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Symptoms of Moral Injury from a Psychological Perspective: A Systematic Review

Yıl 2025, Cilt: 17 Sayı: 4, 760 - 772, 30.12.2025

Feyza Topçu , Mehmet Dinç

https://doi.org/10.18863/pgy.1590616

Öz

Moral injury is a condition associated with severe negative outcomes such as self-harm, suicide attempts, post-traumatic stress disorder (PTSD), substance abuse, and depression. Although research on moral injury has increased in recent years, studies in the Turkish literature remain limited, and no systematic review on this topic has been identified. This gap leads to insufficient recognition of moral injury in clinical settings, often resulting in its confusion with PTSD, which can complicate treatment processes for affected individuals. This systematic review aims to clarify the manifestations and symptoms of moral injury. A comprehensive search was conducted in Web of Science, Science Direct, and Taylor & Francis databases using relevant keywords, focusing on English-language studies. Peer-reviewed articles addressing moral injury symptoms, available as open or early access, were included, while books, theses, reviews, case reports, conference papers, and non-English publications were excluded. The 59 included studies revealed that moral injury impacts not only psychological but also emotional, cognitive, behavioral, social, spiritual, and physical domains. These effects were categorized and analyzed. The studies primarily focused on various occupational groups, particularly veterans, and offer significant recommendations for mental health professionals to develop holistic treatment plans. It is emphasized that researchers should conduct culturally sensitive studies, develop culturally appropriate scales to measure moral injury, and explore how it is understood and manifested. The predominance of studies on specific groups highlights the need for public health research on diverse populations.

Anahtar Kelimeler

moral injury symptoms systematic review

Kaynakça

  • Barnes HA, Hurley RA, Taber KH (2019) Moral injury and PTSD: often co-occurring yet mechanistically different. J Neuropsychiatry Clin Neurosci, 31:98-103.
  • Beck CT (2022) Secondary qualitative analysis of moral injury in obstetric and neonatal nurses. J Obstet Gynecol Neonatal Nurs, 51:166-176.
  • Biscoe N, Bonson A, Nickerson A, Murphy D (2023) Factors associated with exposure to potentially morally injurious events (PMIEs) and moral injury in a clinical sample of veterans. Eur J Trauma Dissociation, 7:100343.
  • Bojanowska A, Piotrowski K (2021) Two levels of personality: temperament and values and their effects on hedonic and eudaimonic well-being. Curr Psychol, 40:1185-1193.
  • Borges LM (2019) A service member's experience of Acceptance and Commitment Therapy for Moral Injury (ACT-MI) via telehealth: “Learning to accept my pain and injury by reconnecting with my values and starting to live a meaningful life”. J Contextual Behav Sci, 13:134-140.
  • Borges LM, Holliman BD, Farnsworth JK, Barnes SM (2023) Perceptions of military experience among veterans reporting lifetime warzone moral injury. J Nerv Ment Dis, 211:796-801.
  • Brémault-Phillips S, Cherwick T, Smith-MacDonald LA, Huh J, Vermetten E (2022) Forgiveness: A key component of healing from moral injury?. Front Psychiatry, 13:906945.
  • Bryan AO, Bryan CJ, Morrow CE, Etienne N, Ray-Sannerud B (2014) Moral injury, suicidal ideation, and suicide attempts in a military sample. Traumatology, 20:154-160.
  • Bryan CJ, Bryan AO, Roberge E, Leifker FR, Rozek DC (2018) Moral injury, posttraumatic stress disorder, and suicidal behavior among National Guard personnel. Psychol Trauma, 10:36-45.
  • Carter C (2021) Organisational injustice in UK frontline services and onset of Moral Injury, Post Traumatic Embitterment Disorder (PTED) and PTSD. Int J Law Crime Justice, 66:100483.
  • Currier JM, Drescher KD, Nieuwsma J (2021) Future directions for addressing moral injury in clinical practice: Concluding comments. InAddressing Moral Injury in Clinical Practice, (Ed KD Currier, J Drescher, J Nieuwsma):261-271. Washington DC, American Psychological Association.
  • de la Rie SM, van Sint Fiet A, Bos JB, Mooren N, Smid G, Gersons BP (2021) Brief Eclectic Psychotherapy for Moral Trauma (BEP-MT): Treatment protocol description and a case study. Eur J Psychotraumatol, 12:1929026.
  • Denham F, Varese F, Hurley M, Allsopp K (2023) Exploring experiences of moral injury and distress among health care workers during the COVID-19 pandemic. Psychol Psychother, 96:833-848.
  • Dursun S, Watkins K (2018) Moral injury: What we know and what we need to know. Mil Behav Health, 6:121-126.
  • Elbasheir A, Fulton TM, Choucair KC, Lathan EC, Spivey, BN, Guelfo A et al. (2024) Moral injury, race-related stress and post-traumatic stress disorder in a trauma-exposed Black population. J Psychiatr Res, 173:326-332.
  • Eikenaar T (2022) Relating to moral injuries: Dutch mental health practitioners on moral injury among military and police workers. Soc Sci Med, 298:114876.
  • Evans WR, Russell LH, Hall-Clark BN, Fina BA, Brown LA, Foa EB et al. (2021) Moral injury and moral healing in prolonged exposure for combat-related PTSD: A case study. Cogn Behav Pract, 28:210-223.
  • Fenton J, Kelly TB (2020) Risk is king and needs to take a backseat! can social workers’ experiences of moral injury strengthen practice? In Risk in Social Work Practice (Ed A Whittaker, B Taylor):89-103. London, UK, Routledge.
  • Festinger L (1962) A Theory of Cognitive Dissonance. Stanford, CA, Stanford University Press.
  • Festinger L, Carlsmith JM (1959) Cognitive consequences of forced compliance. J Abnorm Psychol, 58:203–210.
  • Frankfurt S, Frazier P (2016) A review of research on moral injury in combat veterans. Mil Psychol, 28:318-330.
  • Griffin BJ, Purcell N, Burkman K, Litz BT, Bryan CJ, Schmitz M et al. (2019) Moral injury: An integrative review. J Trauma Stress, 32:350-362.
  • Haight W, Cho M, Soffer-Elnekave R, Nashandi NJ, Suleiman J (2022) Moral injury experienced by emerging adults with child welfare histories in developmental and sociocultural contexts:“I knew the system was broken.” Child Youth Serv Rev, 139:106537.
  • Haight W, Korang-Okrah R, Black JE, Gibson P, Nashandi NJ (2020) Moral injury among Akan women: Lessons for culturally sensitive child welfare interventions. Child Youth Serv Rev, 110:104768.
  • Haight W, Sugrue EP, Calhoun M (2017a) Moral injury among child protection professionals: Implications for the ethical treatment and retention of workers. Child Youth Serv Rev, 82:27-41.
  • Haight W, Sugrue EP, Calhoun M, Black J (2017b) “Basically, I look at it like combat”: Reflections on moral injury by parents involved with child protection services. Child Youth Serv Rev, 82:477-489.
  • Hegarty S, Lamb D, Stevelink SA, Bhundia R, Raine R, Doherty MJ et al (2022) ‘It hurts your heart’: Frontline healthcare worker experiences of moral injury during the COVID-19 pandemic. Eur J Psychotraumatol, 13:2128028.
  • Held P, Klassen BJ, Brennan MB, Zalta AK (2018) Using prolonged exposure and cognitive processing therapy to treat veterans with moral injury-based PTSD: Two case examples. Cogn Behav Pract, 25:377-390.
  • Held P, Klassen BJ, Hall JM, Friese TR, Bertsch-Gout MM, Zalta AK et al. (2019) “I knew it was wrong the moment I got the order”: a narrative thematic analysis of moral injury in combat veterans. Psychol Trauma, 11:396.
  • Hodgson TJ, Carey LB, Koenig HG (2021) Moral injury, Australian veterans and the role of chaplains: An exploratory qualitative study. J Relig Health, 60:3061-3089.
  • Hodgson TJ, Carey LB, Koenig HG (2022) Moral injury, betrayal and retribution: Australian veterans and the role of chaplains. J Relig Health, 61:993-1021.
  • Holtz HK, Weissinger GM, Swavely D, Lynn L, Yoder A, Cotton B et al (2023) The long tail of COVID-19: Implications for the future of emergency nursing. J Emerg Nurs, 49:198-209.
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  • Koenig HG, Al Zaben F (2021). Moral injury: An increasingly recognized and widespread syndrome. J Relig Health, 60:2989-3011.
  • Kopacz MS, Simons KV, Chitaphong K. (2015) Moral injury: An emerging clinical construct with implications for social work education. J Relig Spiritual Soc Work, 34:252-264.
  • Korkmaz H, Dilmaç B (2021) Predictive relations between psychological well-being, Instagram addiction and values in university students. Res Educ Psychol, 5:71-82.
  • Kvitsiani M, Mestvirishvili M, Martskvishvili K, Odilavadze M (2023) Dynamic model of moral injury. Eur J Trauma Dissociation, 7:100313.
  • LaFrance WC Jr, Vo P, Baird G, East R, Stein NR (2020) Moral injury in veterans with nonepileptic seizures. Epilepsy Behav, 102:106681.
  • Litz BT, Stein N, Delaney E, Lebowitz L, Nash WP, Silva C et al. (2009) Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clin Psychol Rev, 29:695-706.
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Psikoloji Perspektifinden Ahlaki Yaralanmanın Görünür Yüzü: Sistematik Bir Derleme

Yıl 2025, Cilt: 17 Sayı: 4, 760 - 772, 30.12.2025

Feyza Topçu , Mehmet Dinç

https://doi.org/10.18863/pgy.1590616

Öz

Ahlaki yaralanma, kendine zarar verme, intihar girişimleri, travma sonrası stres bozukluğu (TSSB), alkol-madde bağımlılığı ve depresyon gibi ciddi olumsuz sonuçlara yol açan bir durumdur. Son yıllarda bu konuda uluslararası araştırmalar artsa da, Türkçe literatürde ahlaki yaralanmaya ilişkin çalışmaların sınırlı olduğu ve sistematik bir derlemenin bulunmadığı gözlenmiştir. Bu eksiklik, klinik ortamda ahlaki yaralanmanın yeterince tanınmamasına ve sıklıkla TSSB ile karıştırılmasına neden olmakta, bu da etkilenen bireylerin tedavisinde zorluklara yol açmaktadır. Bu sistematik derleme, ahlaki yaralanmanın belirtilerini ve görünümünü netleştirerek bireylerin yaşadığı etkileri ortaya koymayı amaçlamaktadır. Web of Science, Science Direct ve Taylor & Francis veri tabanlarında İngilizce yayınlar, ilgili anahtar kelimelerle taranmış; hakemli dergilerde yayımlanan, ahlaki yaralanma belirtilerini ele alan açık ve erken erişim makaleler dahil edilmiş, kitap, tez, derleme, olgu sunumu, bildiri ve İngilizce dışındaki yayınlar ise hariç tutulmuştur. Derlemeye dahil edilen 59 makale, ahlaki yaralanmanın yalnızca psikolojik değil, duygusal, bilişsel, davranışsal, sosyal, manevi ve fiziksel alanlarda da etkilere yol açtığını göstermiştir. Bu etkiler, kategorize edilerek incelenmiştir. Çalışmalar, özellikle gaziler gibi farklı meslek gruplarında yapılmış olup, ruh sağlığı uzmanlarına bütüncül tedavi planları geliştirme konusunda önemli öneriler sunmaktadır. Araştırmacıların kültüre duyarlı çalışmalar yapması, ahlaki yaralanmayı ölçen ölçekler geliştirmesi ve farklı gruplarda halk sağlığına yönelik araştırmalar yürütmesi gerektiği vurgulanmıştır.

Anahtar Kelimeler

Ahlaki yaralanma belirtiler sistematik derleme

Kaynakça

  • Barnes HA, Hurley RA, Taber KH (2019) Moral injury and PTSD: often co-occurring yet mechanistically different. J Neuropsychiatry Clin Neurosci, 31:98-103.
  • Beck CT (2022) Secondary qualitative analysis of moral injury in obstetric and neonatal nurses. J Obstet Gynecol Neonatal Nurs, 51:166-176.
  • Biscoe N, Bonson A, Nickerson A, Murphy D (2023) Factors associated with exposure to potentially morally injurious events (PMIEs) and moral injury in a clinical sample of veterans. Eur J Trauma Dissociation, 7:100343.
  • Bojanowska A, Piotrowski K (2021) Two levels of personality: temperament and values and their effects on hedonic and eudaimonic well-being. Curr Psychol, 40:1185-1193.
  • Borges LM (2019) A service member's experience of Acceptance and Commitment Therapy for Moral Injury (ACT-MI) via telehealth: “Learning to accept my pain and injury by reconnecting with my values and starting to live a meaningful life”. J Contextual Behav Sci, 13:134-140.
  • Borges LM, Holliman BD, Farnsworth JK, Barnes SM (2023) Perceptions of military experience among veterans reporting lifetime warzone moral injury. J Nerv Ment Dis, 211:796-801.
  • Brémault-Phillips S, Cherwick T, Smith-MacDonald LA, Huh J, Vermetten E (2022) Forgiveness: A key component of healing from moral injury?. Front Psychiatry, 13:906945.
  • Bryan AO, Bryan CJ, Morrow CE, Etienne N, Ray-Sannerud B (2014) Moral injury, suicidal ideation, and suicide attempts in a military sample. Traumatology, 20:154-160.
  • Bryan CJ, Bryan AO, Roberge E, Leifker FR, Rozek DC (2018) Moral injury, posttraumatic stress disorder, and suicidal behavior among National Guard personnel. Psychol Trauma, 10:36-45.
  • Carter C (2021) Organisational injustice in UK frontline services and onset of Moral Injury, Post Traumatic Embitterment Disorder (PTED) and PTSD. Int J Law Crime Justice, 66:100483.
  • Currier JM, Drescher KD, Nieuwsma J (2021) Future directions for addressing moral injury in clinical practice: Concluding comments. InAddressing Moral Injury in Clinical Practice, (Ed KD Currier, J Drescher, J Nieuwsma):261-271. Washington DC, American Psychological Association.
  • de la Rie SM, van Sint Fiet A, Bos JB, Mooren N, Smid G, Gersons BP (2021) Brief Eclectic Psychotherapy for Moral Trauma (BEP-MT): Treatment protocol description and a case study. Eur J Psychotraumatol, 12:1929026.
  • Denham F, Varese F, Hurley M, Allsopp K (2023) Exploring experiences of moral injury and distress among health care workers during the COVID-19 pandemic. Psychol Psychother, 96:833-848.
  • Dursun S, Watkins K (2018) Moral injury: What we know and what we need to know. Mil Behav Health, 6:121-126.
  • Elbasheir A, Fulton TM, Choucair KC, Lathan EC, Spivey, BN, Guelfo A et al. (2024) Moral injury, race-related stress and post-traumatic stress disorder in a trauma-exposed Black population. J Psychiatr Res, 173:326-332.
  • Eikenaar T (2022) Relating to moral injuries: Dutch mental health practitioners on moral injury among military and police workers. Soc Sci Med, 298:114876.
  • Evans WR, Russell LH, Hall-Clark BN, Fina BA, Brown LA, Foa EB et al. (2021) Moral injury and moral healing in prolonged exposure for combat-related PTSD: A case study. Cogn Behav Pract, 28:210-223.
  • Fenton J, Kelly TB (2020) Risk is king and needs to take a backseat! can social workers’ experiences of moral injury strengthen practice? In Risk in Social Work Practice (Ed A Whittaker, B Taylor):89-103. London, UK, Routledge.
  • Festinger L (1962) A Theory of Cognitive Dissonance. Stanford, CA, Stanford University Press.
  • Festinger L, Carlsmith JM (1959) Cognitive consequences of forced compliance. J Abnorm Psychol, 58:203–210.
  • Frankfurt S, Frazier P (2016) A review of research on moral injury in combat veterans. Mil Psychol, 28:318-330.
  • Griffin BJ, Purcell N, Burkman K, Litz BT, Bryan CJ, Schmitz M et al. (2019) Moral injury: An integrative review. J Trauma Stress, 32:350-362.
  • Haight W, Cho M, Soffer-Elnekave R, Nashandi NJ, Suleiman J (2022) Moral injury experienced by emerging adults with child welfare histories in developmental and sociocultural contexts:“I knew the system was broken.” Child Youth Serv Rev, 139:106537.
  • Haight W, Korang-Okrah R, Black JE, Gibson P, Nashandi NJ (2020) Moral injury among Akan women: Lessons for culturally sensitive child welfare interventions. Child Youth Serv Rev, 110:104768.
  • Haight W, Sugrue EP, Calhoun M (2017a) Moral injury among child protection professionals: Implications for the ethical treatment and retention of workers. Child Youth Serv Rev, 82:27-41.
  • Haight W, Sugrue EP, Calhoun M, Black J (2017b) “Basically, I look at it like combat”: Reflections on moral injury by parents involved with child protection services. Child Youth Serv Rev, 82:477-489.
  • Hegarty S, Lamb D, Stevelink SA, Bhundia R, Raine R, Doherty MJ et al (2022) ‘It hurts your heart’: Frontline healthcare worker experiences of moral injury during the COVID-19 pandemic. Eur J Psychotraumatol, 13:2128028.
  • Held P, Klassen BJ, Brennan MB, Zalta AK (2018) Using prolonged exposure and cognitive processing therapy to treat veterans with moral injury-based PTSD: Two case examples. Cogn Behav Pract, 25:377-390.
  • Held P, Klassen BJ, Hall JM, Friese TR, Bertsch-Gout MM, Zalta AK et al. (2019) “I knew it was wrong the moment I got the order”: a narrative thematic analysis of moral injury in combat veterans. Psychol Trauma, 11:396.
  • Hodgson TJ, Carey LB, Koenig HG (2021) Moral injury, Australian veterans and the role of chaplains: An exploratory qualitative study. J Relig Health, 60:3061-3089.
  • Hodgson TJ, Carey LB, Koenig HG (2022) Moral injury, betrayal and retribution: Australian veterans and the role of chaplains. J Relig Health, 61:993-1021.
  • Holtz HK, Weissinger GM, Swavely D, Lynn L, Yoder A, Cotton B et al (2023) The long tail of COVID-19: Implications for the future of emergency nursing. J Emerg Nurs, 49:198-209.
  • Houle SA, Vincent C, Jetly R, Ashbaugh AR (2021) Patterns of distress associated with exposure to potentially morally injurious events among Canadian Armed Forces service members and veterans: A multi‐method analysis. J Clin Psychol, 77:2668-2693.
  • Jin J, Weiman K, Bremault-Phillips S, Vermetten E (2022) Moral injury and recovery in uniformed professionals: Lessons from conversations among international students and experts. Front Psychiatry, 13:880442.
  • Koenig HG, Al Zaben F (2021). Moral injury: An increasingly recognized and widespread syndrome. J Relig Health, 60:2989-3011.
  • Kopacz MS, Simons KV, Chitaphong K. (2015) Moral injury: An emerging clinical construct with implications for social work education. J Relig Spiritual Soc Work, 34:252-264.
  • Korkmaz H, Dilmaç B (2021) Predictive relations between psychological well-being, Instagram addiction and values in university students. Res Educ Psychol, 5:71-82.
  • Kvitsiani M, Mestvirishvili M, Martskvishvili K, Odilavadze M (2023) Dynamic model of moral injury. Eur J Trauma Dissociation, 7:100313.
  • LaFrance WC Jr, Vo P, Baird G, East R, Stein NR (2020) Moral injury in veterans with nonepileptic seizures. Epilepsy Behav, 102:106681.
  • Litz BT, Stein N, Delaney E, Lebowitz L, Nash WP, Silva C et al. (2009) Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clin Psychol Rev, 29:695-706.
  • MacNeil S, Deschenes SS, Caldwell W, Brouillard M, Dang-Vu TT, Gouin JP (2017) High-frequency heart rate variability reactivity and trait worry interact to predict the development of sleep disturbances in response to a naturalistic stressor. Ann Behav Med, 51:912–924.
  • McEwen C, Alisic E, Jobson L (2021) Moral injury and mental health: A systematic review and meta-analysis. Traumatology, 27:303.
  • McGowan E (2022) Moral injury in Provisional IRA members: Preliminary evidence of moral beliefs injuring, protecting & disillusioning. Terror Polit Violence, 34:1698-1720.
  • McGuire AP, Nosen E, Lyons JA (2019) Benefits of moral elevation in veterans with PTSD and moral injury: A proposed theoretical framework and pilot study. Mil Behav Health, 7:315-326.
  • Molendijk T (2018) Toward an interdisciplinary conceptualization of moral injury: From unequivocal guilt and anger to moral conflict and disorientation. New Ideas Psychol, 51:1-8.
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  • Mosca CG, Kruger JP (2023) Financial medicine as a source of moral distress: An unrecognised pathway to moral injury in the South African EMS systems. J Emerg Med, 13:235-240.
  • Nielsen K, Agate C, Yarker J, Lewis R (2024) “It’s Business”: a qualitative study of moral injury in business settings; experiences, outcomes and protecting and exacerbating factors. J Bus Ethics, 194:1-17.
  • Ostermann M, Huffziger S, Kleindienst N, Mata J, Schmahl C, Beierlein C et al (2017) Realization of personal values predicts mental health and satisfaction with life in a German population. J Soc Clin Psychol, 36:651-674.
  • Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372:n71.
  • Passardi S, Hocking DC, Morina N, Sundram S, Alisic E (2022) Moral injury related to immigration detention on Nauru: A qualitative study. Eur J Psychotraumatol, 13:2029042.
  • Pernicano PU, Wortmann J, Haynes K (2022) Acceptance and forgiveness therapy for veterans with moral injury: Spiritual and psychological collaboration in group treatment. J Health Care Chaplain, 28:57-58.
  • Purcell N, Burkman K, Keyser J, Fucella P, Maguen S (2018) Healing from moral injury: A qualitative evaluation of the impact of killing treatment for combat veterans. J Aggress Maltreat Trauma, 27:645-673.
  • Reynolds KA, Pankratz L, Jain B, Grocott B, Bonin L, King G et al (2022) Moral injury among frontline long-term care staff and management during the COVID-19 pandemic. Front Health Serv, 2:841244.
  • Ricciardelli R, Johnston MS, Bennett B, Stelnicki AM, Carleton RN (2022) “It is difficult to always be an antagonist”: Ethical, professional, and moral dilemmas as potentially psychologically traumatic events among nurses in Canada. Int J Environ Res Public Health, 19:1454.
  • Rodrigues S, Mercier JM, McCall A, Nannarone M, Hosseiny F (2023) ‘Against everything that got you into the job’: Experiences of potentially morally injurious events among Canadian public safety personnel. Eur J Psychotraumatol, 14:2205332.
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  • Williamson V, Murphy D, Stevelink SA, Allen S, Jones E, Greenberg N (2021b) Delivering treatment to morally injured UK military personnel and veterans: The clinician experience. Mil Psychol, 33:115-123.
  • Williamson V, Murphy D, Stevelink SA, Jones E, Allen S, Greenberg N (2023b) Family and occupational functioning following military trauma exposure and moral injury. BMJ Mil Health, 169:205-211.
  • Wirpsa MJ, Galchutt P, Price CS, Schaefer B, Szilagyi C, Palmer PK (2023) Mandatory COVID-19 vaccination for healthcare workers: The experience of chaplains evaluating religious accommodation requests from coworkers. Soc Sci Med, 332:116103.
  • Worthen M, Ahern J (2014) The causes, course, and consequences of anger problems in veterans returning to civilian life. J Loss Trauma, 19:355-363.
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  • Zerach G, Levi-Belz Y, Griffin BJ, Maguen S (2021) Patterns of exposure to potentially morally injurious events among Israeli combat veterans: A latent class analysis approach. J Anxiety Disord, 79:102378.
Toplam 82 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Psikoloji
Bölüm Derleme
Yazarlar

Feyza Topçu 0000-0002-5853-2670

Mehmet Dinç 0000-0001-9544-8999

Yayımlanma Tarihi 30 Aralık 2025
Gönderilme Tarihi 24 Kasım 2024
Kabul Tarihi 9 Mart 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 17 Sayı: 4

Kaynak Göster

AMA Topçu F, Dinç M. Symptoms of Moral Injury from a Psychological Perspective: A Systematic Review. Psikiyatride Güncel Yaklaşımlar. Aralık 2025;17(4):760-772. doi:10.18863/pgy.1590616

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Psikiyatride Güncel Yaklaşımlar Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.