Houle Stephanie A, Vincent Colin, Jetly Rakesh, Ashbaugh Andrea R
School of Psychology, University of Ottawa, Ottawa, Canada.
Operational Stress Injury Clinic, Royal Ottawa Health Care Group, Ottawa, Canada.
J Clin Psychol. 2021 Nov;77(11):2668-2693. doi: 10.1002/jclp.23205. Epub 2021 Jul 5.
This study describes patterns of distress associated with exposure to potentially morally injurious experiences (PMIEs) in a Canadian military sample.
Thematic analysis was performed on interviews from PMIE-exposed military members and Veterans. Participants also completed structured diagnostic interviews, and measures of trauma exposure and psychopathology. Multiple regression examined associations among these variables. Information on pharmacological treatment and past diagnoses are reported.
Eight qualitative themes were identified: changes in moral attitudes, increased sensitivity and reactivity to moral situations, loss of trust, disruptions in identity, disruptions in spirituality, disruptions in interpersonal relatedness, rumination, and internalizing and externalizing emotions and behaviors. Self-report data revealed that degree of PMIE exposure was meaningfully associated with posttraumatic stress disorder.
Qualitative but not quantitative findings supported existing models of moral injury (MI). Additional research is needed to examine the impact of PMIE type on mental health, and to test basic assumptions of MI theory.
本研究描述了加拿大军事样本中与接触潜在道德伤害性经历（PMIEs）相关的痛苦模式。
对接触过PMIEs的军事人员和退伍军人的访谈进行了主题分析。参与者还完成了结构化诊断访谈，以及创伤暴露和精神病理学测量。多元回归分析了这些变量之间的关联。报告了药物治疗和既往诊断的信息。
确定了八个定性主题：道德态度的变化、对道德情境的敏感性和反应性增加、信任丧失、身份认同紊乱、精神信仰紊乱、人际关系紊乱、沉思以及内化和外化情绪与行为。自我报告数据显示，PMIE暴露程度与创伤后应激障碍有显著关联。
定性而非定量研究结果支持了现有的道德伤害（MI）模型。需要进一步研究以检验PMIE类型对心理健康的影响，并验证MI理论的基本假设。
