Book contents
- Lessons Learned in Disaster Mental Health: The Earthquake in Armenia and Beyond
- Frontispiece
- Lessons Learned in Disaster Mental Health: The Earthquake in Armenia and Beyond
- Copyright page
- Contents
- Dedication
- Preface
- Contributors
- Chapter 1 The 1988 Spitak Earthquake in Armenia and the Implementation of the Psychiatric Outreach Program
- Chapter 2 Diaspora Therapists Working in the Earthquake Zone
- Chapter 3 Treatment Outcome among Early Adolescents Two Decades Post-Earthquake
- Chapter 4 Course and Predictors of PTSD and Depression among Not Treated Children and Adolescents over Two Decades
- Chapter 5 Conscience, Moral Injury, and Psychopathology
- Chapter 6 Natural Disasters and Relocation
- Chapter 7 Long-Term Course of PTSD and Depression Among Adults, Mediating and Moderating Factors in Recovery, and Current Trends for Treatment
- Chapter 8 How the Spitak Earthquake Contributed to our Understanding of the Genetics of PTSD and Associated Disorders
- Chapter 9 Epidemiology of Disasters and the Spitak Earthquake
- Chapter 10 Traumatic Stress Conceptual Framework
- Chapter 11 Memoirs of the Spitak Earthquake
- Chapter 12 Lessons Learned from the Spitak Earthquake and Other Catastrophic Disasters
- Index
- Plate Section (PDF Only)
- References
Chapter 5 - Conscience, Moral Injury, and Psychopathology
Published online by Cambridge University Press: 20 May 2022
Book contents
- Lessons Learned in Disaster Mental Health: The Earthquake in Armenia and Beyond
- Frontispiece
- Lessons Learned in Disaster Mental Health: The Earthquake in Armenia and Beyond
- Copyright page
- Contents
- Dedication
- Preface
- Contributors
- Chapter 1 The 1988 Spitak Earthquake in Armenia and the Implementation of the Psychiatric Outreach Program
- Chapter 2 Diaspora Therapists Working in the Earthquake Zone
- Chapter 3 Treatment Outcome among Early Adolescents Two Decades Post-Earthquake
- Chapter 4 Course and Predictors of PTSD and Depression among Not Treated Children and Adolescents over Two Decades
- Chapter 5 Conscience, Moral Injury, and Psychopathology
- Chapter 6 Natural Disasters and Relocation
- Chapter 7 Long-Term Course of PTSD and Depression Among Adults, Mediating and Moderating Factors in Recovery, and Current Trends for Treatment
- Chapter 8 How the Spitak Earthquake Contributed to our Understanding of the Genetics of PTSD and Associated Disorders
- Chapter 9 Epidemiology of Disasters and the Spitak Earthquake
- Chapter 10 Traumatic Stress Conceptual Framework
- Chapter 11 Memoirs of the Spitak Earthquake
- Chapter 12 Lessons Learned from the Spitak Earthquake and Other Catastrophic Disasters
- Index
- Plate Section (PDF Only)
- References
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
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- Information
- Lessons Learned in Disaster Mental HealthThe Earthquake in Armenia and Beyond, pp. 73 - 96Publisher: Cambridge University PressPrint publication year: 2022
References
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Desk Reference, 5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
Burns, K., and Novick, L. (2017). The Vietnam War. Public Broadcasting Series. Available at: https://kenburns.com/films/vietnam/.Google Scholar
Cicchetti, D. (2016). Understanding developmental pathways from adversity to maladaptation, psychopathology, or resilience. Bulletin of the American Academy of Arts & Sciences, Spring, 27–28.Google Scholar
Currier, J. M., McDermott, R. C., Farnsworth, J. K., Borges, L. M. (2019). Temporal associations between moral injury and posttraumatic stress disorder symptom clusters in military veterans. Journal of Traumatic Stress, 32, 382–392.Google Scholar
Farnsworth, J., (2019). Is and ought: descriptive and prescriptive cognitions in military-related moral injury. Journal of Traumatic Stress, 32, 373–381.CrossRefGoogle ScholarPubMed
Galvin, M. (2014). Psychiatric diagnostic (DSM-5) contexts of psychopathological interference in conscience formation and functioning across the youth-span: a guideline. Conscience Works: Theory, Research and Clinical Applications, 4, 1–40. Retrieved from https://scholarworks.iupui.edu/handle/1805/6583.Google Scholar
Galvin, M., Fletcher, J., & Stilwell, B. (2006). Assessing meaning of suicidal risk behavior in adolescents: three exercises for clinicians. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 745–748.Google Scholar
Galvin, M., Hulvershorn, L, Gaffney, M. (2019). Conscience relevance and sensitivity in psychiatric evaluations in the youth-span. Adolescent Psychiatry, 9, 167–184.Google Scholar
Goenjian, A. K. (1993). A mental health relief program in Armenia after the 1988 earthquake: implementation and clinical observations. British Journal of Psychiatry, 169, 230–239.Google Scholar
Goenjian, A., Stilwell, B., Fairbanks, L., Galvin, M., Karaya, I., & Pynoos, R. (1999). Moral development and psychopathological interference in conscience functioning among adolescents after trauma. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 376–384.CrossRefGoogle ScholarPubMed
Hattan, D., (2018). Invisible Scars of War: A Veteran’s Struggle with Moral Injury. Woodstock, IL: Woodstock Square Press.Google Scholar
Kor, E., & Buccieri, L. (2009). Surviving the Angel of Death: The Story of a Mengele Twin in Auschwitz. Terre Haute, IN: Tanglewood Publishing Company.Google Scholar
Litz, B. T., Stein, N., Delaney, E., Leibowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clinical Psychology Review, 29, 695–706. https://doi.org/10.1016/j.cpr.2009.07.003.Google Scholar
Lurye, S. (2018). Thirty years after the Armenian earthquake, a New Yorker remembers his rescue. December 7, 2018. http://t.me/eurasianetnews.Google Scholar
New Oxford American Dictionary, 3rd ed. (2010). New York, NY: Oxford University Press.Google Scholar
Pinel, P. (1806). A Treatise on Insanity. Messers Cadell & Davies, Strand. https://doi.org/10.1037/10550-000.Google Scholar
Sapolsky, R. M. (2017). Behave: The Biology of Humans at our Best and Worst. New York, NY: Penguin.Google Scholar
Shay, J. (1995). Achilles in Vietnam: Combat Trauma and the Undoing of Character. New York, NY: Touchstone.Google Scholar
Stein, M. and Rothbaum, B. (2018). 175 years of progress in PTSD therapeutics: learning from the past. American Journal of Psychiatry, 175, 508–516.CrossRefGoogle ScholarPubMed
Stilwell, B. (2002a). Trauma, moral development, and conscience functioning. Conscience Works, Theory, Research and Clinical Applications, 2(1), 1–4. Appendix A: The Stilwell Conscience Interview, English and Spanish versions (original work published November 5, 1994). Retrieved from http://scholarworks.iupui.edu/handle/1805/15746 [last accessed July 19, 2021].Google Scholar
Stilwell, B. (2002b). Trauma, moral development, and conscience functioning. Conscience Works, Theory, Research and Clinical Applications, 2(1), 1–4. Appendix B: The Stilwell Structured Conscience Interview. English and Armenian versions (original work published February 11, 1999). Retrieved from http://hdl.handle.net/1805/15743[last accessed July 19, 2021].Google Scholar
Stilwell, B., Galvin, M. (1993). Clinical assessment of the conscience delays and deficiencies in psychopathology. Workshop. Annual Meeting of AACAP, San Antonio, TX. Scientific Proceedings of the Annual Meeting of the American Academy of Child and Adolescent Psychiatry, 9, 16.Google Scholar
Stilwell, B., Galvin, M., & Kopta, M. (1991). Conceptualization of conscience in normal children and adolescents ages 5 to 17. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 16–21.Google Scholar
Stilwell, B, Galvin, M., & Kopta, M. (2000). Right vs. Wrong: Raising a Child with a Conscience. Bloomington, IN: Indiana University Press.Google Scholar
Stilwell, B., Galvin, M., Kopta, M., & Norton, J. (1994). Moral-emotional responsiveness: a two-factor domain of conscience functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 130–139.Google Scholar
Stilwell, B., Galvin, M., Kopta, M., & Padgett, R. (1996). Moral valuation: a third domain of conscience functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 230–239.Google Scholar
Stilwell, B., Galvin, M., Kopta, M., & Padgett, R. (1998). Moral volition: the fifth and final domain leading to an integrated theory of conscience understanding. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 202–210.Google Scholar
Stilwell, B., Galvin, M., Kopta, M., Padgett, R., & Holt, J. (1997). Moralization of attachment: a fourth domain of conscience functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1140–1147.Google Scholar
Thunberg, G., Thunberg, S., Ernman, M., Ernman, B. (2018). Our House Is on Fire: Scenes of a Family and a Planet in Crisis. London: Penguin Books.Google Scholar
Verkamp, B. (1993). Moral Treatment of Returning Warriors in Early Medieval and Modern Times. Chicago, IL: University Chicago Press.Google Scholar