Literature DB >> 29723032

"I knew it was wrong the moment I got the order": A narrative thematic analysis of moral injury in combat veterans.

Philip Held1, Brian J Klassen1, Joanne M Hall2, Tanya R Friese3, Marcel M Bertsch-Gout4, Alyson K Zalta5, Mark H Pollack4.   

Abstract

OBJECTIVE: Moral injury is a nascent construct intended to capture reactions to events that violate deeply held beliefs and moral values. Although a model of moral injury has been proposed, many of the theoretical propositions of this model have yet to be systematically studied.
METHOD: We conducted semistructured interviews with eight veterans who reported experiencing morally injurious events during war zone deployments.
RESULTS: Using narrative thematic analysis, five main themes and associated subthemes emerged from the data. The main themes capture the timing of the event, contextual factors that affected the decision-making process during the morally injurious event, reactions to the moral injurious event, search for purpose and meaning, and opening up.
CONCLUSION: The findings from the present study supported an existing model of moral injury, while extending it in several important ways. Preliminary clinical recommendations and directions for future research are discussed based on the study findings. These include directly exploring the context surrounding the morally injurious event, examining the veterans' moral appraisals, and helping them assume appropriate responsibility for their actions to reduce excessive self-blame. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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Year:  2018        PMID: 29723032      PMCID: PMC6215519          DOI: 10.1037/tra0000364

Source DB:  PubMed          Journal:  Psychol Trauma        ISSN: 1942-969X


  17 in total

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Authors:  Bernice Andrews; Chris R Brewin; Rosanna Philpott; Lorna Stewart
Journal:  Am J Psychiatry       Date:  2007-09       Impact factor: 18.112

2.  Psychometric evaluation of the Moral Injury Events Scale.

Authors:  William P Nash; Teresa L Marino Carper; Mary Alice Mills; Teresa Au; Abigail Goldsmith; Brett T Litz
Journal:  Mil Med       Date:  2013-06       Impact factor: 1.437

3.  Killing in combat may be independently associated with suicidal ideation.

Authors:  Shira Maguen; Thomas J Metzler; Jeane Bosch; Charles R Marmar; Sara J Knight; Thomas C Neylan
Journal:  Depress Anxiety       Date:  2012-04-13       Impact factor: 6.505

4.  A scheme for categorizing traumatic military events.

Authors:  Nathan R Stein; Mary Alice Mills; Kimberly Arditte; Crystal Mendoza; Adam M Borah; Patricia A Resick; Brett T Litz
Journal:  Behav Modif       Date:  2012-06-07

5.  Narrative methods in a study of trauma recovery.

Authors:  Joanne M Hall
Journal:  Qual Health Res       Date:  2010-07-27

6.  Posttraumatic mental and physical health correlates of forgiveness and religious coping in military veterans.

Authors:  C V O Witvliet; K A Phipps; M E Feldman; J C Beckham
Journal:  J Trauma Stress       Date:  2004-06

Review 7.  A narrative framework for understanding experiences of people with severe mental illnesses.

Authors:  Helen Kirkpatrick
Journal:  Arch Psychiatr Nurs       Date:  2008-04       Impact factor: 2.218

8.  Relationship of combat experiences to alcohol misuse among U.S. soldiers returning from the Iraq war.

Authors:  Joshua E Wilk; Paul D Bliese; Paul Y Kim; Jeffrey L Thomas; Dennis McGurk; Charles W Hoge
Journal:  Drug Alcohol Depend       Date:  2010-01-08       Impact factor: 4.492

Review 9.  Moral injury and moral repair in war veterans: a preliminary model and intervention strategy.

Authors:  Brett T Litz; Nathan Stein; Eileen Delaney; Leslie Lebowitz; William P Nash; Caroline Silva; Shira Maguen
Journal:  Clin Psychol Rev       Date:  2009-07-29

10.  The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans.

Authors:  Shira Maguen; Barbara A Lucenko; Mark A Reger; Gregory A Gahm; Brett T Litz; Karen H Seal; Sara J Knight; Charles R Marmar
Journal:  J Trauma Stress       Date:  2010-02
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  3 in total

1.  Commentary on the Special Issue on Moral Injury: Leveraging Existing Constructs to Test the Heuristic Model of Moral Injury.

Authors:  Alyson K Zalta; Philip Held
Journal:  J Trauma Stress       Date:  2020-06-29

Review 2.  Secondary Traumatic Stress and Moral Injury in Maternity Care Providers: A Narrative and Exploratory Review.

Authors:  Kathleen Kendall-Tackett; Cheryl Tatano Beck
Journal:  Front Glob Womens Health       Date:  2022-05-04

3.  Mechanisms of Moral Injury Following Military Sexual Trauma and Combat in Post-9/11 U.S. War Veterans.

Authors:  Sheila B Frankfurt; Bryann B DeBeer; Sandra B Morissette; Nathan A Kimbrel; Heidi La Bash; Eric C Meyer
Journal:  Front Psychiatry       Date:  2018-11-02       Impact factor: 4.157

  3 in total

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