Moral Injury,Betrayal and Retribution: Australian Veterans and the Role of Chaplains

Journal of Religion and Health - This paper presents additional qualitative results from Phase 1 of a larger study examining potentially morally injurious events/experiences (PMIE) and/or moral...     

Moral Injury,Spiritual Care and the Role of Chaplains: An Exploratory Scoping Review of Literature and Resources

This scoping review considered the role of chaplains with regard to ‘moral injury’. Moral injury is gaining increasing notoriety. This is due to greater recognition that trauma (in its various forms) can cause much deeper inflictions and afflictions than just physiological or psychological harm, for there may also be wounds affecting the ‘soul’ that are far more difficult to heal—if at all. As part of a larger research program exploring moral injury, a scoping review of literature and other resources was implemented utilising Arksey and O’Malley’s scoping method (Int J Soc Res Methodol 8(1):19–32, 2005) to focus upon moral injury, spirituality (including religion) and chaplaincy. Of the total number of articles and/or resources noting the term ‘moral injury’ in relation to spiritual/religious issues (n = 482), the results revealed 60 resources that specifically noted moral injury and chaplains (or other similar bestowed title). The majority of these resources were clearly positive about the role (or the potential role) of chaplains with regard to mental health issues and/or moral injury. The World Health Organization International Classification of Diseases: Australian Modification of Health Interventions to the International Statistical Classification of Diseases and related Health problems (10th revision, vol 3—WHO ICD-10-AM, Geneva, 2002), was utilised as a coding framework to classify and identify distinct chaplaincy roles and interventions with regard to assisting people with moral injury. Several recommendations are made concerning moral injury and chaplaincy, most particularly the need for greater research to be conducted.     

Insult,then Injury: Interpersonal and Institutional Betrayal Linked to Health and Dissociation

Psychological trauma, particularly trauma involving betrayal, has been linked to health problems. Betrayal trauma is also characterized by dissociation and difficulty remembering as victims face conflicting demands presented by a harmful but important relationship. Institutional betrayal is related to, but distinct from, interpersonal betrayal and in need of research on its unique effects. The current study has two related goals. First, the association between institutional betrayal and health problems is examined. Second, the previously documented association between institutional betrayal and dissociative symptoms is re-examined, while controlling for betrayal trauma. This study utilizes a sample of 302 college students (70% female, 63% Caucasian) who reported their trauma history (Brief Betrayal Trauma Survey), institutional betrayal history (Institutional Betrayal Questionnaire), distress related to health problems (Patient Health Questionnaire), and dissociative symptoms (Wessex Dissociation Scale). We found that institutional betrayal is uniquely associated with both health problems and dissociative symptoms even when controlling for betrayal trauma exposure. Findings add to the understanding of how institutional betrayal is uniquely associated to trauma-related physical and mental health outcomes. Small effect sizes, likely due to low base rates of health problems and dissociative symptoms in college students, and problems generalizing these results to clinical samples are discussed.     

The Role and Value of Chaplains in the Ambulance Service: Paramedic Perspectives

Journal of Religion and Health - Chaplains are employed by ambulance services in many states across Australia as one element in a suite of initiatives to support the health and wellness of...     

Mortal Losses, Vital Gains: The Role of Spirituality

Grief and its management constitute the general topic of this paper. A personal dynamic of reframing is articulated and defined as a major experiential source of human spirituality. The argument is that exercises in the comparative free association of loss activate dynamic reframing amidst mourning and its associated work of depression. Counselling that involves imagining worse case scenarios may invoke conventional religious belief and practice as constructive tactics of make-believe, ones that actually enlarge perspective and cast past losses into widening horizons of future gains. In effect, human spirituality is an individual's achieved capacity to affirm time and again that his or her great personal losses could have been far worse, in spite of the emotional turmoil and woe surrounding such events.     

Disconnection, Depression, and Spirituality: A Study of the Role of Spirituality and Meaning in the Lives of Individuals with Severe Depression

This qualitative study explores the role of spirituality and meaning among 15 participants suffering from severe depression. During the time of this study, all the participants were in treatment at Loma Linda University Behavioral Medicine Center. The emerging themes are: (1) depression creates a sense of spiritual disconnection. Participants indicated feeling disconnected from God, the community, and oneself; (2) spirituality plays an important role in coping with the pain of depression; (3) there exists a deep yearning for a sense of meaning and a struggle to make sense of one’s pain; and (4) coming to terms with one’s circumstances and one’s depression at some level assists in the healing process.     

Complex Moral Injury: Shattered Moral Assumptions

Journal of Religion and Health - An infographic model of moral injury (MI) is introduced in this conceptual paper that distinguishes the development of a worldview discrepancy-induced genus of MI,...     

Body Awareness,Emotional Clarity,and Authentic Behavior: The Moderating Role of Mindfulness

Emotional clarity is considered a basic component of self-knowledge. However, not much is known regarding its association with self-knowledge in terms of bodily aspects, and the combinations by which these two aspects are used to enhance authentic living. Based on a salutogenic perspective, the current study examined whether emotional clarity and body awareness are associated. Further, we tested the hypothesis that these constructs contribute to authentic behavior through the moderation of mindfulness. 341 university students completed questionnaires assessing body awareness, emotional clarity, mindfulness, and authentic behavior. The findings indicated that body awareness and emotional clarity are moderately correlated. SEM analysis revealed that emotional clarity was correlated with authentic behavior, and that mindfulness moderated the association between body awareness and authentic behavior. Further, a two-factor model for authentic behavior was generated; intrapersonal-authenticity and interpersonal-authenticity. Hierarchical regression analyses indicated that while emotional clarity was associated with both factors, body awareness was only associated with interpersonal-authenticity, through the moderation of mindfulness. Mindfulness further mediated the association between emotional clarity and interpersonal-authenticity. The findings indicate that body awareness and emotional clarity are pivotal for self-knowledge processes, yet demonstrate a complicated mechanism under which they operate. While emotional information seems to be more accessible for authentic behavior enhancement, the use of bodily information is conditioned by mindfulness.     

Moral Injury: Contextualized Care

Amidst the return of military personnel from post-9/11 conflicts, a construct describing the readjustment challenges of some has received increasing attention: moral injury. This term has been variably defined with mental health professionals more recently conceiving of it as a transgression of moral beliefs and expectations that are witnessed, perpetrated, or allowed by the individual. To the extent that morality is a system of conceptualizing right and wrong, individuals’ moral systems are in large measure developmentally and socially derived and interpreted. Thus, in seeking to provide care and aid in reintegration for combat veterans, it is necessary to consider communities that have contributed to an individual’s formation and that might have participated in the interpretation of his/her suffering. This can take many forms, but given that morality is often complexly intertwined with issues of religion, faith, and spirituality for many individuals, and recognizing that much of the current focus on moral injury is emanating out of healthcare contexts, we devote particular attention to how chaplains might be more intentionally engaged in healthcare systems such as the Veterans Health Administration to provide non-judgmental, person-centered, culturally-relevant care rooted in communities of practice to veterans with moral injury.     

The Role of Political Practices in Moral Injury: A Study of Afghanistan Veterans

While much research has been conducted on military trauma, conceptualizations of deployment‐related suffering have been predominantly approached through a medical, individual‐focused lens. Since the military is an instrument of the state, it is crucial to expand the conceptual scope to include political processes, particularly for the fast‐growing literature on “moral injury,” which refers to the emotional impact of perpetrating, witnessing, or falling victim to perceived wrongdoing. This article examines the role of political practices in the onset of moral injury as well as the micropolitical responses of morally injured veterans. A study of the Dutch mission in Uruzgan, Afghanistan, shows that decisions and frames at the political level helped create distressing quandaries on the ground and that in all the ways the political leadership acknowledged the problems that veterans subsequently developed, it also maintained a silence on its direct contribution to these problems, as such perpetuating them. Consequently, veterans tried to make the political leadership take a material and symbolic share in their burden. Clearly, moral conflict may exist both in the veteran and between the veteran and the political domain, and therefore, experiences of institutional betrayal and a resultant search for reparations should be included in theory on moral injury.     

Revs and Psychos: Role,Impact and Interaction of Sport Chaplains and Sport Psychologists within English Premiership Soccer

Despite an increased focus on spirituality and athlete well-being in sport (Watson, 2011), there is limited research regarding those who provide support to the athlete in these areas. The aim of this study was to explore the practice of sport psychologists and sport chaplains within professional soccer, and identify potential for working partnerships. By interviewing three psychologists and four chaplains who are employed currently within English Premiership soccer, it was revealed that significant overlap in their roles existed. The psychologists and chaplains identified barriers that restricted support offered to players, which may be addressed by working cooperatively in the future.     

The Roles of Religiosity and Spirituality in Moral Reasoning

To better understand the influence of religiosity and spirituality on moral reasoning, 1,037 college students completed a survey including demographic questions, a religiosity measure, a spirituality measure, and Forsyth's Ethical Position Questionnaire. Religiosity and spirituality positively correlated with moral idealism, whereas spirituality negatively correlated with moral relativism. However, religiosity and spirituality accounted for a very little variability in moral reasoning, suggesting that they do not directly influence moral reasoning. In addition, female participants reported higher spirituality, but there were no gender differences on a spirituality measure. Future research is needed to examine other factors that may influence moral reasoning.     

彰显道德韧性：应对疫情中的道德创伤

道德韧性是成功应对道德逆境的高尚道德操守。面对新型冠状病毒感染的肺炎疫情,中华民族的道德韧性得以彰显,有效地遏制了道德创伤的发生;但社会个体道德韧性的缺失,也使得部分道德创伤不容忽视,如果任其恣意蔓延必将消解和冲击人们抗击疫情的道德情感和道德意志。抵御疫情中的道德创伤,必须在坚定文化自信中传承道德韧性,在应对道德逆境中塑造道德韧性,在探寻生命意义中升华道德韧性,在领导和权威人士履职尽责中激发道德韧性。     

The Role of Military and Veterans Affairs Chaplains in the Treatment of Alcohol Problems

Chaplains can play a unique and valuable role in the treatment of alcohol dependence, a condition that has physical, psychological, and spiritual dimensions. To best fulfill this role, chaplains need to have a broad understanding of the nature of alcohol problems and current strategies for effectively interacting with individuals who have these problems, especially those with severe problems, and with their families. This article is designed to expand the chaplain’s knowledge about alcohol use disorders as well as evidence-based treatments and to offer recommendations on how chaplains can promote recovery of individuals with alcohol-related problems.     

Health Care Chaplains and their Role on Institutional Ethics Committees: An Australia Study

This paper presents the results of the largest Australian pastoral study concerning the perceptions of health care chaplains about their involvement on hospital research ethics committees (also known in some contexts as institutional ethics committees). Survey results from over 300 Australian health care chaplains indicated that nearly 90% of chaplains believed there was merit in chaplains serving on hospital research ethics committees, yet only a minority (22.7%) had ever participated on such committees. Data from in-depth interviews is also presented exploring the reasons for the lack of participation and the varying opinions regarding the role, appropriateness, and value of chaplains on ethics committees. Some implications of this study with respect to chaplaincy, hospital research ethics committees, health care institutions, ecclesiastical institutions, and government responsibilities are discussed.     

Understanding the Relationship Between Religiousness, Spirituality, and Underage Drinking: The Role of Positive Alcohol Expectancies

Research has consistently found that religiousness and spirituality are negatively associated with underage drinking. However, there is a paucity of research exploring the mechanisms by which these variables influence this important outcome. With 344 underage young adults (ages 18–20; 61 % women), we investigated positive alcohol expectancies as a mediator between religiousness and spirituality (measured separately) and underage alcohol use. Participants completed the Religious Commitment Inventory-10, Daily Spiritual Experiences Scale, Alcohol Expectancies Questionnaire, and Drinking Styles Questionnaire. Results indicate less positive alcohol expectancies partially mediate the relationship between both religiousness and spirituality and underage alcohol use. This suggests religiousness and spirituality’s protective influence on underage drinking is partly due to their influence on expectations about alcohol’s positive effects. Since underage drinking predicts problem drinking later in life and places one at risk for serious physical and mental health problems, it is important to identify specific points of intervention, including expectations about alcohol that rise from religious and spiritual factors.     

Psychological Empowerment,Work Engagement and Turnover Intention: The Role of Leader Relations and Role Clarity in a Financial Institution

This study investigated the relationship between leader-member exchange, role clarity, psychological empowerment, engagement and turnover intention within a financial institution in South Africa. A cross-sectional survey design was used. A convenience sample (N = 278) was taken (males =31%, females =60%; 88% younger than 35 years; 57% with 2–5 years service) from the total population (N = 889). They completed the Leader-Member Exchange Questionnaire (Liden, Wayne, & Stilwell, 1993) Role Conflict and Ambiguity Questionnaire (Rizzo, House, & Lirtzman, 1970), Measuring Empowerment Questionnaire (Spreitzer, 1995), Engagement Questionnaire (May, Gilson, & Harter, 2004) and Intention-to-leave Scale (Sjöberg & Sverke, 2000). A path model was tested with SPSS to determine the relationships of the variables. Furthermore, a theoretical model was tested through the use of structural equation modelling (Arbuckle, 2008). The latent variables included LMX (consisting of two parcels), role clarity (consisting of two parcels), psychological empowerment (consisting of four variables, namely meaning, competence, impact, and self-determination), work engagement (consisting of two parcels), and turnover intention (a manifest variable). Role clarity mediated the relationship between leader-member exchange and psychological empowerment, while psychological empowerment mediated the relationship between role clarity and work engagement as well as turnover intention. Leader-member relations lead to better understanding of roles, while role clarity empowers and engages employees.