A review of research on moral injury in combat veterans

Sheila Frankfurt, Patricia A Frazier

Research output: Contribution to journalArticlepeer-review

215 Scopus citations


The moral injury construct has been proposed to describe the suffering some veterans experience when they engage in acts during combat that violate their beliefs about their own goodness or the goodness of the world. These experiences are labeled transgressive acts to identify them as potentially traumatic experiences distinct from the fear-based traumas associated with posttraumatic stress disorder. The goal of this article was to review empirical and clinical data relevant to transgressive acts and moral injury, to identify gaps in the literature, and to encourage future research and interventions. We reviewed literature on 3 broad arms of the moral injury model proposed by Litz and colleagues (2009): (a) the definition, prevalence, and potential correlates of transgressive acts (e.g., military training and leadership, combat exposure, and personality), (b) the relations between transgressive acts and the moral injury syndrome (e.g., self-handicapping, self-injury, demoralization), and (c) some of the proposed mechanisms of moral injury genesis (e.g., shame, guilt, social withdrawal, and selfcondemnation). We conclude with recommendations for future research for veterans suffering with moral injury.

Original languageEnglish (US)
Pages (from-to)318-330
Number of pages13
JournalMilitary Psychology
Issue number5
StatePublished - Sep 1 2016


  • Combat veteran
  • Moral injury
  • PTSD
  • Transgressive acts
  • Trauma


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