Skip to main content
Top
Gepubliceerd in: Clinical Child and Family Psychology Review 4/2013

01-12-2013

Moral Injury: A Mechanism for War-Related Psychological Trauma in Military Family Members

Auteurs: William P. Nash, Brett T. Litz

Gepubliceerd in: Clinical Child and Family Psychology Review | Uitgave 4/2013

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Recent research has provided compelling evidence of mental health problems in military spouses and children, including post-traumatic stress disorder (PTSD), related to the war-zone deployments, combat exposures, and post-deployment mental health symptoms experienced by military service members in the family. One obstacle to further research and federal programs targeting the psychological health of military family members has been the lack of a clear, compelling, and testable model to explain how war-zone events can result in psychological trauma in military spouses and children. In this article, we propose a possible mechanism for deployment-related psychological trauma in military spouses and children based on the concept of moral injury, a model that has been developed to better understand how service members and veterans may develop PTSD and other serious mental and behavioral problems in the wake of war-zone events that inflict damage to moral belief systems rather by threatening personal life and safety. After describing means of adapting the moral injury model to family systems, we discuss the clinical implications of moral injury, and describe a model for its psychological treatment.
Literatuur
go back to reference Adler, A. B., Wright, K. M., Bliese, P. D., Eckford, R., & Hoge, C. W. (2008). A2 diagnostic criterion for combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 21(3), 301–308.PubMedCrossRef Adler, A. B., Wright, K. M., Bliese, P. D., Eckford, R., & Hoge, C. W. (2008). A2 diagnostic criterion for combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 21(3), 301–308.PubMedCrossRef
go back to reference American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, text revision (DSM-IV-TR). Author. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, text revision (DSM-IV-TR). Author.
go back to reference American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Author. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Author.
go back to reference Bernstein, J. M. (2005). Suffering injustice: Misrecognition as moral injury in critical theory. International Journal of Philosophical Studies, 13, 303–324.CrossRef Bernstein, J. M. (2005). Suffering injustice: Misrecognition as moral injury in critical theory. International Journal of Philosophical Studies, 13, 303–324.CrossRef
go back to reference Breslau, N., & Kessler, R. C. (2001). The stressor criterion in DSM-IV posttraumatic stress disorder: An empirical investigation. Biological Psychiatry, 50, 699–704.PubMedCrossRef Breslau, N., & Kessler, R. C. (2001). The stressor criterion in DSM-IV posttraumatic stress disorder: An empirical investigation. Biological Psychiatry, 50, 699–704.PubMedCrossRef
go back to reference Bryant, R. A., Creamer, M., O’Donnell, M., Silove, D., & McFarlane, A. C. (2011). Heart rate after trauma and the specificity of fear circuitry disorders. Psychological Medicine, 41, 2573–2580.PubMedCrossRef Bryant, R. A., Creamer, M., O’Donnell, M., Silove, D., & McFarlane, A. C. (2011). Heart rate after trauma and the specificity of fear circuitry disorders. Psychological Medicine, 41, 2573–2580.PubMedCrossRef
go back to reference Carelton, R. N., Peluso, D. L., Collimore, K. C., & Asmundson, G. J. G. (2011). Social anxiety and posttraumatic stress symptoms: The impact of distressing social events. Journal of Anxiety Disorders, 25, 49–57.CrossRef Carelton, R. N., Peluso, D. L., Collimore, K. C., & Asmundson, G. J. G. (2011). Social anxiety and posttraumatic stress symptoms: The impact of distressing social events. Journal of Anxiety Disorders, 25, 49–57.CrossRef
go back to reference Caska, C. M., & Renshaw, K. D. (2011). Perceived burden in spouses of national guard/reserve service members deployed during operations enduring and Iraqi freedom. Journal of Anxiety Disorders, 25, 346–351.PubMedCrossRef Caska, C. M., & Renshaw, K. D. (2011). Perceived burden in spouses of national guard/reserve service members deployed during operations enduring and Iraqi freedom. Journal of Anxiety Disorders, 25, 346–351.PubMedCrossRef
go back to reference Currier, J. M., & Holand, J. M. (2012). Examining the role of combat loss among Vietnam War veterans. Journal of Traumatic Stress, 25, 102–105.PubMedCrossRef Currier, J. M., & Holand, J. M. (2012). Examining the role of combat loss among Vietnam War veterans. Journal of Traumatic Stress, 25, 102–105.PubMedCrossRef
go back to reference Davis, B. E. (2010). Parental wartime deployment and the use of mental health services among young military children. Pediatrics, 126, 1215–1216.PubMedCrossRef Davis, B. E. (2010). Parental wartime deployment and the use of mental health services among young military children. Pediatrics, 126, 1215–1216.PubMedCrossRef
go back to reference de Burgh, H. T., White, C. J., Fear, N. T., & Iversen, A. C. (2011). The impact of deployment to Iraq or Afghanistan on partners and wives of military personnel. International Review of Psychiatry, 23, 192–200.PubMedCrossRef de Burgh, H. T., White, C. J., Fear, N. T., & Iversen, A. C. (2011). The impact of deployment to Iraq or Afghanistan on partners and wives of military personnel. International Review of Psychiatry, 23, 192–200.PubMedCrossRef
go back to reference Dean, E. T. (1997). Shook over hell: Post-traumatic stress, Vietnam, and the civil war. Cambridge, MA: Harvard University Press. Dean, E. T. (1997). Shook over hell: Post-traumatic stress, Vietnam, and the civil war. Cambridge, MA: Harvard University Press.
go back to reference Defense Health Board Task Force on Mental Health. (2007). An achievable vision: Report of the Department of Defense Task Force on Mental Health. Falls Church, VA: Defense Health Board. Defense Health Board Task Force on Mental Health. (2007). An achievable vision: Report of the Department of Defense Task Force on Mental Health. Falls Church, VA: Defense Health Board.
go back to reference Dirkswager, A. J. E., Bramsen, I., Adèr, H., & van der Ploeg, H. K. (2005). Secondary traumatization in partners and parents of Dutch peacekeeping soldiers. Journal of Family Psychology, 19(2), 217–226.CrossRef Dirkswager, A. J. E., Bramsen, I., Adèr, H., & van der Ploeg, H. K. (2005). Secondary traumatization in partners and parents of Dutch peacekeeping soldiers. Journal of Family Psychology, 19(2), 217–226.CrossRef
go back to reference Drescher, K., Foy, D., Kelly, C., Leshner, A., Schutz, A., & Litz, B. T. (2011). An exploration of the viability and usefulness of the construct of moral injury in war veterans. Traumatology, 17(1), 8–13.CrossRef Drescher, K., Foy, D., Kelly, C., Leshner, A., Schutz, A., & Litz, B. T. (2011). An exploration of the viability and usefulness of the construct of moral injury in war veterans. Traumatology, 17(1), 8–13.CrossRef
go back to reference Esposito-Smythers, C., Wolff, J., Lemmon, K. M., Bodzy, M., Swenson, R. R., & Spirito, A. (2011). Military youth and the deployment cycle: Emotional health consequences and recommendations for intervention. Journal of Family Psychology, 25(4), 497–507.PubMedCrossRef Esposito-Smythers, C., Wolff, J., Lemmon, K. M., Bodzy, M., Swenson, R. R., & Spirito, A. (2011). Military youth and the deployment cycle: Emotional health consequences and recommendations for intervention. Journal of Family Psychology, 25(4), 497–507.PubMedCrossRef
go back to reference Figley, C. R. (1998). Burnout as systemic traumatic stress: A model for helping traumatized family members. In C. R. Figley (Ed.), Burnout in families: The systemic costs of caring (pp. 15–28). New York: CRC Press. Figley, C. R. (1998). Burnout as systemic traumatic stress: A model for helping traumatized family members. In C. R. Figley (Ed.), Burnout in families: The systemic costs of caring (pp. 15–28). New York: CRC Press.
go back to reference Friedman, M. J. (1981). Post-Vietnam syndrome: Recognition and management. Psychosomatics, 22(11), 931–942.PubMedCrossRef Friedman, M. J. (1981). Post-Vietnam syndrome: Recognition and management. Psychosomatics, 22(11), 931–942.PubMedCrossRef
go back to reference Friedman, M. J., Resick, P. A., Bryant, R. A., & Brewin, C. R. (2011a). Considering PTSD for DSM-5. Depression and Anxiety, 28, 750–769.PubMedCrossRef Friedman, M. J., Resick, P. A., Bryant, R. A., & Brewin, C. R. (2011a). Considering PTSD for DSM-5. Depression and Anxiety, 28, 750–769.PubMedCrossRef
go back to reference Friedman, M. J., Resick, P. A., Bryant, R. A., Strain, J., Horowitz, M., & Spiegel, D. (2011b). Classification of trauma and stressor-related disorders in DSM-5. Depression and Anxiety, 28, 737–749.PubMedCrossRef Friedman, M. J., Resick, P. A., Bryant, R. A., Strain, J., Horowitz, M., & Spiegel, D. (2011b). Classification of trauma and stressor-related disorders in DSM-5. Depression and Anxiety, 28, 737–749.PubMedCrossRef
go back to reference Galovski, T., & Lyons, J. A. (2004). Psychological sequelae of combat violence: A review of the impact of PTSD on the veteran’s family and possible interventions. Aggression and Violent Behavior, 9, 477–501.CrossRef Galovski, T., & Lyons, J. A. (2004). Psychological sequelae of combat violence: A review of the impact of PTSD on the veteran’s family and possible interventions. Aggression and Violent Behavior, 9, 477–501.CrossRef
go back to reference Gold, S. D., Marx, B. P., Soler-Baillo, J. M., & Sloan, D. M. (2005). Is life stress more traumatic than traumatic stress? Anxiety Disorders, 19, 687–698.CrossRef Gold, S. D., Marx, B. P., Soler-Baillo, J. M., & Sloan, D. M. (2005). Is life stress more traumatic than traumatic stress? Anxiety Disorders, 19, 687–698.CrossRef
go back to reference Gorman, L. A., Fitzgerald, H. E., & Blow, A. J. (2010). Parental combat injury and early child development: A conceptual model for differentiating effects of visible and invisible injuries. Psychiatric Quarterly, 81, 1–21.PubMedCrossRef Gorman, L. A., Fitzgerald, H. E., & Blow, A. J. (2010). Parental combat injury and early child development: A conceptual model for differentiating effects of visible and invisible injuries. Psychiatric Quarterly, 81, 1–21.PubMedCrossRef
go back to reference Gray, M. J., Litz, B. T., Hsu, J. L., & Lombardo, T. W. (2004). Psychometric properties of the life events checklist. Assessment, 11(4), 330–341.PubMedCrossRef Gray, M. J., Litz, B. T., Hsu, J. L., & Lombardo, T. W. (2004). Psychometric properties of the life events checklist. Assessment, 11(4), 330–341.PubMedCrossRef
go back to reference Gray, M. J., Schorr, Y., Nash, W., Lebowitz, L., Amidon, A., Lansing, A., et al. (2011). Adaptive disclosure: An open trial of a novel exposure-based intervention for service members with combat-related psychological stress injuries. Behavior Therapy,. doi:10.1016/j.beth.2011.09.001.PubMed Gray, M. J., Schorr, Y., Nash, W., Lebowitz, L., Amidon, A., Lansing, A., et al. (2011). Adaptive disclosure: An open trial of a novel exposure-based intervention for service members with combat-related psychological stress injuries. Behavior Therapy,. doi:10.​1016/​j.​beth.​2011.​09.​001.PubMed
go back to reference Grinker, R. R., & Spegel, J. P. (1945). Men under stress. Cornwall: Blakiston.CrossRef Grinker, R. R., & Spegel, J. P. (1945). Men under stress. Cornwall: Blakiston.CrossRef
go back to reference Hassija, C. M., Jukupcak, M., Maguen, S., & Shipherd, J. C. (2012). The influence of combat and interpersonal trauma on PTSD, depression, and alcohol misuse in U.S. Gulf War and OEF/OIF women veterans. Journal of Traumatic Stress, 25, 216–219.PubMedCrossRef Hassija, C. M., Jukupcak, M., Maguen, S., & Shipherd, J. C. (2012). The influence of combat and interpersonal trauma on PTSD, depression, and alcohol misuse in U.S. Gulf War and OEF/OIF women veterans. Journal of Traumatic Stress, 25, 216–219.PubMedCrossRef
go back to reference Herman, J. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. New York: Basic Books. Herman, J. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. New York: Basic Books.
go back to reference Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13–22.PubMedCrossRef Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13–22.PubMedCrossRef
go back to reference Institute of Medicine. (2012). Treatment for posttraumatic stress disorder in military and veteran populations: Initial assessment. Washington, DC: The National Academies Press. Institute of Medicine. (2012). Treatment for posttraumatic stress disorder in military and veteran populations: Initial assessment. Washington, DC: The National Academies Press.
go back to reference Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology of trauma. New York: Free Press. Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology of trauma. New York: Free Press.
go back to reference Johnson, L. R., McGuire, J., Lazarus, R., & Palmer, A. A. (2012). Pavlovian fear memory circuits and phenotype models of PTSD. Neuropharmacology, 62, 638–646.PubMedCrossRef Johnson, L. R., McGuire, J., Lazarus, R., & Palmer, A. A. (2012). Pavlovian fear memory circuits and phenotype models of PTSD. Neuropharmacology, 62, 638–646.PubMedCrossRef
go back to reference Kilpatrick, D. G., Resnick, H. S., & Acierno, R. (2009). Should PTSD criterion A be retained? Journal of Traumatic Stress, 22(5), 374–383.PubMedCrossRef Kilpatrick, D. G., Resnick, H. S., & Acierno, R. (2009). Should PTSD criterion A be retained? Journal of Traumatic Stress, 22(5), 374–383.PubMedCrossRef
go back to reference Kilpatrick, D. G., Resnick, H. S., Freedy, J. R., Pelcovitz, D., Resick, P., Roth, S., et al. (1998). Posttraumatic stress disorder field trial: Evaluation of the PTSD construct—Criteria A through E. In T. Widiger, A. Frances, H. Pincus, R. Ross, M. First, W. Davis, et al. (Eds.), DSM-IV sourcebook (Vol. 4, pp. 803–844). Washington, DC: American Psychiatric Press. Kilpatrick, D. G., Resnick, H. S., Freedy, J. R., Pelcovitz, D., Resick, P., Roth, S., et al. (1998). Posttraumatic stress disorder field trial: Evaluation of the PTSD construct—Criteria A through E. In T. Widiger, A. Frances, H. Pincus, R. Ross, M. First, W. Davis, et al. (Eds.), DSM-IV sourcebook (Vol. 4, pp. 803–844). Washington, DC: American Psychiatric Press.
go back to reference King, D. W., King, L. A., Gudanowski, D. M., & Vreven, D. L. (1995). Alternative representations of war zone stressors: Relationships to posttraumatic stress disorder in male and female Vietnam veterans. Journal of Abnormal Psychology, 104(1), 184–196.PubMedCrossRef King, D. W., King, L. A., Gudanowski, D. M., & Vreven, D. L. (1995). Alternative representations of war zone stressors: Relationships to posttraumatic stress disorder in male and female Vietnam veterans. Journal of Abnormal Psychology, 104(1), 184–196.PubMedCrossRef
go back to reference Klarić, M., Frančišković, T., Obrdalj, E. C., Petrić, D., Britvić, D., & Zovko, N. (2012). Psychiatric and health impact of primary and secondary traumatization in wives of veterans with posttraumatic stress disorder. Psychiatria Danubina, 24(3), 280–286.PubMed Klarić, M., Frančišković, T., Obrdalj, E. C., Petrić, D., Britvić, D., & Zovko, N. (2012). Psychiatric and health impact of primary and secondary traumatization in wives of veterans with posttraumatic stress disorder. Psychiatria Danubina, 24(3), 280–286.PubMed
go back to reference Lester, P., Peterson, K., Reeves, J., Knauss, L., Glover, D., Mogil, C., et al. (2010). The long war and parental combat deployment: Effects on military children and at-home spouses. American Academy of Child and Adolescent Psychiatry, 49(4), 310–320. Lester, P., Peterson, K., Reeves, J., Knauss, L., Glover, D., Mogil, C., et al. (2010). The long war and parental combat deployment: Effects on military children and at-home spouses. American Academy of Child and Adolescent Psychiatry, 49(4), 310–320.
go back to reference Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., et al. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706.PubMedCrossRef Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., et al. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706.PubMedCrossRef
go back to reference Long, M. R., Elhai, J. D., Schweinle, A., Gray, M. J., Grubaugh, A. L., & Frueh, B. C. (2008). Differences in posttraumatic stress disorder diagnostic rates and symptom severity between criterion A1 and non-criterion A1 stressors. Journal of Anxiety Disorders, 22, 1255–1263.PubMedCrossRef Long, M. R., Elhai, J. D., Schweinle, A., Gray, M. J., Grubaugh, A. L., & Frueh, B. C. (2008). Differences in posttraumatic stress disorder diagnostic rates and symptom severity between criterion A1 and non-criterion A1 stressors. Journal of Anxiety Disorders, 22, 1255–1263.PubMedCrossRef
go back to reference MacDermid Wadsworth, S., Lester, P., Marini, C., Cozza, S., Sornborger, J., Strouse, T., et al. (2013). Approaching family-focused systems of care for military and veteran families. Military Behavioral Health, 1, 1–10.CrossRef MacDermid Wadsworth, S., Lester, P., Marini, C., Cozza, S., Sornborger, J., Strouse, T., et al. (2013). Approaching family-focused systems of care for military and veteran families. Military Behavioral Health, 1, 1–10.CrossRef
go back to reference Maguen, S., Lucenko, B. A., Reger, M. A., Gahm, G. A., Litz, B. T., et al. (2010). The impact of reported direct and indirect killing on mental health symptoms in Iraq War veterans. Journal of Traumatic Stress, 23(1), 86–90.PubMed Maguen, S., Lucenko, B. A., Reger, M. A., Gahm, G. A., Litz, B. T., et al. (2010). The impact of reported direct and indirect killing on mental health symptoms in Iraq War veterans. Journal of Traumatic Stress, 23(1), 86–90.PubMed
go back to reference Mahan, A. L., & Ressler, K. J. (2012). Fear conditioning, synaptic plasticity and the amygdala: Implications for posttraumatic stress disorder. Trends in Neurosciences, 35(1), 24–35.PubMedCrossRef Mahan, A. L., & Ressler, K. J. (2012). Fear conditioning, synaptic plasticity and the amygdala: Implications for posttraumatic stress disorder. Trends in Neurosciences, 35(1), 24–35.PubMedCrossRef
go back to reference Maloney, L. J. (1988). Posttraumatic stresses on women partners of Vietnam veterans. Smith College Studies in Social Work, 58(2), 122–143.CrossRef Maloney, L. J. (1988). Posttraumatic stresses on women partners of Vietnam veterans. Smith College Studies in Social Work, 58(2), 122–143.CrossRef
go back to reference Mansfield, A. J., Kaufman, J. S., Engel, C. C., & Gaynes, B. N. (2011). Deployment and mental health diagnoses among children of US Army personnel. Archives of Pediatric and Adolescent Medicine, 165(11), 999–1005.CrossRef Mansfield, A. J., Kaufman, J. S., Engel, C. C., & Gaynes, B. N. (2011). Deployment and mental health diagnoses among children of US Army personnel. Archives of Pediatric and Adolescent Medicine, 165(11), 999–1005.CrossRef
go back to reference Mansfield, A. J., Kaufman, J. S., Marshall, S. W., Gaynes, B. N., Morrissey, J. P., & Engel, C. C. (2010). Deployment and the use of mental health services among U.S. Army wives. New England Journal of Medicine, 362(2), 101–109.PubMedCrossRef Mansfield, A. J., Kaufman, J. S., Marshall, S. W., Gaynes, B. N., Morrissey, J. P., & Engel, C. C. (2010). Deployment and the use of mental health services among U.S. Army wives. New England Journal of Medicine, 362(2), 101–109.PubMedCrossRef
go back to reference Marmar, C. R., McAslin, S. E., Metzler, T. J., Best, S., Weiss, D., Fagan, J., et al. (2006). Predictors of posttraumatic stress in police and other first responders. Annals of the New York Academy of Sciences, 1071, 1–18.PubMedCrossRef Marmar, C. R., McAslin, S. E., Metzler, T. J., Best, S., Weiss, D., Fagan, J., et al. (2006). Predictors of posttraumatic stress in police and other first responders. Annals of the New York Academy of Sciences, 1071, 1–18.PubMedCrossRef
go back to reference Meagher, R. E. (2006). Herakles gone mad: Rethinking heroism in an age of endless war. New York: Olive Branch Press. Meagher, R. E. (2006). Herakles gone mad: Rethinking heroism in an age of endless war. New York: Olive Branch Press.
go back to reference Nash, W. P. (2011). U.S. Marine Corps and Navy combat and operational stress continuum model: A tool for leaders. In E. C. Ritchie (Ed.), Combat and operational behavioral health (pp. 107–119). Fort Detrick, MD: Borden Institute Press. Nash, W. P. (2011). U.S. Marine Corps and Navy combat and operational stress continuum model: A tool for leaders. In E. C. Ritchie (Ed.), Combat and operational behavioral health (pp. 107–119). Fort Detrick, MD: Borden Institute Press.
go back to reference Nash, W. P., Marino Carper, T. L., Mills, M. A., Au, T., Goldsmith, A., & Litz, B. T. (2013). Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646–652.PubMed Nash, W. P., Marino Carper, T. L., Mills, M. A., Au, T., Goldsmith, A., & Litz, B. T. (2013). Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646–652.PubMed
go back to reference Nash, W. P., Vasterling, J., Ewing-Cobbs, L., Horn, S., Gaskin, T., Golden, J., et al. (2010). Consensus recommendations for common data elements for operational stress research and surveillance: Report of a Federal Interagency Working Group. Archives of Physical Medicine and Rehabilitation, 91, 1673–1683.PubMedCrossRef Nash, W. P., Vasterling, J., Ewing-Cobbs, L., Horn, S., Gaskin, T., Golden, J., et al. (2010). Consensus recommendations for common data elements for operational stress research and surveillance: Report of a Federal Interagency Working Group. Archives of Physical Medicine and Rehabilitation, 91, 1673–1683.PubMedCrossRef
go back to reference Nelson Goff, B. S., & Smith, D. B. (2005). Systemic traumatic stress: The couple adaptation to traumatic stress model. Journal of Marital and Family Therapy, 31(2), 145–157.CrossRef Nelson Goff, B. S., & Smith, D. B. (2005). Systemic traumatic stress: The couple adaptation to traumatic stress model. Journal of Marital and Family Therapy, 31(2), 145–157.CrossRef
go back to reference O’Toole, B. I., Outram, S., Catts, S. V., & Pierse, K. R. (2010). The mental health of partners of Australian Vietnam veterans three decades after the war and its relation to veteran military service, combat, and PTSD. Journal of Nervous and Mental Diseases, 198, 841–845.CrossRef O’Toole, B. I., Outram, S., Catts, S. V., & Pierse, K. R. (2010). The mental health of partners of Australian Vietnam veterans three decades after the war and its relation to veteran military service, combat, and PTSD. Journal of Nervous and Mental Diseases, 198, 841–845.CrossRef
go back to reference Paris, R., DeVoe, E. R., Ross, A. M., & Acker, M. L. (2010). When a parent goes to war: Effects of parental deployment on very young children and implications for intervention. American Journal of Orthopsychiatry, 80(4), 610–618.PubMedCrossRef Paris, R., DeVoe, E. R., Ross, A. M., & Acker, M. L. (2010). When a parent goes to war: Effects of parental deployment on very young children and implications for intervention. American Journal of Orthopsychiatry, 80(4), 610–618.PubMedCrossRef
go back to reference Pemberton, J. R., Kramer, T. L., Borrego, J., Jr., & Owen, R. R. (2012). Kids at the VA? A call for evidence-based parenting interventions for returning veterans. Psychological Services. Advance online publication. doi:10.1037/a0029995. Pemberton, J. R., Kramer, T. L., Borrego, J., Jr., & Owen, R. R. (2012). Kids at the VA? A call for evidence-based parenting interventions for returning veterans. Psychological Services. Advance online publication. doi:10.​1037/​a0029995.
go back to reference Reed, S. C., Bell, J. F., & Edwards, T. C. (2011). Adolescent well-being in Washington State military families. American Journal of Public Health, 101(9), 1676–1682.PubMed Reed, S. C., Bell, J. F., & Edwards, T. C. (2011). Adolescent well-being in Washington State military families. American Journal of Public Health, 101(9), 1676–1682.PubMed
go back to reference Renshaw, K. D., Allen, E. S., Rhoades, G. K., Blais, R. K., Markman, H. J., & Stanley, S. M. (2011). Distress in spouses of service members with symptoms of combat-related PTSD: Secondary traumatic stress or general psychological distress? Journal of Family Psychology, 25(4), 461–469.PubMedCrossRef Renshaw, K. D., Allen, E. S., Rhoades, G. K., Blais, R. K., Markman, H. J., & Stanley, S. M. (2011). Distress in spouses of service members with symptoms of combat-related PTSD: Secondary traumatic stress or general psychological distress? Journal of Family Psychology, 25(4), 461–469.PubMedCrossRef
go back to reference Rosenheck, R., & Nathan, P. (1985). Secondary traumatization in children of Vietnam veterans. Hospital & Community Psychiatry, 36(5), 538–539. Rosenheck, R., & Nathan, P. (1985). Secondary traumatization in children of Vietnam veterans. Hospital & Community Psychiatry, 36(5), 538–539.
go back to reference Shay, J. (1994). Achilles in Vietnam: Combat trauma and the undoing of character. New York: Scribner. Shay, J. (1994). Achilles in Vietnam: Combat trauma and the undoing of character. New York: Scribner.
go back to reference Shay, J. (2002). Odysseus in America: Combat trauma and the trials of homecoming. New York: Scribner. Shay, J. (2002). Odysseus in America: Combat trauma and the trials of homecoming. New York: Scribner.
go back to reference Shay, J. (2011). Casualties. Dædalus, the Journal of the American Academy of Arts and Sciences, 140(3), 180–188. Shay, J. (2011). Casualties. Dædalus, the Journal of the American Academy of Arts and Sciences, 140(3), 180–188.
go back to reference Sheppard, S. C., Malatras, J. W., & Israel, A. C. (2010). The impact of deployment on U.S. military families. American Psychologist, 65(6), 599–609.PubMedCrossRef Sheppard, S. C., Malatras, J. W., & Israel, A. C. (2010). The impact of deployment on U.S. military families. American Psychologist, 65(6), 599–609.PubMedCrossRef
go back to reference Shrira, A., Shmotkin, D., & Litwin, H. (2012). Potentially traumatic events at different points in the life span and mental health: Findings from SHARE-Israel. American Journal of Orthopsychiatry, 82, 251–259.PubMedCrossRef Shrira, A., Shmotkin, D., & Litwin, H. (2012). Potentially traumatic events at different points in the life span and mental health: Findings from SHARE-Israel. American Journal of Orthopsychiatry, 82, 251–259.PubMedCrossRef
go back to reference Smith, T. C., Ryan, M. A. K., Wingard, D. L., Slymen, D. J., Sallis, J. F., & Kritz-Silverstein, D. (2008). New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: Prospective population based US military cohort study. British Medical Journal, 336(7640), 366–371.PubMedCrossRef Smith, T. C., Ryan, M. A. K., Wingard, D. L., Slymen, D. J., Sallis, J. F., & Kritz-Silverstein, D. (2008). New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: Prospective population based US military cohort study. British Medical Journal, 336(7640), 366–371.PubMedCrossRef
go back to reference Solomon, Z., Waysman, M., Levy, G., Fried, B., Mikulincer, M., Benbenishty, R., et al. (1992). From front line to home front: A study of secondary traumatization. Family Process, 31, 289–302.PubMedCrossRef Solomon, Z., Waysman, M., Levy, G., Fried, B., Mikulincer, M., Benbenishty, R., et al. (1992). From front line to home front: A study of secondary traumatization. Family Process, 31, 289–302.PubMedCrossRef
go back to reference Steenkamp, M. M., Litz, B. T., Gray, M. J., Lebowitz, L., Nash, W., Conoscenti, L., et al. (2011). A brief exposure-based intervention for service members with PTSD. Cognitive and Behavioral Practice, 18, 98–107.CrossRef Steenkamp, M. M., Litz, B. T., Gray, M. J., Lebowitz, L., Nash, W., Conoscenti, L., et al. (2011). A brief exposure-based intervention for service members with PTSD. Cognitive and Behavioral Practice, 18, 98–107.CrossRef
go back to reference Tanielian, T., & Jaycox, L. H. (Eds.). (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: RAND Corporation. Tanielian, T., & Jaycox, L. H. (Eds.). (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: RAND Corporation.
go back to reference Verdeli, H., Baily, C., Vousoura, E., Belser, A., Singla, D., & Manos, G. (2011). The case for treating depression in military spouses. Journal of Family Psychology, 25(4), 488–496.PubMedCrossRef Verdeli, H., Baily, C., Vousoura, E., Belser, A., Singla, D., & Manos, G. (2011). The case for treating depression in military spouses. Journal of Family Psychology, 25(4), 488–496.PubMedCrossRef
go back to reference Walker, M. U. (2006). Moral repair: Reconstructing moral relations after wrongdoing. Cambridge: Cambridge University Press.CrossRef Walker, M. U. (2006). Moral repair: Reconstructing moral relations after wrongdoing. Cambridge: Cambridge University Press.CrossRef
go back to reference Weathers, F. W., & Keane, T. M. (2007). The criterion A problem revisited: Controversies and challenges in defining and measuring psychological trauma. Journal of Traumatic Stress, 20(2), 107–121.PubMedCrossRef Weathers, F. W., & Keane, T. M. (2007). The criterion A problem revisited: Controversies and challenges in defining and measuring psychological trauma. Journal of Traumatic Stress, 20(2), 107–121.PubMedCrossRef
Metagegevens
Titel
Moral Injury: A Mechanism for War-Related Psychological Trauma in Military Family Members
Auteurs
William P. Nash
Brett T. Litz
Publicatiedatum
01-12-2013
Uitgeverij
Springer US
Gepubliceerd in
Clinical Child and Family Psychology Review / Uitgave 4/2013
Print ISSN: 1096-4037
Elektronisch ISSN: 1573-2827
DOI
https://doi.org/10.1007/s10567-013-0146-y

Andere artikelen Uitgave 4/2013

Clinical Child and Family Psychology Review 4/2013 Naar de uitgave