiers in Psychology, 12, 681. https://doi.org/10.3389/fpsyg.2021.639781CrossRef

Levi-Belz, Y., Greene, T., & Zerach, G. (2020). Associations between moral injury, PTSD clusters, and depression among Israeli veterans: A network approach. European Journal of Psychotraumatology, 11(1), 1–13. https://doi.org/10.1080/20008198.2020.1736411CrossRef

Litz, B. T., Lebowitz, L., Gray, M. J., & Nash, W. P. (2017). Adaptive disclosure: A new treatment for military trauma, loss, and moral injury. Guilford Publications.

Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706. https://doi.org/10.1016/j.cpr.2009.07.003CrossRefPubMed

Lloyd, C. S., Nicholson, A. A., Densmore, M., Théberge, J., Neufeld, R. W., Jetly, R., McKinnon, M. C., & Lanius, R. A. (2021). Shame on the brain: Neural correlates of moral injury event recall in posttraumatic stress disorder. Depression and Anxiety, 38, 596–605. https://doi.org/10.1002/da.23128CrossRefPubMed

Maguen, S., & Burkman, K. (2013). Combat-related killing: Expanding evidence-based treatments for PTSD. Cognitive and Behavioral Practice, 20(4), 476–479. https://doi.org/10.1016/j.cbpra.2013.05.003CrossRef

Maguen, S., Burkman, K., Madden, E., Dinh, J., Bosch, J., Keyser, J., Schmitz, M., & Neylan, T. C. (2017). Impact of killing in war: A randomized, controlled pilot trial. Journal of Clinical Psychology, 73(9), 997–1012. https://doi.org/10.1002/jclp.22471CrossRefPubMed

Mantri, S., Lawson, J. M., Wang, Z., & Koenig, H. G. (2020). Identifying moral injury in healthcare professionals: The Moral Injury Symptom Scale-HP. Journal of Religion and Health, 59(5), 2323–2340. https://doi.org/10.1007/s10943-020-01065-wCrossRefPubMed

Mantri, S., Lawson, J. M., Wang, Z., & Koenig, H. G. (2021a). Prevalence and predictors of moral injury symptoms in health care professionals. Journal of Nervous and Mental Disease, 209(3), 174–180. https://doi.org/10.1097/NMD.0000000000001277CrossRef

Mantri, S., Song, Y. K., Lawson, J. M., Berger, E. J., & Koenig, H. G. (2021b). Moral injury and burnout in health care professionals during the COVID-19 pandemic. Journal of Nervous and Mental Disease. https://doi.org/10.1097/NMD.0000000000001367 in press.CrossRef

Miller, S. C. (2009). Moral injury and relational harm: Analyzing rape in Darfur. Journal of Social Philosophy, 40(4), 504–523. https://doi.org/10.1111/j.1467-9833.2009.01468.xCrossRef

Murray, E. (2019). Moral injury and paramedic practice. Journal of Paramedic Practice, 11(10), 424–425. https://doi.org/10.12968/jpar.2019.11.10.424CrossRef

Nash, W. P., Marino Carper, T. L., Mills, M. A., Au, T., Goldsmith, A., & Litz, B. T. (2013). Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646–652. https://doi.org/10.7205/MILMED-D-13-00017CrossRefPubMed

Nash, W. P., Vasterling, J., Ewing-Cobbs, L., Horn, S., Gaskin, T., Golden, J., Riley, W. T., Bowles, S. V., Favret, J., Lester, P., & Koffman, R. (2010). Consensus recommendations for common data elements for operational stress research and surveillance: Report of a federal interagency working group. Archives of Physical Medicine and Rehabilitation, 91(11), 1673–1683. https://doi.org/10.1016/j.apmr.2010.06.035CrossRefPubMed

Nickerson, A., Schnyder, U., Bryant, R. A., Schick, M., Mueller, J., & Morina, N. (2015). Moral injury in traumatized refugees. Psychotherapy and Psychosomatics, 84(2), 122–123. https://doi.org/10.1159/000369353CrossRefPubMed

Nieuwsma, J. A., Brancu, M., Wortmann, J., Smigelsky, M. A., King, H. A., VISN 6 MIRECC Workgroup, & Meador, K. G. (2021). Screening for moral injury and comparatively evaluating moral injury measures in relation to mental illness symptomatology and diagnosis. Clinical Psychology & Psychotherapy, 28(1), 239–250. https://doi.org/10.1002/cpp.2503CrossRef

Nieuwsma, J., Walser, R. D., Farnsworth, J. K., Drescher, K. D., Meador, K. G., & Nash, W. (2015). Possibilities within acceptance and commitment therapy for approaching moral injury. Current Psychiatry Reviews, 11(3), 193–206. https://doi.org/10.2174/1573400511666150629105234CrossRef

O’Garo, K. G., & Koenig, H. G. (2018). A pilot study of Spiritually Integrated Cognitive Processing Therapy (SICPT) in the treatment of moral injury in clients with PTSD. Durham, North Carolina: Duke University Center for Spirituality Theology and Health (IRB # Pro00084666).

Papazoglou, K., Blumberg, D. M., Chiongbian, V. B., Tuttle, B. M., Kamkar, K., Chopko, B., Milliard, B., Aukhojee, P., & Koskelainen, M. (2020). The role of moral injury in PTSD among law enforcement officers: A brief report. Frontiers in Psychology, 11, 310. https://doi.org/10.3389/fpsyg.2020.00310CrossRefPubMedPubMedCentral

Papazoglou, K., & Chopko, B. (2017). The role of moral suffering (moral distress and moral injury) in police compassion fatigue and PTSD: An unexplored topic. Frontiers in Psychology, 8, 1999. https://doi.org/10.3389/fpsyg.2017.01999CrossRefPubMedPubMedCentral

Paul, L. A., Gros, D. F., Strachan, M., Worsham, G., Foa, E. B., & Acierno, R. (2014). Prolonged exposure for guilt and shame in a veteran of Operation Iraqi Freedom. American Journal of Psychotherapy, 68(3), 277–286. https://doi.org/10.1176/appi.psychotherapy.2014.68.3.277CrossRefPubMedPubMedCentral

Pearce, M. J., Haynes, K. N., Currier, J. M., O’Garo, K. G., & Koenig, H. G. (2017). Spiritually-integrated cognitive processing therapy veteran/military version: Therapist’s manual (with religion-specific appendices). Duke University Center for Spirituality, Theology and Health.

Pearce, M. J., Haynes, K., Rivera, N. R., & Koenig, H. G. (2018). Spiritually-integrated cognitive processing therapy: A new treatment for PTSD and moral injury. Global Advances in Health and Medicine, 7, 1–7. https://doi.org/10.1177/2164956118759939CrossRef

Pearce, M. J., Koenig, H. G., Robins, C. J., Nelson, B., Shaw, S. F., Cohen, H. J., & King, M. B. (2015). Religiously integrated cognitive behavioral therapy: A new method of treatment for major depression in patients with chronic medical illness. Psychotherapy, 52(1), 56–66. https://doi.org/10.1037/a0036448CrossRefPubMed

Pernicano, P., & Haynes, K. (2021). Moral injury psychoeducation group facilitator guide: Introduction to acceptance and forgiveness. San Antonio, TX: San Antonio VA MIRECC (contact chaplain Kerry Haynes [Kerry.Haynes@va.gov] for more information).

Purcell, N., Burkman, K., Keyser, J., Fucella, P., & Maguen, S. (2018). Healing from moral injury: A qualitative evaluation of the impact of killing treatment for combat veterans. Journal of Aggression, Maltreatment & Trauma, 27(6), 645–673. https://doi.org/10.1080/10926771.2018.1463582CrossRef

Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Religion and morality (pp 285–287). In Cognitive processing therapy for PTSD. New York, NY: Guilford Press.

Rozek, D. C., & Bryan, C. J. (2021). A cognitive behavioral model of moral injury. In J. M. Currier, K. D. Drescher, & J. Nieuwsma (Eds.), Addressing moral injury in clinical practice (pp. 19–33). American Psychological Association. https://doi.org/10.1037/0000204-002CrossRef

Shapiro, F., & Laliotis, D. (2015). EMDR therapy for trauma-related disorders. In U. Schnyder & M. Cloitre (Eds.), Evidence based treatments for trauma-related psychological disorders. Springer. https://doi.org/10.1007/978-3-319-07109-1_11CrossRef

Shay, J. (1994). Achilles in Vietnam: Combat trauma and the undoing of character. Scribner.

Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182–191. https://doi.org/10.1037/a0036090CrossRef

Stovall, M., Hansen, L., & van Ryn, M. (2020). A critical review: Moral injury in nurses in the aftermath of a patient safety incident. Journal of Nursing Scholarship, 52(3), 320–328. https://doi.org/10.1111/jnu.12551CrossRefPubMed

Sugrue, E. P. (2020). Moral injury among professionals in K–12 education. American Educational Research Journal, 57(1), 43–68.CrossRef

Sun, D., Phillips, R. D., Mulready, H. L., Zablonski, S. T., Turner, J. A., Turner, M. D., McClymond, K., Nieuwsma, J. A., & Morey, R. A. (2019). Resting-state brain fluctuation and functional connectivity dissociate moral injury from posttraumatic stress disorder. Depression and Anxiety, 36(5), 442–452. https://doi.org/10.1002/da.22883CrossRefPubMedPubMedCentral

Talbot, S. G., & Dean, W. (2018). Physicians aren’t ‘burning out.’ They’re suffering from moral injury. Stat, 7(26), 18.

VA/DoD. (2017). VA/DoD clinical practice guidelines for the management of posttraumatic stress disorder and acute stress disorder, version 3.0. Retrieved July 6, 2021, from https://www.healthquality.va.gov/guidelines/MH/ptsd/VADoDPTSDCPGFinal.pdf.

Verkamp, B. (2006). The moral treatment of returning warriors in early medieval and modern times. University of Scranton Press.

Volk, F., & Koenig, H. G. (2019). Moral injury and religiosity in active duty US Military with PTSD symptoms. Military Behavioral Health, 7(1), 64–72. https://doi.org/10.1080/21635781.2018.1436102CrossRef

Wade, N. R. (2016). Integrating cognitive processing therapy and spirituality for the treatment of Post-Traumatic Stress Disorder in the military. Social Work & Christianity, 43(3), 59–72.

Wang, Z., Harold, K. G., Tong, Y., Wen, J., Sui, M., Liu, H., Zaben, F. A., & Liu, G. (2021). Moral injury in Chinese health professionals during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/tra0001026CrossRef

Wang, Z. Z., Koenig, H. G., Tong, Y., Wen, J., Sui, M., Liu, H., & Liu, G. (2020). Psychometric properties of the Moral Injury Symptoms Scale among Chinese health professionals during the COVID-19 pandemic. BMC Psychiatry, 20, 556. https://doi.org/10.1186/s12888-020-02954-wCrossRef

West, C. (2017). Warrior Welcome Home. Retrieved June 7, 2021, from http://christchurchcathedral.org.au/wp-content/uploads/2017/08/WWH-NTParticipant-Invitation.docx

Williamson, V., Greenberg, N., & Murphy, D. (2021). Predictors of moral injury in UK treatment seeking veterans. Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2020.104889 in press.CrossRef

Wisco, B. E., Marx, B. P., May, C. L., Martini, B., Krystal, J. H., Southwick, S. M., & Pietrzak, R. H. (2017). Moral injury in US combat veterans: Results from the national health and resilience in veterans study. Depression and Anxiety, 34(4), 340–347. https://doi.org/10.1002/da.22614CrossRef

Titel: Moral Injury: An Increasingly Recognized and Widespread Syndrome
verfasst von: Harold G. Koenig
Faten Al Zaben
Publikationsdatum: 10.07.2021
Verlag: Springer US
Erschienen in: Journal of Religion and Health / Ausgabe 5/2021
Print ISSN: 0022-4197
Elektronische ISSN: 1573-6571
DOI: https://doi.org/10.1007/s10943-021-01328-0

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Moral Injury: An Increasingly Recognized and Widespread Syndrome

Abstract

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

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