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Moving Forward from Moral Injury: A Mixed Methods Study Investigating the Use of 3MDR for Treatment-Resistant PTSD

Author

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  • Lorraine Smith-MacDonald

    (Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
    St. Stephen’s College, Edmonton, AB T6G 2J6, Canada)

  • Chelsea Jones

    (Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Alberta Health Services, Edmonton, AB T5J 3E4, Canada)

  • Matthew R. G. Brown

    (Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Department of Computing Science, University of Alberta, Edmonton, AB T6G 2S4, Canada)

  • Rachel S. Dunleavy

    (St. Stephen’s College, Edmonton, AB T6G 2J6, Canada)

  • Annelies VanderLaan

    (Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada)

  • Zornitsa Kaneva

    (Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada)

  • Tristin Hamilton

    (Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Alberta Health Services, Edmonton, AB T5J 3E4, Canada)

  • Lisa Burback

    (Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada)

  • Eric Vermetten

    (Department of Psychiatry, Leiden University Medical Centre, Leiden University, 2333 ZA Leiden, The Netherlands)

  • Suzette Brémault-Phillips

    (Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation, University of Alberta, Edmonton, AB T6G 2G4, Canada
    Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada)

Abstract

Background: Exposure to trauma and potentially morally injurious events may lead to moral injury (MI). The link between MI and posttraumatic stress disorder (PTSD) may have particularly relevant implications for treatment-resistant PTSD (TR-PTSD). Multi-modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR), a technology-assisted exposure-based trauma therapy that has been used in the treatment of PTSD, may also be an acceptable modality for patients in the treatment of TR-PTSD and MI. This proof-of-concept study aimed to investigate (1) whether MI co-occurs in military members (MMs) and veterans with TR-PTSD, and (2) the perspectives of MMs and veterans with TR-PTSD utilizing 3MDR for MI. Methods: This study employed a mixed-methods clinical trial. Military Members and veterans participated in this study (N = 11) through self-reported questionnaires, video recordings of treatment sessions, and semi-structured interviews post-session and post-intervention, with longitudinal follow-up to 6 months. Results: MI scores correlated with self-reported measures of mental health symptoms related to PTSD. The thematic analysis revealed three emergent themes: (1) Realities of War, (2) Wrestling Scruples, and (3) Moral Sensemaking. Conclusion: MI was highly correlated with TR-PTSD and themes regarding MI. This result, while preliminary, allows for the postulation that MI may be contributing to the continuation of PTSD symptoms in TR-PTSD, and that 3MDR may be an acceptable modality for addressing these symptoms in MMs and veterans.

Suggested Citation

  • Lorraine Smith-MacDonald & Chelsea Jones & Matthew R. G. Brown & Rachel S. Dunleavy & Annelies VanderLaan & Zornitsa Kaneva & Tristin Hamilton & Lisa Burback & Eric Vermetten & Suzette Brémault-Philli, 2023. "Moving Forward from Moral Injury: A Mixed Methods Study Investigating the Use of 3MDR for Treatment-Resistant PTSD," IJERPH, MDPI, vol. 20(7), pages 1-18, April.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:7:p:5415-:d:1116818
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    References listed on IDEAS

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    1. Budden, Ashwin, 2009. "The role of shame in posttraumatic stress disorder: A proposal for a socio-emotional model for DSM-V," Social Science & Medicine, Elsevier, vol. 69(7), pages 1032-1039, October.
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