Six-domain framework of moral injury as the organizing structure for impact assessment¶

Theory · All theories
Evidence · no claims cited

Description¶

The article adopts the six domains of moral injury delineated by an international consortium (Litz et al.) as the syndromal definition of moral injury and the organizing structure of the interview's impact section: alterations in self- and other-perception, alterations in moral thinking, social impacts, moral emotions and moods, self-harming/sabotaging behaviors, and changes in beliefs about life meaning and purpose. The article states that "the six-domain framework of Litz et al. [5] provided the organizing structure for the impact section of the interview." Section 3 of the final interview carries these domains as subheadings, plus impact on other areas of life. The framework lets the interview map impact systematically without presupposing diagnostic boundaries.

Design Implications¶

Context¶

Requirements¶

• Used alongside a definition of a PMIE as a high-stakes event in which deeply held beliefs of right and wrong are at stake, irrespective of outcome

Constraints¶

• Debate remains around what constitutes a PMIE and the boundaries of moral injury versus normative distress, so the framework does not yield diagnostic cut-offs

Target Learners¶

• military veterans
• clinicians and moral injury researchers

Target Learning Objectives¶

• recognizing and describing the six domains of moral injury impact
• distinguishing the PMIE event from its psychosocial outcome

Claims¶

Related Theories¶

• Cimi M Clinical Interview

Examples¶

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Key Sources¶

• de Goede, M. L., Boelen, P. A., Litz, B. T., & ter Heide, F. J. J. (2026). Mapping moral injury: Development and feasibility of the Clinical Interview for Moral Injury—military version (CIMI-M). PLOS One. https://doi.org/10.1371/journal.pone.0359553