What is Moral Injury?

What is the Result of Moral Injury? 

The aftermath of violating your own morals can lead to distressing inner conflict. Emotional responses may include: 

• Shame  
• Guilt 
• Anxiety about possible consequences 
• Anger about betrayal-based moral injuries 
• Behavioral Responses of moral injury: 
• Alienation 
• Withdrawal and self-condemnation  
• Self-harming 
• Alcohol or drug use 

The difference between moral injury and Post-traumatic Stress Disorder (PTSD) 

• PTSD is a mental disorder that is diagnosed based on specific criteria. Moral injury is a dimensional problem with no threshold for its presence. 
• An individual with PTSD may not feel that they have violated their moral code and this diagnosis doesn’t sufficiently sum up moral injury.  

Current Research for Treatment of Moral Injury 

Currently, there are two interventions that are being tested which target moral injury among veterans of war.  

Impact of Killing in War (IOK) written with a cognitive behavioral framework 

• Psychoeducation on various aspects of killing in war that cause inner conflict 
• Identifying meaningful elements and cognitive attributions related to killing in war 
• Process of self-forgiveness 
• Making amends  

Adaptive Disclosure (AD) experiential exposure-based approach 

• The use of exposure to uncover core features of focal combat and operational trauma and as a means of articulating the meaning and implication of these events.  
• Ideal for life-threat-based or loss-based trauma  
• Guidance through a dialogue a compassionate professional about their transgression