BMJ Military Health, Год журнала: 2021, Номер 169(e1), С. e6 - e8
Опубликована: Авг. 9, 2021
Moral injury is defined as profound psychological distress that experienced after an event(s) violates one’s deeply held moral or ethical code.[1][1] Morally injurious events typically include acts of omission, commission betrayal by trusted others. Unlike ‘classically’ traumatic
Язык: Английский
BMJ Military Health, Год журнала: 2022, Номер 170(6), С. 519 - 528
Опубликована: Ноя. 28, 2022
Introduction Individuals who have been exposed to a traumatic event can develop profound feelings of guilt, shame and anger. Yet, studies treatments for post-traumatic stress disorder (PTSD) largely investigated changes in PTSD symptoms relating sense ongoing fear or threat the effectiveness such post-trauma related anger symptom reduction is comparatively not well understood. Methods This review systematically examined existing treatment approaches three associated with exposure events: Studies included had be published after 2010 sample size n=50 greater ensure stable outcome estimates. Results 15 were included, consisting both civilian (ex-) military population samples wide range events (eg, combat-related, sexual abuse). Findings indicated moderate strength evidence that cognitive-based exposure-based are similarly effective reducing symptoms. Cognitive-based found effectively reduce guilt anger, while appeared Conclusions The findings suggest importance confronting discussing during therapy, rather than using less directive supportive counselling).Nonetheless, these results promising, firm conclusions regarding comparative long-term impact could drawn due insufficient evidence. Further empirical research needed examine populations investigate which (or combination thereof) more long-term.
Язык: Английский
Процитировано
11
International Journal of Social Psychiatry, Год журнала: 2023, Номер 69(5), С. 1134 - 1144
Опубликована: Фев. 3, 2023
In this prospective study, we examined pre-enlistment characteristics and pre-deployment protective factors of exposure to potentially morally injurious events (PMIEs) among Israeli active-duty combatants, as well psychiatric symptomatology outcomes exposure.A sample 335 combatants participated in a 2.5-year study with three waves measurements (T1: 12 months before enlistment, T2: 6 following enlistment- pre deployment, T3: 18 post deployment). Participants' were assessed via semi-structured interviews (T1) validated self-report measures (T2-T3) between 2019 2021.Latent Class Analysis (LCA) was used identify classes characterized by unique patterns PMIEs (T2): Minimal Exposure (56.6%), Betrayal-Only (25.5%), High (17.8%). Higher levels psychological flexibility associated higher odds for inclusion the high class (T2). As compared minimal class, both betrayal-only mental health symptoms MI-related (T2).This is first antecedents combatants. Clinicians treating should be aware different types their possible outcomes.
Язык: Английский
Процитировано
6
Crisis, Год журнала: 2022, Номер 44(3), С. 198 - 208
Опубликована: Фев. 9, 2022
Background: Modern warfare in a civilian setting may expose combatants to severe moral challenges. Whereas most of these challenges are handled effectively, some potentially morally injurious events (PMIEs) have deleterious psychological effects on the combatants, such as suicide ideation (SI). Self-disclosure, which includes sharing distressing thoughts and emotions, has been recognized protective factor against SI aftermath stressful events. The current study is first examine moderating role self-disclosure relationship between PMIE exposure among combat veterans. Method: A sample 190 recently discharged Israeli veterans completed validated self-report questionnaires measuring exposure, PMIEs, depressive symptoms, SI, cross-sectional design study. Results: dimensions significantly contributed SI. Notably, model indicated that moderated link PMIE-Self demonstrated stronger association with low than those high self-disclosure. Limitations: Cross-sectional volunteers, findings not be directly generalizable veterans' population. Conclusion: promoting sense belongingness, interpersonal bonding, support, might diminish risk following exposure. Various mechanisms accounting for associations suggested, clinical implications interactions discussed.
Язык: Английский
Процитировано
9
East European Journal of Psycholinguistics, Год журнала: 2023, Номер unknown
Опубликована: Июнь 29, 2023
Moral injury (MI) is one of the main emotional distress in military personnel. Findings suggest that wartime there are an endless number potentially morally injurious events, which determine maladaptive cognitions, moral emotions guilt and shame, inefficient behaviour. Notwithstanding strong association between MI post-traumatic stress disorder (PTSD) recognized studies, still a gap accurate data aligned with identifying differences PTSD terms treatment healing. This study aims to establish conceptual boundaries injury, systematically review empirical literature on them Specifically, we explored summarized co-occurrence personnel evaluated PTSD, as well other distress. The results indicate key aspects comparison include definition symptomology, measurement, neural underpinning, treatment. Considering consequences poor social well-being, sufferings behavioral patterns, treatments focusing separately from PTSD-focused models much needed. Acknowledgements part Injury Healing Combatants: Neuropsychological Correlates Psychological Interventions project funded by Ministry Education Science Ukraine (2022-2023). Disclosure statement No potential conflict interest was reported authors.
Язык: Английский
Процитировано
5
Frontiers in Psychology, Год журнала: 2023, Номер 14
Опубликована: Май 9, 2023
The experiences of military personnel moving into civilian life can be varied for the individual, families and communities. This paper aims to shed light on various meanings multiple “nested” transitions in context attending a mental health service UK. was achieved through secondary analysis semi-structured interviews with veterans who were engaging UK further interview lead. A thematic employed based descriptive phenomenological approach. Results indicate that an appropriate support infrastructure needs put place prior to, during after transition life. appropriateness includes themes specific connectedness others, accessibility, professionals' culture awareness stigma. Although findings suggest community services need veterans' needs, many are similar those general population. Therefore, integrated healthcare system is essential Drawing international evidence as well current findings, implications policy practice highlighted throughout.
Язык: Английский
Процитировано
4
BMJ Military Health, Год журнала: 2023, Номер unknown, С. e002457 - e002457
Опубликована: Июнь 21, 2023
Moral injury concerns transgressive harms and the outcomes that such experiences may cause. A gap in literature surrounding moral injury, an outcome be important to include mounting evidence toward need for formal clinical acknowledgement of has do with relationship between quality life. No studies have examined this US military veterans-a population is disproportionately exposed potentially morally injurious events.A nationwide cross-sectional survey was conducted yielding 1495 veterans. Participants were asked questions about life, among other things. Multivariable linear regression used characterise adjusted life.Moral (mean=40.1 out 98) quality-of-life (mean=69.5 100) scores calculated sample. inversely associated life model, indicating worsening decreased (adjusted unstandardised beta coefficient (b)=-0.3, p<0.001). Results showed age moderated said relationship, ageing veterans experienced increasingly worse severe (b=-0.1, p=0.003).Results study rapidly worsens age. More work needed more precisely understand determine best strategies intervention.
Язык: Английский
Процитировано
4
European journal of psychotraumatology, Год журнала: 2022, Номер 13(2)
Опубликована: Ноя. 1, 2022
Experiencing potentially morally injurious events (PMIEs) has been found to be significantly associated with poor mental health outcomes in military personnel/veterans. Currently, no manualised treatment for moral injury-related difficulties UK veterans exists. This article describes the design, methods and expected data collection of Restore & Rebuild (R&R) protocol, which aims develop procedures treat injury related ill informed by a codesign approach.
Язык: Английский
Процитировано
7
BMJ Military Health, Год журнала: 2021, Номер 169(5), С. 419 - 424
Опубликована: Окт. 25, 2021
Introduction Despite making up about 11% of the UK military, there remains limited investigation on impact adversity women experience during their service in military. Military can result a range well-being difficulties that may persist following transition out The present study therefore examined prevalence and correlates different types military (defined as sexual harassment, assault, emotional bullying physical assault) within community sample veterans. Methods Participants were recruited from charity supporting 750 veterans completed an online survey collecting information sociodemographic factors, adversity, well mental health difficulties. Associations between variables explored using multivariate logistic regressions. Results findings indicate high (22.5% 5.1% 22.7% 3.3% assault). Younger women, those who held officer rank reported having combat or support role most at risk adversity. All significantly associated with probable post-traumatic stress disorder. Sexual harassment was additionally somatisation; assault alcohol difficulties; common difficulties, low social loneliness. Conclusions This indicates are adverse experiences provides evidence such adversities well-being. Further research is required to better understand these relationships.
Язык: Английский
Процитировано
9
medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2022, Номер unknown
Опубликована: Июнь 16, 2022
Abstract Background Potentially morally injurious events (PMIEs) can negatively impact mental health. The COVID-19 pandemic may have placed healthcare staff at risk of moral injury. Aim To examine the PMIE on wellbeing. Method 12,965 (clinical and non-clinical) were recruited from 18 NHS-England trusts into a survey exposure Results PMIEs significantly associated with adverse health symptoms across staff. Specific work factors experiences injury, including being redeployed, lack PPE, having colleague die COVID-19. Nurses who reported disorders more likely to report all forms than those without (AOR 2.7; 95% CI 2.2, 3.3). Doctors only betrayal events, such as breach trust by colleagues 2.7, 1.5, 4.9). Conclusions A considerable proportion NHS in both clinical non-clinical roles during pandemic. Prospective research is needed identify direction causation between injury disorder well continuing monitor longer term outcomes PMIEs.
Язык: Английский
Процитировано
6
BMJ Military Health, Год журнала: 2023, Номер unknown, С. e002413 - e002413
Опубликована: Июнь 16, 2023
Introduction Research into the factors resulting in suicide military veteran population has yet to reach a consensus. Available research is concentrated on small number of countries, and there lack consistency with contradictory conclusions. The USA produced significant amount country where identified as national health crisis, but UK, little regarding veterans from British Armed Forces. Methods This systematic review was conducted according Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines. Corresponding literature searches were PsychINFO, MEDLINE CINAHL. Articles that discussed suicide, suicidal ideation, prevalence or risk among Forces eligible review. A total 10 articles met inclusion criteria analysed. Results Veterans' rates found be comparable those general UK population. method used most commonly hanging strangulation. Firearms recorded 2% cases. Demographic often some stating older younger. However, female at higher than civilians. Those who had deployed combat operations lower finding took longer seek help mental (MH) difficulties reported more ideation. Conclusions Peer-reviewed publications have revealed broadly while highlighting differences across international armed forces. Veteran demographics, service history, transition MH all been potential also indicated are their civilian counterparts due being predominantly male; this could skew results requires investigation. Current limited further exploration required.
Язык: Английский
Процитировано
3