提高道德伤害概念的清晰度。

IF 16.3 1区 医学 Q1 PSYCHIATRY Psychotherapy and Psychosomatics Pub Date : 2024-10-07 DOI:10.1159/000540030
Sheila Frankfurt O'Brien,Isabelle Baptista,Philip R Szeszko
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引用次数: 0

摘要

背景 "道德伤害 "这一概念在研究文献和媒体中被广泛使用,以广泛描述涉及侵犯个人是非感的事件(此处称为 "潜在道德伤害事件"[PMIEs])所造成的影响。我们讨论了这一概念是否能可靠地与既有的精神诊断和心理概念区分开来,以及在分离或分类高强度生活压力事件的影响时所面临的固有挑战,这些事件可能构成了大多数精神创伤和痛苦事件。我们对声称可以测量 "道德伤害 "的评估方法进行了回顾,并讨论了其局限性,如与既有心理测量工具共同存在的测量差异。我们得出的结论是,"道德伤害 "这一概念可以提供一个解释框架,用于解释为什么某人会被内疚、羞愧和/或愤怒所困扰,而现有的精神诊断(如创伤后应激障碍和抑郁症)则全面描述了某人在经历极端应激事件后可能会经历的情况。我们提出了更好地澄清 "道德伤害 "与既有精神病学类别之间界限的方向,可用于加强对这一概念的概念化和评估。
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Enhancing Conceptual Clarity regarding the Construct of Moral Injury.
BACKGROUND The construct of "moral injury" is used widely in the research literature and media to broadly describe the impact of events involving perceived violations of one's sense of right and wrong (herein referred to as "potentially morally injurious events" [PMIEs]). SUMMARY In this theoretical review, we provided a brief overview of the "moral injury" construct and its limitations including the lack of consensus-drawn boundaries and operational definitions to guide hypothesis-driven research. We discussed whether this construct can be reliably distinguished from established psychiatric diagnoses and psychological constructs and the inherent challenges in separating or classifying the impact of high-magnitude stressful life events that likely form the majority of PMIEs. Assessments that purportedly measure "moral injury" are reviewed and limitations are discussed such as shared measurement variance with established psychological instruments. KEY MESSAGES We identified conceptual strategies for investigating behavioral and neurobiological features of PMIEs that could be used to inform the field of traumatic stress. We concluded that the construct of "moral injury" may provide an interpretive framework for positing why someone may be beset by guilt, shame, and/or rage whereas existing psychiatric diagnoses such as post-traumatic stress disorder and depression provide comprehensive descriptions regarding what someone might experience following extremely stressful events. We proposed directions to better clarify the boundaries of "moral injury" versus established psychiatric categories that could be used to enhance the conceptualization and assessment of this construct.
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来源期刊
Psychotherapy and Psychosomatics
Psychotherapy and Psychosomatics 医学-精神病学
CiteScore
29.40
自引率
6.10%
发文量
46
期刊介绍: Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.
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