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Moral Injury and PTSD: Often Co-Occurring Yet Mechanistically Different
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“While Posttraumatic stress disorder (PTSD) and moral injury (MI) often co-occur, both are conceptually distinct: PTSD is defined by fear-based responses to life threat (e.g., hyperarousal, re-experiencing, and avoidance of trauma cues), whereas MI centers on transgressions of deeply held moral beliefs and is marked disrupted moral meaning (10, 14, 19).”
From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [10]
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“Recent empirical and theoretical literature suggests that MI-related distress is sustained by maladaptive self-referential processing—recurrent rumination, rigid moral self-appraisal, and self-condemning narratives that reorganize identity around perceived transgression or betrayal (8, 10, 15–18).”
From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [10]
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“Although MI often co-occurs with posttraumatic stress disorder (PTSD), it is widely understood as a distinct moral–psychological condition not fully captured by fear-based trauma models”
From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [10]
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“MI is increasingly conceptualized as a distinct psychosocial syndrome involving enduring disruptions in moral identity, meaning systems, and self-evaluative processes following exposure to potentially morally injurious events (4, 8–13).”
From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [10]
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BackgroundSpiritually Integrated Cognitive Processing Therapy for Moral Injury in the Setting of PTSD
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Difficulties with emotion regulation within PTSD clusters and moral injury subtypes
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Metadata
- Authors
- Barnes, H. A., Hurley, R. A., & Taber, K. H.
- Affiliations
- W. G. (Bill) Hefner VA Medical Center (US)
- Venue
- The Journal of Neuropsychiatry and Clinical Neurosciences
- Published
- 2019-04
- Volume
- 31
- Issue
- 2
- Pages
- A4-103
- ISSN
- 0895-0172 (ISSN-L)
- 1545-7222
- OpenAlex
- W2942372106
- Semantic Scholar
- 8d5bbfa64f99860e143534191f3a73ab8c7a5271
- Cited by
- 172
- References
- 71
- Citations by year
- 2026: 19 · 2025: 26 · 2024: 22 · 2023: 34 · 2022: 31 · 2021: 23 · 2020: 14 · 2019: 2
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neuropsychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- moral injury, post-traumatic stress disorder, co-occurrence, pathophysiological mechanisms
- MeSH terms
- Psychological Trauma, Combat Disorders, Humans, Morals, Psychotherapy, Self Concept, Stress Disorders, Post-Traumatic, Forgiveness
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