Exploring themes of moral injury and resilience among women in a transitional living center

Moral injury is a construct that has primarily been studied in war veterans, police officers, and military nurses. It involves a change in an individual’s expectations about their own or another’s behavior in the face of events involving a violation of their beliefs about themselves, observation of unethical behavior by others, and/or witnessing human suffering that violates beliefs in the goodness of humanity. Research indicates that moral injury involves at least five major themes: betrayal and trust issues; social problems; spiritual/existential issues; psychological symptoms; and self-deprecation. Moral injury represents an important, emerging area of study that may facilitate a better understanding of the treatment and recovery needs of individuals who have experienced trauma. The purpose of the present study was to examine whether moral injury may be present in populations experiencing non-war-related trauma: specifically, women who have experienced homelessness and/or intimate partner violence (IPV). A second goal was to explore themes of resilience and coping. Eight women residing at a transitional living center were individually interviewed regarding their experiences; a brief demographic questionnaire and the Trauma History Screen - Lite Version were also administered. Participants were diverse with regard to age (M = 33.88 years) and ethnicity. All eight had experienced homelessness and seven reported IPV. The researcher conducted qualitative analyses, guided by grounded theory, of the interview transcripts. Ten major themes were identified, eight of which overlapped substantially with the five core themes of moral injury. Self-deprecation was the most prominent theme in the present study. It was relevant to experiences of both homelessness and IPV; it was expressed to some degree by all participants. Six major themes of coping and resilience were also identified, with personal factors related to the individual emerging as the most prominent. This exploratory study indicates that moral injury may be a relevant construct in understanding the experiences of women who have endured extreme, non-war-related stressors such as IPV and homelessness. Consideration of moral injury may be useful in identifying treatment priorities, including the need to examine the impact of trauma on the self. Other findings, limitations, and research recommendations are also discussed