The Psychological and Emotional Impact of Unintentional Killing: Moral Injury in a Civilian Population

Moral injury (MI) refers to functionally impairing guilt, shame, and emotional distress emanating from events in which one's actions or inactions result in death, serious injury, or great harm to others. The great majority of research bearing on this emerging construct to date has focused on military populations and combat contexts; much less is known about characteristics and correlates of MI among civilians. Though most civilians will not encounter the types of events that give rise to MI in combat settings, accidents culminating in death or serious injury to others can and do happen. This article focuses on the presentation of MI, posttraumatic stress, and depressive symptoms among 131 individuals who were responsible for accidents that killed other individuals. Findings revealed that MI, posttraumatic stress disorder, and depressive symptoms remained significantly elevated for years after the accident. Regression analyses showed that event-related bullying/ostracization by others and self-blame were associated with poorer adjustment while social support and connectedness were associated with better outcomes. Connectedness with others mediated the association between social support and MI.