Abstract
This chapter aims to carefully distinguish Post-Traumatic Stress Disorder (PTSD) from Moral Injury (MI) and review the role of the spiritual dimension in the causation, healing, and prevention of both syndromes. We argue that by giving due consideration to this spiritual dimension, the U.S. military can better prepare soldiers to encounter potentially morally injurious events (PMIEs) in deployment and combat.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Notes
- 1.
- 2.
- 3.
References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association Publishing, Washington. https://doi.org/10.1176/appi.books.9780890425596
Blucher R (2003) Jonathan Shay’s Achilles in Vietnam and Odysseus in America. J Mil Ethics 2(2):160–167. https://doi.org/10.1080/1502750310000153
Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, Zettle RD (2011) Preliminary psychometric properties of the acceptance and action questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther 42:676–688. https://doi.org/10.1016/j.beth.2011.03.007
Brock RN, Lettini G (2012) Soul repair: recovering from moral injury after war. Beacon Press, Boston
Bravo A, Kelley ML, Mason R, Ehlke SJ, Vinci C, Redman JC (2020) Rumination as a mediator of the associations between moral injury and mental health problems in combat-wounded veterans. Traumatol (Tallahassee, Fla.) 26(1):52–60. https://doi.org/10.1037/trm0000198
Bryan AO, Bryan CJ, Morrow CE, Etienne N, Ray-Sannerud B (2014) Moral injury, suicidal ideation, and suicide attempts in a military sample. Traumatol (Tallahassee, Fla.) 20(3):154–160. https://doi.org/10.1037/h0099852
Carey L, Hodgson TJ (2018) Chaplaincy, spiritual care and moral injury: considerations regarding screening and treatment. Front Psych 9:619–619. https://doi.org/10.3389/fpsyt.2018.00619
Currier JM, Holland JM, Drescher KD (2015) Spirituality factors in the prediction of outcomes of PTSD treatment for U.S. Military Veterans. J Trauma Stress 28(1):57–64. https://doi.org/10.1002/jts.21978
Da Costa JM (1871) On irritable heart: a clinical study of a form of functional cardiac disorder and its consequences. Am J Med Sci 61:17–52
Forkus SR, Breines JG, Weiss NH (2019) Morally injurious experiences and mental health: the moderating role of self-compassion. Psychol Trauma 11(6):630–638. https://doi.org/10.1037/tra0000446
Frankfurt S, Frazier P (2016) A review of research on moral injury in combat veterans. Mil Psychol 28:318–330. https://doi.org/10.1037/mil0000132
Garcia V (2011) PTSD in the military: history, attitudes, and treatment—argument for a paradigm shift. ProQuest Dissertations Publishing
Hall NA, Everson AT, Billingsley MR, Miller MB (2022) Moral injury, mental health and behavioural health outcomes: a systematic review of the literature. Clin Psychol Psychother 29(1):92–110. https://doi.org/10.1002/cpp.2607
Herman JL (1997) Trauma and recovery: the aftermath of violence—from domestic abuse to political terror. Basic Books, New York
Hiraoka R, Meyer EC, Kimbrel NA, DeBeer BB, Gulliver SB, Morissette SB (2015) Self-compassion as a prospective predictor of PTSD symptom severity among Trauma-exposed U.S. Iraq and Afghanistan war veterans. J Trauma Stress 28(2):127–133. https://doi.org/10.1002/jts.21995
Jinkerson JD (2016) Defining and assessing moral injury: a syndrome perspective. Traumatology 22(2):122–130. https://doi.org/10.1037/trm0000069
Kardiner A (1941) The traumatic neuroses of war. Hoeber, New York
Kelley ML, Chae JW, Bravo AJ, Milam AL, Agha E, Gaylord SA, Vinci C, Currier JM (2021) Own soul’s warning: moral injury, suicidal ideation, and meaning in life. Psychol Trauma 13(7):740–748. https://doi.org/10.1037/tra0001047
Koenig H, Ames D, Youssef NA, Oliver JP, Volk F, Teng EJ, Haynes K, Erickson ZD, Arnold I, O’Garo K, Pearce M (2018) The Moral injury symptom scale-military version. J Relig Health 57(1):249–265. https://doi.org/10.1007/s10943-017-0531-9
Koenig H, Ames D, Youssef NA, Oliver JP, Volk F, Teng EJ, Haynes K, Erickson ZD, Arnold I, O’Garo K, Pearce M (2018) Screening for moral injury: the moral injury symptom scale—military version short form. Mil Med 183(11–12):E659–E665. https://doi.org/10.1093/milmed/usy017
Koenig H, Al Zaben F (2021) Moral injury: an increasingly recognized and widespread syndrome. J Relig Health 60(5):2989–3011. https://doi.org/10.1007/s10943-021-01328-0
Kopacz MS, Connery AL, Bishop TM, Bryan CJ, Drescher KD, Currier JM, Pigeon WR (2015) Moral injury: a new challenge for complementary and alternative medicine. Complement Ther Med 24:29–33. https://doi.org/10.1016/j.ctim.2015.11.003
Lancaster SL, Erbes CR (2017) Importance of moral appraisals in military veterans. Traumatol (Tallahassee, Fla.) 23(4):317–322. https://doi.org/10.1037/trm0000123
Lancaster SL, Irene Harris J (2018) Measures of morally injurious experiences: a quantitative comparison. Psychiatry Res 264:15–19. https://doi.org/10.1016/j.psychres.2018.03.057
Lasiuk GC, Hegadoren KM (2006) Posttraumatic stress disorder part I: historical development of the concept. Perspect Psychiatr Care 42(1):13–20. https://doi.org/10.1111/j.1744-6163.2006.00045.x
Litz BT, Stein N, Delaney E, Lebowitz L, Nash WP, Silva C, Maguen S (2009) Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev 29(8):695–706. https://doi.org/10.1016/j.cpr.2009.07.003
Meyer EC, La Bash H, DeBeer BB, Kimbrel NA, Gulliver SB, Morissette SB (2019) Psychological inflexibility predicts PTSD symptom severity in war veterans after accounting for established PTSD risk factors and personality. Psychol Trauma 11(4):383–390. https://doi.org/10.1037/tra0000358
Military Health System (2020a) Total force fitness. https://www.health.mil/News/In-the-Spotlight/Total-Force-Fitness. Accessed 27 Nov 2020
Military Health System (2020b) Joint chiefs say mind, body, spirit all part of total force fitness. https://okinawa.stripes.com/community-news/joint-chiefs-say-mind-body-spirit-all-part-total-force-fitness. Accessed 27 Nov 2020
Myers ABR (1870) On the etiology and prevalence of diseases of the heart among soldiers. J. Churchill, London
Myers CS (1915) A contribution to the study of shell shock. Lancet 188:316–320
Nash WP, Marino Carper TL, Mills MA, Au T, Goldsmith A, Litz BT (2013) Psychometric evaluation of the moral injury events scale. Mil Med 178(6):646–652. https://doi.org/10.7205/MILMED-D-13-00017
Oren L, Possick C (2010) Is ideology a risk factor for PTSD symptom severity among Israeli political evacuees? Ideology as a risk factor for PTSD. J Trauma Stress 23(4):483–490. https://doi.org/10.1002/jts.20540
Park CL, Currier JM, Harris JI, Slattery JM (2017) The centrality of meaning in human lives. In: Park CL, Currier JM, Harris JI, Slattery JM (eds) Trauma, meaning, and spirituality: Translating research into clinical practice. American Psychological Association, Washington, pp 15–38. https://doi-org.ezproxy.lib.usf.edu/10.1037/15961-002
Park CL, Currier JM, Harris JI, Slattery JM (2017) Trauma, meaning, and spirituality: translating research into clinical practice, 1st edn. American Psychological Association, Washington
Pearce M, Haynes K, Rivera NR, Koenig HG (2018) Spiritually integrated cognitive processing therapy: a new treatment for post-traumatic stress disorder that targets moral injury. Glob Adv Health Med 7.https://doi.org/10.1177/2164956118759939
Potts GW (2022) Caring for the whole soldier in the wake of COVID-19. In: Farhadi A, Masys A (eds) The great power competition, vol 2. Springer, Cham. https://doi.org/10.1007/978-3-030-90390-9_15
Ramchand R, Schell TL, Jaycox LH, Tanielian T (2011) Epidemiology of trauma events and mental health outcomes among service members deployed to Iraq and Afghanistan. In: Ruzek JI, Schnurr PP, Vasterling JJ, Friedman MJ (eds) Caring for veterans with deployment-related stress disorders. American Psychological Association, Washington, pp 13–34. https://doi-org.ezproxy.lib.usf.edu/10.1037/12323-001
Ruzek J (2011) Caring for veterans with deployment-related stress disorders: Iraq, Afghanistan, and beyond, 1st edn. American Psychological Association, Washington
Shay J (2003) Achilles in Vietnam: combat trauma and the undoing of character. Scribner Press, New York
Shay J (2014) Moral injury. Psychoanal Psychol 31(2):182–191. https://doi.org/10.1037/a0036090
U.S. Department of Veterans Affairs (2022) PTSD: National Center for PTSD. https://www.ptsd.va.gov/understand_tx/talk_therapy.asp. Accessed 31 May 2022
Van der Kolk B (2014) The body keeps the score: brain, mind, and body in the healing of trauma. Penguin soldier, New York
Van der Kolk BA, Weiseth L, Van der Hart O (1996) History of trauma in psychiatry. In: Van Der Kolk BA, McFarlane AC, Weisaeth L (eds) Traumatic stress: the effects of overwhelming experience on mind, body, and society. Guilford Press, New York, pp 47–74
Wortmann JH, Park CL, Edmondson DE (2011) Trauma and PTSD symptoms: Does spiritual struggle mediate the link? 3(4): 442–452. https://doi.org/10.1037/a0021413
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Potts, G.W., Abadal, L.M. (2023). The Spiritual Dimension of Moral Injury and PTSD. In: Farhadi, A., Masys, A. (eds) The Great Power Competition Volume 4. Springer, Cham. https://doi.org/10.1007/978-3-031-22934-3_17
Download citation
DOI: https://doi.org/10.1007/978-3-031-22934-3_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-22933-6
Online ISBN: 978-3-031-22934-3
eBook Packages: Political Science and International StudiesPolitical Science and International Studies (R0)