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心理学视角下的道德损伤

本站小编 Free考研考试/2022-01-01

艾攀, 戴艳
四川师范大学心理学院, 成都 610068
收稿日期:2020-12-31出版日期:2022-01-15发布日期:2021-11-25
通讯作者:戴艳, E-mail: daiyanch@163.com



Moral injury: A review from the perspective of psychology

AI Pan, DAI Yan
School of Psychology, Sichuan Normal University, Chengdu 610068, China
Received:2020-12-31Online:2022-01-15Published:2021-11-25







摘要/Abstract


摘要: 道德损伤是指个体实施、未能阻止、目睹或听闻违背自身深层的道德信念和期望的行为, 对心理、生理、精神、行为和社会的持久影响。道德损伤作为一个跨学科概念, 自2009年Litz从心理学角度对其重新做出界定以来, 在心理学、伦理学、精神病学、社会学等领域引起了广泛关注。目前研究者已经编制出多个多维度量表来对道德损伤的事件或症状进行测量, 运用认知行为疗法、认知加工疗法和针对道德损伤研发的适当暴露疗法等措施来进行干预。未来的研究可以继续深入探究道德损伤的发生发展机制, 确立道德损伤的诊断标准, 推广道德损伤的适用范围, 丰富道德损伤的内涵, 从而拓展道德损伤研究的广度和深度。


[1] 陈秀丽, 王璐颖, 蒋訸. (2020). 实习医务人员道德创伤现状及相关性研究.中国医学伦理学, 033(011), 1335-1340.
[2] 肖楚兰, 杨放, 常运立. (2018). 道德创伤的发生机制探析.中国医学伦理学, 31(2), 151-158.
[3] 杨放, 常运立. (2015). 道德创伤: 军事医学伦理新概念.医学与哲学: A, 36(11), 9-14.
[4] Ames D., Erickson Z., Youssef N. A., Arnold I., Adamson C. S., Sones A. C., … Koenig H. G. (2019). Moral injury, religiosity, and suicide risk in U.S. veterans and active duty military with PTSD symptoms.Military Medicine, 184(3-4), e271-e278.
[5] Barnes H. A., Hurley R. A., & Taber K. H. (2019). Moral injury and PTSD: Often co-occurring yet mechanistically different.The Journal of Neuropsychiatry and Clinical Neurosciences, 31(2), A4-103.
[6] Beard, M. (2015). Conceptual distinctions. In T. Frame (Ed.), Moral injury: Unseen wounds in an age of barbarism (pp. 112-125). Sydney: UNSW Press.
[7] Bergman H. E., Przeworski A., & Feeny N. C. (2017). Rates of subthreshold PTSD among U.S. military veterans and service members: A literature review.Military Psychology, 29(2), 117-127.
[8] Bryan C. J., Bryan A. O., Anestis M. D., Anestis J. C., Green B. A., Etienne N., … Ray-Sannerud B. (2016). Measuring moral injury: Psychometric properties of the moral injury events scale in two military samples.Assessment, 23(5), 557-570.
[9] Bryan C. J., Morrow C. E., Etienne N., & Ray‐Sannerud B. (2013). Guilt, shame, and suicidal ideation in a military outpatient clinical sample.Depression and Anxiety, 30(1), 55-60.
[10] Carey L. B., Hodgson T. J., Krikheli L., Soh R. Y., Armour A.-R., Singh T. K., & Impiombato C. G. (2016). Moral injury, spiritual care and the role of chaplains: An exploratory scoping review of literature and resources.Journal of Religion and Health, 55(4), 1218-1245.
[11] Cenkner D. P., Yeomans P. D., Antal C. J., & Scott J. C. (2020). A pilot study of a moral injury group intervention co-facilitated by a chaplain and psychologist.Journal of Traumatic Stress, 34(2), 367-374.
[12] Chong M. Y., Wang W. C., Hsieh W. C., Lee C. Y., Chiu N. M., Yeh W. C., … Chen C. L. (2004). Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital.The British Journal of Psychiatry, 185(2), 127-133.
[13] Currier J. M., Farnsworth J. K., Drescher K. D., McDermott R. C., Sims B. M., & Albright D. L. (2018). Development and evaluation of the expressions of moral injury scale-military version.Clinical Psychology & Psychotherapy, 25(3), 474-488.
[14] Currier J. M., Holland J. M., Drescher K., & Foy D. (2015). Initial psychometric evaluation of the moral injury questionnaire-military version.Clinical Psychology & Psychotherapy, 22(1), 54-63.
[15] Drescher K. D., Foy D. W., Kelly C., Leshner A., Schutz K., & Litz B. (2011). An exploration of the viability and usefulness of the construct of moral injury in war veterans.Traumatology, 17(1), 8-13.
[16] Farnsworth J. K., Drescher K. D., Evans W., & Walser R. D. (2017). A functional approach to understanding and treating military-related moral injury.Journal of Contextual Behavioral Science, 6(4), 391-397.
[17] Frankfurt S. B., Frazier P., & Engdahl B. (2017). Indirect relations between transgressive acts and general combat exposure and moral injury.Military Medicine, 182(11-12), e1950-e1956.
[18] Fulton J. J., Calhoun P. S., Wagner H. R., Schry A. R., Hair L. P., Feeling N., … Beckham J. C. (2015). The prevalence of posttraumatic stress disorder in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans: A meta-analysis.Journal of Anxiety Disorders, 31, 98-107.
[19] Furniss G. M.(1994). The social context of pastoral care: Defining the life situation. Louisville, KY: Westminster John Knox Press.
[20] Galovski T. E., Blain L. M., Chappuis C., & Fletcher T. (2013). Sex differences in recovery from PTSD in male and female interpersonal assault survivors.Behaviour Research and Therapy, 51(6), 247-255.
[21] Gray M. J., Schorr Y., Nash W., Lebowitz L., Amidon A., Lansing A., … Litz B. T. (2012). Adaptive disclosure: An open trial of a novel exposure-based intervention for service members with combat-related psychological stress injuries.Behavior Therapy, 43(2), 407-415.
[22] Griffin B. J., Purcell N., Burkman K., Litz B. T., Bryan C. J., Schmitz M., … Maguen S. (2019). Moral injury: An integrative review.Journal of Traumatic Stress, 32(3), 350-362.
[23] Haight W., Sugrue E., Calhoun M., & Black J. (2016). A scoping study of moral injury: Identifying directions for social work research.Children and Youth Services Review, 70, 190-200.
[24] Hamrick H. C., Kelley M. L., & Bravo A. J. (2019). Morally injurious events, moral injury, and suicidality among recent-era veterans: The moderating effects of rumination and mindfulness.Military Behavioral Health, 8(1), 109-120.
[25] Held P., Klassen B. J., Brennan M. B., & Zalta A. K. (2018). Using prolonged exposure and cognitive processing therapy to treat veterans with moral injury- based PTSD: Two case examples.Cognitive and Behavioral Practice, 25(3), 377-390.
[26] Hines S. E., Chin K. H., Glick D. R., & Wickwire E. M. (2021). Trends in moral injury, distress, and resilience factors among healthcare workers at the beginning of the COVID-19 pandemic.International Journal of Environmental Research and Public Health, 18(2), 488.
[27] Hodgson, T. J., & Carey, L. B. (2017). Moral injury and definitional clarity: Betrayal, spirituality and the role of chaplains.Journal of Religion and Health, 56(4), 1212-1228.
[28] Jinkerson, J. D. (2016). Defining and assessing moral injury: A syndrome perspective.Traumatology, 22(2), 122-130.
[29] Jordan A. H., Eisen E., Bolton E., Nash W. P., & Litz B. T. (2017). Distinguishing war-related PTSD resulting from perpetration-and betrayal-based morally injurious events.Psychological Trauma: Theory, Research, Practice, and Policy, 9(6), 627.
[30] Koenig H. G., Ames D., Youssef N. A., Oliver J. P., Volk F., Teng E. J., … Pearce M. (2018a). Screening for moral injury: The moral injury symptom scale-military version short form.Military Medicine, 183(11-12), e659-e665.
[31] Koenig H. G., Ames D., Youssef N. A., Oliver J. P., Volk F., Teng E. J., … Pearce M. (2018b). The moral injury symptom scale-military version.Journal of Religion and Health, 57(1), 249-265.
[32] Koenig H. G., Boucher N. A., Oliver R. J. P., Youssef N., Mooney S. R., Currier J. M., & Pearce M. (2017). Rationale for spiritually oriented cognitive processing therapy for moral injury in active duty military and veterans with posttraumatic stress disorder.The Journal of Nervous and Mental Disease, 205(2), 147-153.
[33] Koenig H. G., Youssef N. A., & Pearce M. (2019). Assessment of moral injury in veterans and active duty military personnel with PTSD: A review.Frontiers in Psychiatry, 10, 443.
[34] Kopacz M. S., Ames D., & Koenig H. G. (2019). It's time to talk about physician burnout and moral injury.The Lancet Psychiatry, 6(11), e28.
[35] Kopacz M. S., Connery A. L., Bishop T. M., Bryan C. J., Drescher K. D., Currier J. M., & Pigeon W. R. (2016). Moral injury: A new challenge for complementary and alternative medicine.Complementary Therapies in Medicine, 24, 29-33.
[36] Levinson, M. (2015). Moral injury and the ethics of educational injustice.Harvard Educational Review, 85(2), 203-228.
[37] Leys, R. (2006). Image and trauma.Science in Context, 19(1), 137-149.
[38] Litz B. T., Lebowitz L., Gray M. J., & Nash W. P. (2016). Adaptive disclosure: A new treatment for military trauma, loss, and moral injury. New York, NY: Guilford Publications.
[39] Litz B. T., Stein N., Delaney E., Lebowitz L., Nash W. P., Silva C., & Maguen S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy.Clinical Psychology Review, 29(8), 695-706.
[40] Lobb E. A., Schmidt S., Jerzmanowska N., Swing A. M., & Thristiawati S. (2019). Patient reported outcomes of pastoral care in a hospital setting.Journal of Health Care Chaplaincy, 25(4), 131-146.
[41] Mantri S., Lawson J. M., Wang Z. Z., & Koenig H. G. (2020). Identifying moral injury in healthcare professionals: The moral injury symptom scale-hp.Journal of Religion and Health, 59(5), 2323-2340.
[42] McCarthy, M. M. (2016). An exploration of moral injury as experienced by combat veterans (Unpublished doctorial dissertation). Antioch University.
[43] 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.
[44] Neria, Y., & Pickover, A. (2019). Commentary on the special issue on moral injury: Advances, gaps in literature, and future directions.Journal of Traumatic Stress, 32(3), 459-464.
[45] Nickerson A., Schnyder U., Bryant R. A., Schick M., Mueller J., & Morina N. (2015). Moral injury in traumatized refugees.Psychotherapy and Psychosomatics, 84(2), 122-123.
[46] Niederland, W. G. (1964). Psychiatric disorders among persecution victims: A contribution to the understanding of concentration camp pathology and its after-effects.The Journal of Nervous and Mental Disease, 139(5), 458-474.
[47] Nieuwsma J. A., Walser R. D., Farnsworth J. K., Drescher K. D., Meador K. G., & Nash W. (2015). Possibilities within acceptance and commitment therapy for approaching moral injury.Current Psychiatry Reviews, 11(3), 193-206.
[48] Papazoglou, K., & Chopko, B. (2017). The role of moral suffering (moral distress and moral injury) in police compassion fatigue and PTSD: An unexplored topic.Frontiers in Psychology, 8, 1999.
[49] Pearce M., Haynes K., Rivera N. R., & Koenig H. G. (2018). Spiritually integrated cognitive processing therapy: A new treatment for post-traumatic stress disorder that targets moral injury.Global Advances in Health and Medicine, 7, 1-7.
[50] Raffay J., Wood E., & Todd A. (2016). Service user views of spiritual and pastoral care (chaplaincy) in NHS mental health services: A co-produced constructivist grounded theory investigation.BMC Psychiatry, 16(1), 200.
[51] Raven J., Wurie H., & Witter S. (2018). Health workers' experiences of coping with the Ebola epidemic in Sierra Leone's health system: A qualitative study.BMC Health Services Research, 18(1), 1-9.
[52] Resick P. A., Monson C. M., & Chard K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. New York, NY: Guilford Publications.
[53] Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims.Journal of Consulting and Clinical Psychology, 60(5), 748-756.
[54] Resick P. A., Wachen J. S., Mintz J., Young-McCaughan S., Roache J. D., Borah A. M., … Peterson A. L. (2015). A randomized clinical trial of group cognitive processing therapy compared with group present-centered therapy for PTSD among active duty military personnel.Journal of Consulting and Clinical Psychology, 83(6), 1058-1068.
[55] Resick P. A., Williams L. F., Suvak M. K., Monson C. M., & Gradus J. L. (2012). Long-term outcomes of cognitive-behavioral treatments for posttraumatic stress disorder among female rape survivors.Journal of Consulting and Clinical Psychology, 80(2), 201.
[56] Shay, J. (1994). Achilles in Vietnam: Combat trauma and the undoing of character. New York, NY: Antheneum.
[57] Shay, J. (2002). Odysseus in America: Combat trauma and the trials of homecoming. New York, NY: Simon and Schuster.
[58] Shay, J. (2014). Moral injury.Psychoanalytic Psychology, 31(2), 182-191.
[59] Steenkamp M. M., Litz B. T., Gray M. J., Lebowitz L., Nash W., Conoscenti L., .. Lang A. (2011). A brief exposure-based intervention for service members with PTSD.Cognitive and Behavioral Practice, 18(1), 98-107.
[60] Steenkamp M. M., Schlenger W. E., Corry N., Henn-Haase C., Qian M., Li M., .. Marmar C. (2017). Predictors of PTSD 40 years after combat: Findings from the National Vietnam Veterans longitudinal study.Depression and Anxiety, 34(8), 711-722.
[61] Stein N. R., Mills M. A., Arditte K., Mendoza C., Borah A. M., Resick P. A., … Strong Star Consortium. (2012). A scheme for categorizing traumatic military events.Behavior Modification, 36(6), 787-807.
[62] Stephenson K. R., Simpson T. L., Martinez M. E., & Kearney D. J. (2017). Changes in mindfulness and posttraumatic stress disorder symptoms among veterans enrolled in mindfulness-based stress reduction.Journal of Clinical Psychology, 73(3), 201-217.
[63] Wang Z. Z., Koenig H. G., Tong Y., Wen J., Sui M., Liu, H. Y, & Liu, G. T. (2020). Psychometric properties of the moral injury symptom scale among Chinese health professionals during the COVID-19 pandemic.BMC Psychiatry, 20(1), 1-10.




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