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Cited by 166Posttraumatic Stress Disorder ResearchReligion, Spirituality, and PsychologyPsychology of Moral and Emotional Judgment

Moral Injury: An Increasingly Recognized and Widespread Syndrome

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Koenig, Harold G., Al Zaben, Faten·2021·Journal of Religion and Health
DOI 10.1007/s10943-021-01328-0PMC PMC8270769
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Abstract

Moral injury (MI), originally discussed in relationship to transgressing moral beliefs and values during wartime among military personnel, has expanded beyond this context to include similar emotions experienced by healthcare professionals, first responders, and others experiencing moral emotions resulting from actions taken or observations made during traumatic events or circumstances. In this article, we review the history, definition, measurement, prevalence, distinctiveness, psychological consequences, manifestations (in and outside of military settings), and correlates of MI in different settings. We also review secular psychological treatments, spiritually integrated therapies, and pastoral care approaches (specific for clergy and chaplains) used to treat MI and the evidence documenting their efficacy. Finally, we examine directions for future research needed to fill the many gaps in our knowledge about MI, how it develops, and how to help those suffering from it.

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  • A substantial body of research supports the involvement of professional health care chaplains in treating moral injury given their training in moral theory, religious traditions, and spiritual practices.

    “A substantial body of research supports the involvement of professional health care chaplains in treating moral injury (MI), given their training in moral theory, religious traditions, and spiritual practices (3, 111–113).”

    From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [3]

    The Pastoral Care Interventions section (page unavailable) says chaplains are well positioned to address moral injury and describes chaplain-led approaches, including small pilot studies. But the Future Directions section calls for more trials of pastoral care interventions; the paper does not establish a substantial body of supporting research or specify training in moral theory as the reason for chaplains’ involvement. (LLM, conf=0.88)

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References 90 · Cited by 166

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Authors
Koenig, H. G., & Al Zaben, F.
Affiliations
Duke University (US)
Corresponding author
Koenig, Harold G.
ORCID
Koenig, Harold G.
Venue
Journal of Religion and Health
Publisher
Springer Science and Business Media LLC
Published
2021-07-10
Volume
60
Issue
5
Pages
2989-3011
ISSN
  • 0022-4197 (ISSN-L)
  • 1573-6571
DOI
10.1007/s10943-021-01328-0
PMC
PMC8270769
OpenAlex
W3178151596
Cited by
166
References
90
Citations by year
2026: 40 · 2025: 45 · 2024: 26 · 2023: 31 · 2022: 20 · 2021: 4
FWCI
2.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Religion and Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Psychology of Moral and Emotional Judgment
Keywords
moral injury, moral emotions, military personnel, healthcare workers, first responders, moral transgression, psychological impact, prevalence, measurement, pastoral care, chaplaincy, treatment efficacy
MeSH terms
Clergy, Humans, Military Personnel, Morals, Pastoral Care, Stress Disorders, Post-Traumatic

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