Moral injury, mental health and behavioural health outcomes: A systematic review of the literature

Clinical Psychology & Psychotherapy, Journal Year: 2021, Volume and Issue: 29(1), P. 92 - 110

Published: May 1, 2021

Despite a burgeoning of research on moral injury in the past decade, existing reviews have not explored breadth consequences and multitude pathways through which potentially morally injurious experiences (PMIEs) influence mental behavioural health outcomes. This study aimed to identify associations between health. Literature searches psychological medical databases were conducted April 2020. Eligible studies measured or PMIEs, outcomes (e.g., depression, substance use suicidality). Fifty-seven publications representing 49 separate samples included. Studies examined impact post-traumatic stress disorder (PTSD) (n = 43); depression 32); anxiety 15); suicide 14); 'other' outcomes, including pain, burnout, sleep disturbance treatment-seeking behaviours 11). The majority found significant positive injury-related constructs, outcomes; however, also cross-sectional focused military samples. Proposed mediators included lack social support, negative cognitions meaning-making. Moderators self-compassion, pre-deployment education mindfulness. Moral is associated with variety Research needed determine mechanisms by may these over time.

Language: Английский

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Association of Self-Compassion With Suicidal Thoughts and Behaviors and Non-suicidal Self Injury: A Meta-Analysis

Frontiers in Psychology, Journal Year: 2021, Volume and Issue: 12

Published: May 28, 2021

Self-compassion functions as a psychological buffer in the face of negative life experiences. Considering that suicidal thoughts and behaviors (STBs) non-suicidal self-injury (NSSI) are often accompanied by intense feelings about self (e.g., self-loathing, self-isolation), self-compassion may have potential to alleviate these attitudes toward oneself. This meta-analysis investigated associations with STBs NSSI.

Language: Английский

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Defining Moral Injury Among Military Populations: A Systematic Review

Journal of Traumatic Stress, Journal Year: 2020, Volume and Issue: 33(4), P. 575 - 586

Published: June 22, 2020

Abstract Military service often requires engaging in activities, witnessing acts, or immediate decision‐making that may violate the moral codes and personal values to which most individuals ascribe. If unacknowledged, these factors can lead injuries affect physical, psychological, social, spiritual health of military men women. The term injury has been assigned soul‐ceasing experiences. Although researchers have attempted define what leads such experiences, inconsistencies across definitions exist. In addition, nearly all existing lacked empirical support. purpose present systematic review was explore how defined research with populations, using Cooper's approach synthesis as well PRISMA guidelines. An in‐depth 124 articles yielded 12 key literature. Two were grounded evidence, suggesting much more is needed strengthen face validity reliability construct. Quality rankings developed categorize each included articles. findings punctuate need for evidence further injury, particularly among samples inclusive members biopsychosocial–spiritual experiences associated injuries.

Language: Английский

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Moral injury and mental health outcomes among Israeli health and social care workers during the COVID-19 pandemic: a latent class analysis approach

European journal of psychotraumatology, Journal Year: 2021, Volume and Issue: 12(1)

Published: Jan. 1, 2021

The COVID-19 pandemic poses unique challenges to health and social care workers (HSCWs) who face morally challenging life-threatening decisions. Following exposure events that transgress moral beliefs expectations, HSCWs might experience psychological, social, spiritual problems referred as Moral Injury (MI).The objectives of this study were examine patterns potentially injurious (PMIEs) among their associations with MI, mental outcomes psychological correlates.A sample 296 Israeli volunteered complete a cross-sectional electronic survey validated self-report questionnaires in February March 2021. Latent Class Analysis (LCA) was used identify classes characterized by PMIEs. Socio-demographic, work COVID-related variables predict PMIEs, differences mental-health correlates between assessed.Three subgroups identified: 'high exposure' (19.5%), 'betrayal-only' (31.3%), 'minimal (49.4%). Perceived stress increases the odds for inclusion classes. Participants both High Exposure class betrayal-only reported higher levels depressive, anxiety, posttraumatic more injury symptoms compared class. Importantly, lower self-compassion self-criticism, relative those class.The study's findings offer an overview complex PMIEs associated predictors outcomes. Clinicians treating coping related should be aware contribution HSCWs' distress constellation high self-criticism low PMIEs.Antecedentes: La pandemia por la presenta desafíos únicos para los trabajadores sociales y de salud (TSSs), quienes atraviesan decisiones moralmente desafiantes potencialmente mortales. Luego exposición eventos que transgreden las creencias expectativas morales, TSSs podrían experimentar problemas psicológicos, espirituales conocidos como daño (DM).Objetivo: Los objetivos este estudio fueron el evaluar patrones dañinos (EPDMs) en sus asociaciones con DM, consecuencias correlatos psicológicos.Métodos: Se constituyó una muestra israelíes voluntarios, cual completó un sondeo electrónico transversal cuestionarios autorreporte durante febrero marzo del empleó análisis clase latente (ACL) identificar clases caracterizadas EPDMs. emplearon variantes sociodemográficas, laborales asociadas predecir También se evaluaron diferencias sobre psicológicos entre clases.Resultados: identificaron tres subgrupos: ‘Alta exposición’ (19,5%), ‘solo traición’ (31,3%) ‘exposición mínima’ (49,4%). El estrés percibido incrementa riesgo ser incluido ‘alta traición’. participantes tanto reportaron niveles más altos síntomas depresivos, ansiedad, postraumáticos comparado mínima’. De manera importante, bajos autocompasión autocrítica comparación mínima’.Conclusiones: hallazgos revelan panorama complejas EPDMs predictores asociadas. clínicos tratan afrontan asociado deberían estar informados respecto contribución tiene distrés singular constelación alta baja EPDMs.背景:COVID-19 疫情给面对道德挑战和危及生命决定的卫生和社会护理工作者 (HSCW) 带来了独特的挑战。在暴露于违反道德信念和期待的事件之后, HSCW 可能会遇到心理, 社会和精神问题, 称为道德伤害 (MI)。目的:本研究旨在考查 暴露于潜在道德伤害事件 (PMIE) 的模式及其与 心理健康结果和心理相关因素的关联。方法:一个296 名以色列 HSCW的样本在 2021 年 2 月和 3 月自愿使用经过验证的自我报告问卷完成了横断面电子调查。潜在类别分析 用于识别以暴露于 PMIE 的独特模式为特征的类别。社会人口统计学, 工作和 COVID 相关变量被用来预测暴露于 的模式, 并评估了心理健康结果的差异和类别之间的心理相关因素。结果:识别出三个亚组:‘高暴露’ ‘仅背叛’ (31.3%) 和‘最低暴露’ (49.4%) 。感知压力增加了被归为‘高暴露’和‘仅背叛’类别的几率。与‘最低暴露’类别相比, 高暴露类和仅背叛类的参与者报告的抑郁, 焦虑, 创伤后和道德伤害症状水平更高。重要的是, 与‘最低暴露’类别相比, ‘高暴露’和‘仅背叛’类别都报告了较低水平的自我同情和较高水平的自我批评。结论:本研究的发现概述了 暴露模式与相关预测因子和结果之间的复杂关联。治疗 应对 相关应激的HSCW的临床医生应该意识到暴露于 对 痛苦的贡献, 以及暴露于 的 中高自我批评和低自我同情的独特群集。.

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Prevalence of occupational moral injury and post-traumatic embitterment disorder: a systematic review and meta-analysis

BMJ Open, Journal Year: 2024, Volume and Issue: 14(2), P. e071776 - e071776

Published: Feb. 1, 2024

Occupational moral injury and post-traumatic embitterment disorder (PTED) describe the psychological distress caused by exposure to injustice at work. This meta-analysis aims determine prevalence of occupational PTED establish whether estimates differ depending on occupation. A systematic review meta-analysis. Google Scholar, PubMed, APA PsycINFO, Web Science Core Collection, Scopus, ScienceDirect Sage Journals Online were searched in June 2020 updated November 2022. Observational studies that measured or average scores injury, any group geographical location. Two independent reviewers screened coded eligible studies. Study design, participant demographics, sampling method, location, measurement tool extracted. Risk bias was assessed using Quality Assessment Checklist for Prevalence Studies tool. Meta-analysis conducted random effects models. Results could not be combined summarised qualitatively a narrative synthesis Guidance Systematic Reviews. In total, 88 across armed forces veterans, healthcare, first responders, educators, journalists, child protection service employees, unemployed, public-sector employees mixed occupations included. included each separate based measure used ranged from 2 30. The pooled clinically relevant healthcare professionals 45%, potentially morally injurious event (PMIE) 67%. Exposure transgressions others betrayal significantly lower than civilian occupations. Pooled 26%. PMIEs, symptoms are prevalent work more likely forces. CRD42020191766.

Language: Английский

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Cross-Cultural Comparison of Mental Health Between German and South African Employees: Shame, Self-Compassion, Work Engagement, and Work Motivation

Frontiers in Psychology, Journal Year: 2021, Volume and Issue: 12

Published: June 22, 2021

The negative impact of the coronavirus disease outbreak 2019 (COVID-19) on work mental health is reported in many countries including Germany and South Africa: two culturally distinct countries. This study aims to compare between workforces appraise how cultural characteristics may their status. A cross-sectional was used with self-report measures regarding (i) problems, (ii) shame, (iii) self-compassion, (iv) engagement (v) motivation. 257 German employees 225 African have completed those scales. reports results following Strengthening Reporting Observational Studies Epidemiology (STROBE) guidelines. T -tests, correlation regression analyses were performed. had lower problems higher self-compassion than Africans. Mental positively associated shame amotivation, negatively intrinsic motivation both groups. Lastly, a PP 2.0 construct, strongest predictor for Our suggest that culture’s long-term orientation, uncertainty avoidance restraint help explain these differences, important While levels differed countries, cultivating be an effective way protect Findings can inform managers HR staff refine wellbeing strategies reduce pandemic, especially German-South organizations.

Language: Английский

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Mindfulness, Self-compassion, Self-injury, and Suicidal thoughts and Behaviors: a Correlational Meta-analysis

Mindfulness, Journal Year: 2022, Volume and Issue: 13(4), P. 821 - 842

Published: Jan. 31, 2022

Language: Английский

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Moral Injury is a Risk Factor for Substance Use and Suicidality Among US Military Veterans with and without Traumatic Brain Injury

Journal of Religion and Health, Journal Year: 2023, Volume and Issue: 62(6), P. 3926 - 3941

Published: Sept. 7, 2023

Language: Английский

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The Internal Consistency of the Moral Injury Event Scale

European Journal of Psychological Assessment, Journal Year: 2024, Volume and Issue: unknown

Published: April 15, 2024

Abstract: The Moral Injury Event Scale (MIES) is a tool for measuring exposure to potentially morally injurious event(s) and distress. Although it reported acceptable psychometric properties in its initial development studies, has since been used multiple contexts populations without assessment of changing properties. A reliability generalization the MIES Sub-Scales was therefore undertaken. systematic search electronic databases (PsychINFO; PTSD Pubs; MEDLINE; Scopus; Web Science) identified 42 studies reporting internal consistencies (Cronbach’s α) up April 2022. Unfortunately, few any other form or validity metric (e.g., test-retest, inter-rater reliability). random effects model with Bayesian analytic framework DerSimonian-Laird (1986) estimate used. review found be an internally consistent based on α estimates at both Full-scale (α = .88; 95% CI [.87–.89]) Sub-scales .82–.92; [.79–.93]). uncovered high heterogeneity inconsistencies administration modification although figures generally remained above levels ≥ .70). Based review, represents reliably events distress Full according pooled Cronbach’s estimates.

Language: Английский

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Investigating the Psychometric Properties and Measurement Invariance of the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale in Veteran Men and Women

Journal of Psychopathology and Behavioral Assessment, Journal Year: 2025, Volume and Issue: 47(1)

Published: Jan. 24, 2025

Language: Английский

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