‘Moral injury’ officially recognized as mental health condition
Moral injury—psychological harm incurred from committing, witnessing, or being subject to actions that violate one’s moral code—has officially been recognized by the American Psychiatric Association (APA), thanks to research led by Harvard T.H. Chan School of Public Health. The APA included “moral problem” in the newest version of its Diagnostic and Statistical Manual of Mental Disorders (DSM), the handbook for classifying and diagnosing mental health conditions used by U.S. mental health care providers.
In a Sept. 16 Psychology Today article, Tyler VanderWeele, John L. Loeb and Frances Lehman Loeb Professor of Epidemiology and director of the Human Flourishing Program at Harvard (HFH), and Jennifer Wortham, a research associate at HFH, described their research on moral injury and subsequent work with the APA.
“Over the past several years, [HFH has] been trying to develop a more unified approach to moral injury and to moral distress that would be applicable to perpetrators, witnesses, and victims,” they wrote. “After months of synthesis of prior work, we defined ‘moral distress’ as ‘distress that arises because personal experience disrupts or threatens: (a) one’s sense of the goodness of oneself, of others, of institutions, or of what are understood to be higher powers, or (b) one’s beliefs or intuitions about right and wrong, or good and evil.’ When that distress became sufficiently persistent it would constitute ‘moral injury.’”
VanderWeele and Wortham introduced this definition, and the research behind it, in a March 4 Frontiers in Psychology study. The study sparked collaboration with the APA to ensure that moral injury was incorporated into the DSM.
“Our hope is that [inclusion in the DSM] opens important opportunities for awareness and treatment of moral trauma, moral distress, and moral injury,” VanderWeele and Wortham wrote in the Psychology Today article. “If we are to truly provide person-centered care, the very real possibility of moral distress and moral injury needs to be acknowledged. The present recognition within psychiatry is a step forward in this regard.”
Learn more:
Read the study: Moral trauma, moral distress, moral injury, and moral injury disorder: definitions and assessments
Read the Psychology Today article: The Importance of Recognizing Moral Trauma in Clinical Care
Read an HFH press release: DSM recognizes moral injury, thanks to Human Flourishing Program research
