A qualitative analysis of the impact of potentially morally injurious experiences in the Canadian Armed Forces

Abstract: Moral injury (MI) refers to the psychological, social, and spiritual consequences of exposure to events that transgress core moral beliefs. Such consequences include unresolved moral dissonance, negative self-attributions regarding the morally transgressive event(s), intense guilt and shame, lack of trust in others, spiritual or existential inner conflict, and social withdrawal. Research shows exposure to potentially morally injurious events (PMIEs) is associated with self-harm and suicidality, substance use and social problems and an increased risk of post-traumatic stress disorder (PTSD) and depression. Indeed, features of MI overlap with both disorders, and the determination as to where MI fits within the current nosology of mental illness remains an open question. The purpose of this study was to identify themes of distress associated with PMIE exposure using interview data obtained from Canadian Armed Forces (CAF) members and Veterans.