Citation

Khan AJ, Griffin BJ, Maguen S. Curr. Treat. Options Psychiatry 2023; 10(3): 259-287.

Copyright

(Copyright © 2023, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s40501-023-00293-7

PMID

unavailable

Abstract

PURPOSE of Review: This review summarizes empirical studies investigating the associations between moral injury and suicide-related outcomes. Recent Findings: A total of 47 studies met inclusion criteria and were reviewed. Samples included military, veteran, and civilian populations. Overall, more exposure to potentially morally injurious events (PMIE) and greater morally injurious symptom severity were both related to increased risk for suicide-related outcomes, including suicidal ideation and suicide attempt[s], and composite suicide-related variables. The strength of the association depended on the population, assessments used to measure moral injury and suicide-related outcomes, and covariates included in the model. Mediators and moderators of the association were identified including depression, posttraumatic stress, hopelessness, guilt, shame, social support, and resilience. Summary: Moral injury confers a unique risk for suicide-related outcomes even after accounting for formalized psychiatric diagnosis. Suicide prevention programs for military service members, veterans, and civilians working in high-stress environments may benefit from targeted interventions to address moral injury. While suicide-related outcomes have not been included in efficacy trials of moral injury interventions, mediators and moderators of the association between moral injury and suicide-related outcomes are potential targets for therapeutic change, including disclosure, self-forgiveness, and meaning-making. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023.

Language: en

Keywords

Review; Treatment; Suicide attempt; Suicidal ideation; Moral injury