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在高压力、服务型职业中,道德伤害与自杀意念和自杀未遂独立相关。

Moral injury is independently associated with suicidal ideation and suicide attempt in high-stress, service-oriented occupations.

作者信息

Griffin Brandon J, Maguen Shira, McCue Matthew L, Pietrzak Robert H, McLean Carmen P, Hamblen Jessica L, Jendro Ashlyn M, Norman Sonya B

机构信息

Mental Health Service, Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.

Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

出版信息

Npj Ment Health Res. 2025 Aug 1;4(1):32. doi: 10.1038/s44184-025-00151-9.

DOI:10.1038/s44184-025-00151-9
PMID:40751003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12317004/
Abstract

This study explores the link between moral injury and suicidal thoughts and behaviors among US military veterans, healthcare workers, and first responders (N = 1232). Specifically, it investigates the risk associated with moral injury that is not attributable to common mental health issues. Among the participants, 12.1% reported experiencing suicidal ideation in the past two weeks, and 7.4% had attempted suicide in their lifetime. Individuals who screened positive for probable moral injury (6.0% of the sample) had significantly higher odds of current suicidal ideation (AOR = 3.38, 95% CI = 1.65, 6.96) and lifetime attempt (AOR = 6.20, 95% CI = 2.87, 13.40), even after accounting for demographic, occupational, and mental health factors. The findings highlight the need to address moral injury alongside other mental health issues in comprehensive suicide prevention programs for high-stress, service-oriented professions.

摘要

本研究探讨了美国退伍军人、医护人员和急救人员(N = 1232)中道德伤害与自杀念头及行为之间的联系。具体而言,它调查了与道德伤害相关的风险,这种风险并非由常见心理健康问题所致。在参与者中,12.1%报告在过去两周内有过自杀念头,7.4%曾有过终身自杀未遂经历。筛查出可能存在道德伤害阳性的个体(占样本的6.0%),即使在考虑了人口统计学、职业和心理健康因素后,当前有自杀念头的几率(调整后比值比[AOR]=3.38,95%置信区间[CI]=1.65,6.96)和终身自杀未遂几率(AOR = 6.20,95% CI = 2.87,13.40)仍显著更高。研究结果凸显了在针对高压力、服务型职业的综合自杀预防项目中,除其他心理健康问题外,还需关注道德伤害。

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本文引用的文献

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Prevalence of Moral Injury in Nationally Representative Samples of Combat Veterans, Healthcare Workers, and First Responders.在具有全国代表性的退伍军人、医护人员和急救人员样本中道德伤害的患病率。
J Gen Intern Med. 2025 Jan 29. doi: 10.1007/s11606-024-09337-x.
2
The moral injury, posttraumatic stress disorder, and suicidal behaviors in health professionals 1 year after the COVID-19 pandemic peak in China.中国 COVID-19 疫情高峰期过后 1 年,医护人员的道德创伤、创伤后应激障碍和自杀行为。
Psychol Trauma. 2023 Sep;15(Suppl 2):S352-S356. doi: 10.1037/tra0001483.
3
Using the Moral Injury and Distress Scale to identify clinically meaningful moral injury.使用道德伤害与痛苦量表来识别具有临床意义的道德伤害。
J Trauma Stress. 2024 Aug;37(4):685-696. doi: 10.1002/jts.23050. Epub 2024 Apr 24.
4
The impact of moral injury on suicide risk among recently discharged Israeli veterans: A longitudinal moderated mediation model of trauma-related guilt and self-forgiveness.道德伤害对近期退伍的以色列老兵自杀风险的影响:创伤相关内疚和自我宽恕的纵向调节中介模型
Psychol Trauma. 2025 Jul;17(5):1023-1032. doi: 10.1037/tra0001651. Epub 2024 Jan 15.
5
Moral injury and mental health among health-care workers during the COVID-19 pandemic: meta-analysis.COVID-19 大流行期间医护人员的道德伤害和心理健康:荟萃分析。
Eur J Psychotraumatol. 2023;15(1):2299659. doi: 10.1080/20008066.2023.2299659. Epub 2024 Jan 8.
6
Burnout, moral injury, and suicidal/self-harm ideation among healthcare professionals in Mainland China: Insights from an online survey during the COVID-19 pandemic.中国大陆医护人员的倦怠、道德伤害和自杀/自残意念:新冠疫情期间在线调查的洞察。
Int J Psychiatry Med. 2024 Jul;59(4):487-502. doi: 10.1177/00912174231219041. Epub 2023 Dec 4.
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J Affect Disord. 2023 Nov 1;340:551-554. doi: 10.1016/j.jad.2023.08.040. Epub 2023 Aug 7.
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Psychol Med. 2023 May;53(7):3200-3209. doi: 10.1017/S0033291721005274. Epub 2022 Jan 17.
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