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Psychological Trauma Theory Research Practice and Policy
Article . 2025 . Peer-reviewed
License: CC BY
Data sources: Crossref
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Article . 2025
Data sources: UQ eSpace
UQ eSpace
Article . 2025
Data sources: UQ eSpace
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Moral injury front and center: The relationship between event centrality and moral injury.

Authors: Kari E. James; Blake M. McKimmie; Fiona Maccallum;

Moral injury front and center: The relationship between event centrality and moral injury.

Abstract

Moral injury is a potentially deleterious mental health outcome arising from unresolved distress associated with exposure to events that transgress an individual's moral code. Primarily characterized by guilt and shame, moral injury also shares some features with posttraumatic stress disorder (PTSD). However, treatments that are effective for PTSD may be limited in their effectiveness for moral injury, indicating the importance of understanding factors that distinguish the two. Research indicates that the extent to which a potentially traumatic event comes to dominate an individual's self-identity (event centrality) is associated with PTSD severity. We sought to identify whether, and to what extent, a similar association exists between event centrality and moral injury.In this cross-sectional study, we examined the extent to which event centrality was associated with outcomes following exposure to potentially morally injurious events. Adults (N = 232) exposed to a potentially morally injurious event completed validated measures of event centrality and event-related distress, traumatic stress, depression, anxiety, guilt, and shame.Greater event centrality was associated with more severe event-related distress and traumatic stress, though the association was significantly larger for traumatic stress. Further, the relationship between event centrality and event-related distress was fully mediated by guilt and shame, whereas the relationship with traumatic stress was only partially mediated by guilt and shame.These findings indicate that the extent to which a potentially morally injurious event dominates an individual's self-identity is important to moral injury outcomes, and shed light on features that distinguish moral injury from PTSD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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Keywords

52 Psychology, 5203 Clinical and health psychology

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
hybrid