Citation

Koenig HG, Ames D, Büssing A. Front. Psychiatry 2019; 10: e596.

Affiliation

IUNCTUS-Competence Center for Christian Spirituality, Philosophical-Theological Academy, Münster, Germany.

Copyright

(Copyright © 2019, Frontiers Media)

DOI

10.3389/fpsyt.2019.00596

PMID

31496962

PMCID

PMC6712088

Abstract

Moral injury (MI) is a relatively new syndrome, yet one that has been around for a long time. MI often accompanies posttraumatic stress disorder (PTSD) and is especially common in active duty military (ADM) and veterans as a result of combat experiences and other military-related traumas. MI may also be common in noncombat veterans, health professionals, and even civilian populations. The purpose of this Research Topic is to define and describe MI in veterans and ADM, examine how it is assessed and differentiated from PTSD, and begin to explore ways that psychiatrists and other health professionals can identify and address it. In this issue, we present perspectives and new research on MI from around the world, including the USA and Canada, Australia, France, and Germany.

When it occurs in the military, MI has been defined as the emotional, spiritual, and moral consequences of committing and/or observing others commit transgressions of deeply held moral values during combat or combat-related circumstances (1). Another common definition describes MI as “a betrayal of what’s right, by someone who holds legitimate authority, in a high-stakes situation” (2), in other words, betrayal by commanders who may have placed service members in a position that forced them to transgress moral boundaries. Brief measures now exist that have been psychometrically validated to identify symptoms of MI among veterans and those currently in the military (3). Research has shown that >50% of ADM with PTSD symptoms have four or more symptoms of MI in the severe range (9 or 10 on a 1–10 scale) (4), and nearly 60% of veterans with PTSD have five or more such symptoms ...

Language: en

Keywords

PTSD; definition; moral injury; screening; veterans