Implementation of Innovative Treatment for Moral Injury Syndrome: A Hybrid Type 2 Study

Launched by VA OFFICE OF RESEARCH AND DEVELOPMENT · Jan 19, 2024

Keywords

ClinConnect Summary

Background: Moral injury syndrome (MIS) consists of the psychological and behavioral sequelae of experiences that challenge moral, spiritual, or values related beliefs. Symptoms of MIS may include hopelessness, helplessness, loss of previously held spiritual beliefs, struggle with a Higher Power, difficulty with forgiveness, lack of meaning or purpose, reduced trust in self or others, or intractable guilt, shame or anger. Individuals managing MIS are up to twice as likely as their peers to consider and attempt suicide, and derive less benefit from psychotherapy. There are few evidence-based...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• Veteran status and:
• • (a) validation of any of the first three items on the Moral Injury and Distress Scale, which is consistent with probable MIS
• • (b) willingness to be randomized to either treatment condition
• • (c) stability on mental health medications for at least 8 weeks
• • (d) age of 18 years or older
• Exclusion Criteria:
• • (a) insufficient capacity to consent
• • (b) active psychosis or substance use at levels that would interfere with treatment, assessed via chart review, the Alcohol Use Disorders Identification Test - Concise (AUDIT-C) score, and the Mini International Neuropsychiatric Interview (MINI)
• • (c) currently involved in evidence-based psychotherapy for MIS, or evidence-based psychotherapy for PTSD, assessed via chart review and intake interview
• • (d) managing any severe psychopathology that, in the opinion of the investigative team, requires immediate clinical attention, such as imminent suicide risk, assessed via the MINI and supplemental homicide risk questions.