Qualitative Examination of Veteran Perspectives on Moral Injury Restricted; Files Only
Zeuthen, Christopher (Spring 2023)
Published
Abstract
Moral injury (MI) is a term coined by Johnathan Shay in his book Achilles of Vietnam. Brett Litz first defined it as the result of “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.” Current literature has focused on definitional clarity, diagnosis, and treatment of a moral injury. This study aims to uncover veteran perspectives on a range of topics on moral injury, including thoughts on the construct, risk factors for a MI, MI’s connection to PTSD, and awareness and treatment of MI. Semi-structured interviews were conducted with veterans (n=14) across all military branches. Transcripts were uploaded to MAXQDA. Statements made by each participant were highlighted and organized into common themes. Sample themes included “gender,” “combat,” and “PTSD.”
Veterans largely supported the idea of MI but differed in its application to the military context. Most asserted that the risk for a MI did not differ for sex, age, race, or branch. Participants who differentiated between these factors believed women were at a heightened risk. There was variation in responses on how the level of combat exposure influenced the risk of MI. A spiritual and religious background was viewed as beneficial in buffering against the effects of MI. Veterans perceived there to be an overlap between PTSD and MI.
Regarding the application of MI, veterans' responses emphasized using senior military officials and the post-deployment period as opportune ways to increase awareness of MI. Utilizing religious professionals, fellow veterans, and the VA were key elements veterans presented for treatment of a MI. Results from this study may provide insight that can optimize the presentation of MI and direct resources to veterans at perceived heightened risk of MI.
Table of Contents
Chapter 1: Introduction…….................................................................................1
Chapter 2: 22 Veterans, Current State of Veteran’s Mental Health....................5
Chapter 3: Foundations of Moral Injury
3.1 Origins & Definitions………………..............................................................8
3.2 Moral Injury vs. PTSD...................................................................................14
3.3 Applications & Outstanding Questions..........................................................17
Chapter 4: Methodology.....................................................................................23
Chapter 5: Results
5.1 Lived Moral Injury.........................................................................................25
5.2 Initial Thoughts..............................................................................................27
5.3 Populations at Risk……………....................................................................29
5.4 PTSD & Moral Injury....................................................................................35
5.5 Spirituality & Religion……………………………......................................37
5.6 Application of Moral Injury..........................................................................39
Chapter 6: Discussion, Limitations, and Concluding Remarks.........................46
References..........................................................................................................54
Appendix............................................................................................................58
Key Terms: Moral Injury, PTSD, Veterans, Veteran Mental Health
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File download under embargo until 19 May 2025 | 2023-04-14 11:37:37 -0400 | File download under embargo until 19 May 2025 |
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