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ONLY ONE OF TWO DEFINITIONS REQUIRES BETRAYAL
Have You Ever Been Betrayed By Someone In Charge Of You?
A Psychiatrist Treating Vietnam Veterans Called That Moral Injury
His Definition Also Required A High Stakes Situation
That Definition Left Out Wrongs A Person Commits Themselves
A Research Team Later Built A Model That Included Them
The Psychiatrist Wrote That The Two Differ Mainly In Who Acts
A Later Scale Measured Transgressions And Betrayals Separately
Studies Of Service Members Disagree On What Betrayal Predicts
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OKAY BACK FROM TROY 🏺
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A VIETNAM CLINIC AND THE ILIAD 🛡️
A Psychiatrist Named Shay Spent 20 Years At A Veterans Affairs Clinic
In Boston He Was The Only Psychiatrist There
The Clinic Was Called The Veterans Improvement Program
It Opened 10 Years Before Shay Arrived
The Program Was Founded For The Most Troubled Vietnam Veterans
Shay Built His Definition From His Patients' Narratives
He Also Drew On The Iliad Which Is An Early Greek Epic By Homer
Shay's Own Definition Has Three Required Parts
Moral Injury Needs A Betrayal Of What's Right
The Betrayal Must Come From Someone With Legitimate Authority
It Must Also Happen When The Stakes Are High
Shay Wrote That All Three Are Required
He Reads The Iliad's Story Of Achilles As A Story Of Moral Injury
Achilles Was A Commander Under A Leader Named Agamemnon
Agamemnon Seized Briseis Whom Shay Calls Achilles' Medal Of Honor
That Publicly Dishonored Achilles In Front Of The Troops
Shay Wrote That Act Was No Private Wrong
In His View The Use Of Military Power Has No Private Wrongs
Shay Published A Short Article Drawn From The Iliad In 1991
It Appeared In The Journal Of Traumatic Stress
The Article Grew Into His 1994 Book Achilles In Vietnam
Shay Wrote That He Apparently Coined The Term In Mental Health
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A SECOND DEFINITION ADDED THE SELF ⚔️
In 2009 A Team Led By A Researcher Named Litz Proposed A Model
It Was The First Model And Definition Of Moral Injury
The Model Gives Three Examples Of Potentially Morally Injurious Events
Perpetrating A Transgression Is One
Failing To Prevent One Is Another
Bearing Witness To One Is The Third
Each Act Goes Against Deeply Held Moral Beliefs
In 2014 Shay Compared His Own Definition To Litz's
He Wrote That The Two Differ Mainly In One Thing
That Thing Is Who Commits The Violation
In Shay's Version The Violator Is Someone In Power
Shay Wrote That In Litz's Version It Is The Self
Litz Wrote That The 2009 Model Did Not Fully Cover Harm By Others
His Recent Review Describes Events Where Others Do The Wrong
One Example Is Betrayal By A Leader In A High Stakes Situation
Another Is Being Compelled By Leaders To Cover Up Grave Mistakes
Shay Wrote That Both Forms Impair The Capacity For Trust
They Also Raise Despair And Suicide Risk And Violence Toward Others
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HOW OFTEN BETRAYAL IS REPORTED 🎖️
Researchers Built A Scale To Measure Morally Injurious Events
It Was Named The Moral Injury Events Scale
Active Duty Marines Took It One Week After A War Zone Deployment
They Took It Again Three Months Later
The Scale Started With 11 Items
Two Were Dropped Because They Correlated Poorly With The Total Score
The Remaining 9 Items Split Into Two Groups
One Group Was Perceived Transgressions
The Other Was Perceived Betrayals
Three Of The Scale's Items Ask About Being Betrayed
They Cover Leaders And Peers And People Outside The Military
Unlike Other Items They Do Not Ask If The Person Was Troubled By It
Two Nationally Representative Studies Of Veterans Used The Scale
Between 25.5 And 41.1 Percent Reported Betrayal Events
Personal Transgressions Ranged From 10.8 To 18.8 Percent
For Transgressions By Others It Was 25.5 To 27.9 Percent
The Studies Counted A Reported Event In Different Ways
A National Sample Of US Iraq And Afghanistan Veterans Was Also Studied
Betrayal There Was Associated With Suicide Attempts After Deployment
Transgressions By Self Were Associated With Suicidal Thoughts
An Active Duty Sample Produced A Different Pattern
Transgressions Predicted A Past Suicide Attempt Better Than Betrayal
The Two Samples Did Not Point To The Same Type
