Moral injury appraisals and dissociation: Associations in a sample of trauma-exposed community members.
Moral injury appraisals and dissociation: Associations in a sample of trauma-exposed community members.
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道德伤害评估和分离：遭受创伤的社区成员样本中的关联。
DOI：
10.1080/15299732.2023.2231010
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Fani,Negar
中科院分区：
文献类型：
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作者：
Lathan,EmmaC;Sheikh,IfrahS;Guelfo,Alfonsina;Choucair,KhaledC;Fulton,Travis;Julian,Jacob;Mekawi,Yara;Currier,JosephM;Powers,Abigail;Fani,Negar
对创伤的评估是创伤后应激障碍症状（如精神分离）发展的关键因素。个体可能将创伤评价为道德伤害（即道德伤害暴露[MIE]），并经历与这种暴露相关的随后的道德痛苦（即道德伤害痛苦[MID]）。然而，迄今为止，对道德伤害评价和分离之间关系的调查有限，特别是在社区人口中。本研究调查了从公立医院和/或社区广告招募的创伤暴露社区成员样本（n= 177, 58.2%黑人，89.3%女性）中MIE和MID与分离的六个方面（脱离、人格解体、现实感丧失、记忆障碍、情感束缚、身份分离）的关系。参与者完成了评估创伤暴露、MIE、MID、分离和创伤后应激障碍（PTSD）症状的测量。偏相关分析显示，在控制PTSD症状后，MIE与脱离感相关，r= 0.23,p≤。025，人格解体，r= .25,p≤。MID与去人格化相关，r= 0.19,p≤0.025。性别调节了每种关联，女性参与者的关联更强。研究结果表明，道德伤害评估与女性平民中更严重的分离症状有关，因此，可能需要在经验支持的治疗中特别针对这些症状。
Appraisal of trauma is a critical factor in the development of impairing post-traumatic stress symptoms, such as dissociation. Individuals may appraise trauma as morally injurious (i.e., moral injury exposure [MIE]) and experience subsequent moral distress related to this exposure (i.e., moral injury distress [MID]). To date, however, investigation into the relations between moral injury appraisals and dissociation has been limited, particularly within community populations. This study investigated MIE and MID in relation to six facets of dissociation (disengagement, depersonalization, derealization, memory disturbances, emotional constriction, identity dissociation) in a sample of trauma-exposed community members (n= 177, 58.2% Black, 89.3% female) recruited from a public hospital and/or community advertisements. Participants completed measures assessing trauma exposure, MIE, MID, dissociation, and posttraumatic stress disorder (PTSD) symptoms. Partial correlation analyses revealed that after controlling for PTSD symptoms, MIE was correlated with disengagement,r= .23,p≤ .025, and depersonalization,r= .25,p≤ .001, and MID was correlated with depersonalization,r= .19,p≤ .025. Sex moderated each association, with stronger associations observed for female participants. Findings suggest that moral injury appraisals are linked to more severe dissociative symptoms among female civilians, and as such, may need to be specifically targeted in empirically supported treatments.