Psychological trauma : theory, research, practice and policy · 2026
The impact of potentially morally injurious events on the effectiveness of evidence-based psychotherapies for PTSD.
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Midkiff Melanie F, Coe Laura Stayton, Chard Kathleen
Аннотация
OBJECTIVE: Morally injurious events are a more recent area of interest in the field of trauma psychology. Some suggest that current, evidence-based psychotherapies for posttraumatic stress disorder (PTSD) do not adequately address PTSD symptoms stemming from events perceived as morally injurious; however, this has not been clearly demonstrated in the literature. The goal of this study was to add to emerging evidence and explore whether current evidence-based psychotherapies for PTSD can adequately address PTSD symptoms resulting from both (PMIE) potentially morally injurious and (non-PMIE) nonmorally injurious events.
METHOD: The present study compared response to outpatient PTSD treatment in veterans who endorsed their index trauma as morally injurious (PMIE; n = 81) and those who denied viewing their index trauma as morally injurious (non-PMIE; n = 76).
RESULTS: A multilevel modeling analysis demonstrated that both groups experienced a significant reduction in PTSD symptoms over the course of treatment, as measured by the PTSD Checklist for DSM-5, B = -1.59, SE = 0.18, 95% CI [-1.94, -1.24], t(98.64) = -9.03, p < .001. There was no difference in treatment response between PMIE and non-PMIE groups, PMIE × Time interaction; B = .00, SE = 0.27, 95% CI [-0.54, 0.55], t(105.97) = .02, p = .985, after controlling for military sexual trauma, the only demographic variable with pretreatment group differences.
CONCLUSIONS: These results suggest that for many veterans, current evidence-based psychotherapies for PTSD may effectively reduce PTSD symptoms even when PTSD results from an event they perceive as morally injurious. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
METHOD: The present study compared response to outpatient PTSD treatment in veterans who endorsed their index trauma as morally injurious (PMIE; n = 81) and those who denied viewing their index trauma as morally injurious (non-PMIE; n = 76).
RESULTS: A multilevel modeling analysis demonstrated that both groups experienced a significant reduction in PTSD symptoms over the course of treatment, as measured by the PTSD Checklist for DSM-5, B = -1.59, SE = 0.18, 95% CI [-1.94, -1.24], t(98.64) = -9.03, p < .001. There was no difference in treatment response between PMIE and non-PMIE groups, PMIE × Time interaction; B = .00, SE = 0.27, 95% CI [-0.54, 0.55], t(105.97) = .02, p = .985, after controlling for military sexual trauma, the only demographic variable with pretreatment group differences.
CONCLUSIONS: These results suggest that for many veterans, current evidence-based psychotherapies for PTSD may effectively reduce PTSD symptoms even when PTSD results from an event they perceive as morally injurious. (PsycInfo Database Record (c) 2026 APA, all rights reserved).