ArticlePsychological medicine2023
Civilian moral injury: associations with trauma type and high-frequency heart rate variability in two trauma-exposed community-based samples.
Article in Psychological medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 14 citations in OpenAlex.
- Structure and correlates of the Moral Injury Exposure and Symptom Scale for Civilians (MIESS-C) in a community sample with high trauma exposure.European journal of psychotraumatology · 2026Article
- Resting-State Neural Signatures of Moral Injury: Associations With Rumination.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2026Article
- Navigating the aftermath: Understanding the support needs of Veteran crewmen and their families decades after trauma.Journal of military, veteran and family health · 2026Article
- Moral injury, race-related stress and post-traumatic stress disorder in a trauma-exposed Black population.Journal of psychiatric research · 2024Article
- Civilian Moral Injury and Amygdala Functional Connectivity During Attention to Threat.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2024Article
- Moral injury appraisals and dissociation: Associations in a sample of trauma-exposed community members.Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD)Article
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Authors and funding
13 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMoral injury exposure (MIE) and distress (MID) may indirectly affect the relationship between trauma exposure and alterations in autonomic regulation [assessed via high-frequency heart rate variability (hfHRV)] in civilians, but this has not been tested in prior research. We conducted two exploratory studies to examine trauma types' associations with MIE and MID among civilian medical patients (Study 1) and explore how these facets may indirectly affect the relationship between trauma type and hfHRV among civilians seeking mental health services (Study 2).
methodsParticipants recruited from a public hospital and/or community advertisements (Study 1,
resultsChildhood sexual abuse emerged as the only significant predictor of MIE,
conclusionsMoral injury was uniquely associated with sexual violence and lower hfHRV in civilians. Data highlight moral injury as a pathway through which autonomic dysregulation may emerge and its salience for trauma treatment selection.
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