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Chapter 5 - Conscience, Moral Injury, and Psychopathology

Published online by Cambridge University Press:  20 May 2022

By
Barbara Stilwell  and
Matthew Galvin
Edited by
Armen Goenjian ,
Alan Steinberg  and
Robert Pynoos
Armen Goenjian
Affiliation:
David Geffen School of Medicine; UCLA/Duke University National Center for Child Traumatic Stress
Alan Steinberg
Affiliation:
UCLA/Duke University National Center for Child Traumatic Stress
Robert Pynoos
Affiliation:
UCLA/Duke University National Center for Child Traumatic Stress
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Summary

This chapter provides an overview of the process of moral development and the five domains of conscience functioning in children and adolescents. It describes how moral development and conscience functioning are affected by moral injuries and exposure to a natural disaster, specifically the 1988 Spitak earthquake. Alterations to conscience development and interference with conscience functioning resonate with the concept of moral injury, scientific studies of which have described moral injury in both combat and civilian populations. Both fields have been hampered by the fact that the current psychiatric diagnostic system for PTSD and depression in DSM-5, although identifying cognitive disturbances as symptoms, does not include specific reference to the moral domain. While symptoms of PTSD and depression may co-occur with conscience impairment, the moral injury involved requires creative methods for delineating the impact on demoralization and identifying potential treatments for re-moralization. Examples of conscience-sensitive evaluation methods for the domains of conscience – conceptualization, moral attachment, moral-emotional responsiveness, moral valuation, and moral volition – are presented. Each domain points the way to treatment possibilities.

Keywords

consciencemoral developmentmoral injurytraumapsychopathological interference to conscience functioningnatural disastermoralizationdemoralizationre-moralization
Type
Chapter
Information
Lessons Learned in Disaster Mental Health
The Earthquake in Armenia and Beyond
 , pp. 73 - 96
Publisher: Cambridge University Press
Print publication year: 2022

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