Correlates and Dimensionality of Moral Injury in Combat Veterans around Globe: A Systematic Review
Keywords:
Moral Injury, Post-traumatic Stress Disorder, Guilt, Shame, VeteransAbstract
The review elucidates the view of Moral Injury (MI), a profound psychological and emotional response to transgressions of deeply held moral beliefs, experienced by military personnel and veterans. A PRISMA-guided literature search was conducted across four databases, 27 studies yielding a comprehensive overview of moral injury's historical evolution, neurobiological correlates, psychological, spiritual, and ethical dimensions. Standardized assessment tools, such as the Moral Injury Symptom Scale - Military Version Short Form (MISS-M-SF) and the Moral Judgment Interview (MJI), were utilized to evaluate MI and its related symptoms. Findings show that MI is a distinctive construct from PTSD, illustrated by guilt, shame, anger, and spiritual distress. Military personnel across various countries and conflicts experience Moral Injury, leading to long-term psychological and social consequences. The review highlights the need for a consensus definition, targeted interventions, and interdisciplinary collaboration to address moral injury's multifaceted impacts.
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