Williamson Victoria, Murphy Dominic, Stevelink Sharon A M, Allen Shannon, Jones Edgar, Greenberg Neil
King's Centre for Military Health Research, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.
Combat Stress, Research Department, Tyrwhitt House, Combat Stress, Leatherhead, Surrey, UK.
Eur J Psychotraumatol. 2020 Jan 9;11(1):1704554. doi: 10.1080/20008198.2019.1704554. eCollection 2020.
: Exposure to a potentially morally injurious event (PMIE) has been found to be associated with a range of adverse mental health outcomes. However, how the psychological consequences following PMIEs compare to those encountered after a traumatic, but not a PMIE, remain poorly understood. : The aim was to qualitatively explore UK military veterans' responses to experiences of trauma and moral injury and the impact of such events on psychological wellbeing. : Thirty male veterans who reported exposure to traumatic and/or morally injurious events were recruited. Semi-structured qualitative interviews were conducted, and data were analysed using thematic analysis. : Six veterans described exposure to a non-morally injurious traumatic event, 15 reported experiencing a PMIE, and 9 described exposure to a 'mixed' event which was simultaneously morally injurious and traumatic. Veterans who encountered a PMIE described experiencing moral dissonance, or a clash between concurrently held sets of values (e.g. military values versus civilian values), which provoked considerable psychological distress. Veterans' cognitions and responses were found to differ following a PMIE compared to a traumatic, but not PMIE, which could have negative implications for daily functioning. Several risk and protective factors for experiencing distress following a PMIE were described. : This study provides some of the first evidence that events experienced by UK veterans can simultaneously be morally injurious and traumatic or life-threatening as well as highlighting the process by which moral injury may occur in UK veterans. These findings illustrate the need to examine effective pathways for prevention and intervention for veterans who have experienced a morally injurious event.
研究发现，接触潜在的道德伤害事件（PMIE）与一系列不良心理健康结果相关。然而，与创伤事件（而非PMIE）后的心理后果相比，PMIE后的心理后果如何，目前仍知之甚少。
目的是定性探索英国退伍军人对创伤和道德伤害经历的反应，以及此类事件对心理健康的影响。
招募了30名报告接触过创伤性和/或道德伤害事件的男性退伍军人。进行了半结构化定性访谈，并使用主题分析对数据进行了分析。
6名退伍军人描述了接触非道德伤害性创伤事件的经历，15人报告经历了PMIE，9人描述接触了同时具有道德伤害性和创伤性的“混合”事件。经历PMIE的退伍军人描述了经历道德失调，或同时持有的多套价值观之间的冲突（例如军事价值观与平民价值观），这引发了相当大的心理困扰。与创伤事件（而非PMIE）相比，退伍军人在经历PMIE后的认知和反应有所不同，这可能对日常功能产生负面影响。还描述了经历PMIE后产生困扰的几个风险和保护因素。
这项研究提供了一些初步证据，表明英国退伍军人经历的事件可能同时具有道德伤害性、创伤性或危及生命，同时也凸显了英国退伍军人可能发生道德伤害的过程。这些发现表明，有必要研究针对经历过道德伤害事件的退伍军人的有效预防和干预途径。
