Citation

Békés V, Szabó D, Lévay EE, Salgó E, Unoka Z. J. Personal. Disord. 2023; 37(4): 406-423.

Copyright

(Copyright © 2023, Guilford Publications)

DOI

10.1521/pedi.2023.37.4.406

PMID

37721777

Abstract

Moral injury (MI) has received increased research attention in the past decades. However, despite its detrimental mental health consequences, MI has not been studied in psychiatric patients. We aimed to establish the relationship between childhood trauma, MI, and borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and disturbances in self-organization symptoms (DSO), a core diagnostic criterion of complex PTSD besides PTSD symptoms, and shame as a moral emotion in an inpatient psychiatric sample (N = 240). We found that the impact of childhood trauma on present BPD, PTSD, and DSO symptoms was mediated by MI and shame; the models accounted for up to 31% of variance in symptomatology. To our knowledge, this study is the first to investigate MI in a psychiatric sample, and our results highlight the importance of considering MI as a critical factor of patient experiences in relation to childhood trauma that potentially contributes to the development of psychiatric symptoms.

Language: en

Keywords

Humans; *Stress Disorders, Post-Traumatic; shame; posttraumatic stress disorder; *Adverse Childhood Experiences; *Borderline Personality Disorder/complications; borderline personality disorder; complex posttraumatic stress disorder; disturbances in self-organization; Inpatients; moral injury; Shame