Conceptualization of moral injury: A socio-cognitive perspective

As research into moral injury (MI) develops, a clearer conceptualization is needed to support further research and development of treatments. This article draws on the existing MI literature and proposes a new model for its conceptualization. The authors propose that central to MI is deterioration in the relationship with self, others, and humanity, leading to global belief and behavioural changes. A definition of what is, and is not, a potentially morally injurious event (PMIE) is also presented, and the authors argue that events need to be high stakes and threaten previously held beliefs, regardless of the event's outcome. The model highlights key predisposing factors that may influence the later development and maintenance of MI, such as adverse childhood experiences and factors surrounding the event. By considering what distinguishes PMIEs from Diagnostic and Statistical Manual of Mental Disorders (5th ed.) posttraumatic stress disorder criterion A events and what factors may lead to MI, a better understanding of MI development and treatment can be considered.