Moral injury and moral repair in war veterans: A preliminary model and intervention strategy

Litz, Brett T.; Stein, Nathan R.; Delaney, Eileen; Lebowitz, Leslie; Nash, William P.; Silva, Caroline; Maguen, Shira

doi:10.1016/j.cpr.2009.07.003

Cited by 1,831 publications

(2,461 citation statements)

References 52 publications

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“…Such interventions may be especially helpful for trauma groups that experience high personal involvement and therefore greater levels of guilt and more severe PTSD symptomatology (e.g. soldiers; Litz et al, 2009). In this context it needs to be noted that findings supporting the notion of increased trauma-related guilt intensifying PTSD symptomatology do not indicate, in turn, that a decrease in trauma-related guilt will help alleviate these symptoms.…”

Section: Discussionmentioning

confidence: 99%

The role of guilt in Posttraumatic Stress Disorder

Bub

Lommen

2017

European Journal of Psychotraumatology

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Background: A growing body of evidence supports the notion that the emotional profile of Posttraumatic Stress Disorder (PTSD) may be more diverse than traditional accounts presume. PTSD’s image as an anxiety-based disorder is undergoing change as the significance of other emotions in its development becomes more evident. Experimental research is needed in order to expand the understanding of underlying processes driving the development of PTSD. Objective: Experimentally test the influence of stressor-related guilt on the occurrence of PTSD symptomatology. Method: A non-clinical student sample faced an analogue trauma, a stressor in the form of a computer crash and related loss of data. We either personally blamed participants for causing the incident (blame group) or told them that it was a technical failure and therefore not their fault (no-blame group). Levels of guilt before and after the incident as well as number and associated distress of incident-related intrusions were assessed using a one-day diary and compared between groups. Results: The guilt manipulation was successful: feelings of guilt significantly increased in the blame group but not in the no-blame group. Furthermore, the blame group showed a significantly higher number of intrusions and associated distress compared to the no-blame group at one-day follow-up. Conclusions: These laboratory findings indicate that feelings of guilt may lead to increased PTSD symptomatology, supporting the view that guilt experienced in reaction to a traumatic event may be part of a causal mechanism driving the development of PTSD.

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Section: Discussionmentioning

confidence: 99%

The role of guilt in Posttraumatic Stress Disorder

Bub

Lommen

2017

European Journal of Psychotraumatology

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“…Much recent attention has been devoted to the construct of "moral injury"-that is, the idea that war can present profound moral and ethical challenges that can have corresponding deleterious spiritual and psychosocial consequences (Drescher et al, 2011;Gray et al, 2012;Litz et al, 2009). In research examining Veterans with PTSD, more severe PTSD has been found among those who harbor combat guilt (Henning & Frueh, 1997) and those who have difficulty with forgiveness (Witvliet, Phipps, Feldman, & Beckham, 2004).…”

Section: Introductionmentioning

confidence: 99%

Chaplaincy and Mental Health in the Department of Veterans Affairs and Department of Defense

Nieuwsma

Rhodes²,

Jackson

et al. 2013

Journal of Health Care Chaplaincy

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Chaplains play important roles in caring for Veterans and Service members with mental health problems. As part of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Integrated Mental Health Strategy, we used a sequential approach to examining intersections between chaplaincy and mental health by gathering and building upon: (1) input from key subject matter experts; (2) quantitative data from the VA/DoD Chaplain Survey (N = 2,163; response rate of 75% in VA and 60% in DoD); and (3) qualitative data from site visits to 33 VA and DoD facilities. Findings indicate that chaplains are extensively involved in caring for individuals with mental health problems, yet integration between mental health and chaplaincy is frequently limited due to difficulties between the disciplines in establishing familiarity and trust. We present recommendations for improving integration of services, and we suggest key domains for future research.

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“…Thus, it is not surprising that discussions about how an experience of violence can function as a catalyst for growth generally focus on survivors of violent victimisation, not perpetrators. This is understandable given our natural tendency to empathise with victims of tragic and uncontrollable circumstances, and given that theories of post-traumatic growth were developed against the backdrop of PTSD research (Joseph & Linley, 2005), which at least historically has also focused on cases of victimization (Litz et al, 2009). However, with research demonstrating an association between PTSD and violence committed during active service (MacNair, 2015), there is a need to integrate divergent theories to understand the psychological processes of recovery, resilience, and post-traumatic growth in this population.…”

Section: Defining Post-traumatic Growthmentioning

confidence: 99%