Table 2.

Moral injury—Bio-psycho-social-spiritual symptoms^(a).

Biological/ physical injury	Psychological/ emotional injury	Social/ familial injury	Spiritual injury
Insomnia “Startle-reflex” Alcohol abuse Drug addiction Loss of memory Self-sabotage / Self-harm Suicide	Anger & Betrayal Shame, Guilt, Sorrow Loss of trust in self Loss of trust in others Fear and Anxiety Re-experiencing the moral conflict/Flashbacks Nightmares Gambling addition Sexual/Porn Addiction Self-deprecation Loss of self-worth Depression Suicidal ideation	Spousal/Partner Disconnection Child-Parent Disconnection Family Disconnection Collegial Disconnection Occupational dysfunction Professional Disconnection Legal and disciplinary issues Community/Cultural Disconnection Social Alienation	Anger & Betrayal Shame, Guilt, Sorrow Loss of trust in self Loss of trust in others Loss of faith/ belief Moral pain /dissonance Questioning morality Self-condemnation Spiritual/existential crisis Loss of purpose in life Fatalism Loss of caring Ontological loss of meaning. Feeling “haunted”

Source:

^(a)Hodgson and Carey (17).