Exploring the Maladaptive Cognitions of Moral Injury

Moral injury and Post-Traumatic Stress Disorder (PTSD) are two prominent mental health problems that affect military personnel. Moral injury results when the individual is exposed to a situation or event that violates their moral code; however, PTSD results when there is a substantial threat of harm. Moral injury is a relatively new construct within the literature with research starting in the late 2000s. Although distorted cognitions are core components of PTSD symptomatology, there has been no research of cognitions in moral injury.

The current study sought to differentiate PTSD and moral injury using the specific maladaptive cognitions associated with trauma (i.e., self-worth and judgement, threat of harm, forgiveness of the situation reliability, trustworthiness of others, forgiveness of others, forgiveness of self, and atonement). Participants (N=253) were previously deployed military personnel, 90.1% of whom experienced foreign deployment(s). Results indicated that moral injury was defined by atonement, self-worth and judgement, reliability and trustworthiness of others, and forgiveness of others while PTSD was defined by threat of harm and forgiveness of the situation. Forgiveness of self was not associated with moral injury nor PTSD. The current investigation provides further empirical support to identify moral injury as a construct distinct from PTSD.