References

• Barth, T. M., Lord, C. G., Thakkar, V. J., & Brock, R. N. (2020). Effects of resilience strength training on constructs associated with moral injury among veterans. Journal of Veterans Studies, 6(2), 101–113.
   Google Scholar
• Berents, H. (2020). Politics, policy-making and the presence of images of suffering children. International Affairs, 96(3), 593–608. doi:10.1093/ia/iiz275
   Web of Science ®Google Scholar
• Betancourt, T. S., Thomson, D. L., Brennan, R. T., Antonaccio, C. M., Gilman, S. E., & VanderWeele, T. J. (2020). Stigma and acceptance of Sierra Leone’s child soldiers: A prospective longitudinal study of adult mental health and social functioning. Journal of the American Academy of Child & Adolescent Psychiatry, 59(6), 715–726. doi:10.1016/j.jaac.2019.05.026
   PubMed Web of Science ®Google Scholar
• Blinka, D., & Harris, H. W. (2016). Moral injury in warriors and veterans: The challenge to social work. Social Work and Christianity, 43(3), 7.
   Google Scholar
• Bluett, E. J. (2017). Effectiveness of acceptance and commitment therapy as a treatment for posttraumatic stress disorder and moral injury [Doctoral dissertation). Utah State University]. ProQuest Dissertations Publishing.
   Google Scholar
• Borges, L. M. (2019). A service member's experience of acceptance and commitment therapy for moral injury (ACT-MI) via telehealth: “Learning to accept my pain and injury by reconnecting with my values and starting to live a meaningful life”. Journal of Contextual Behavioral Science, 13, 134–140.
   Web of Science ®Google Scholar
• Boulos, D., & Zamorski, M. A. (2016). Contribution of the mission in Afghanistan to the burden of past-year mental disorders in Canadian armed forces personnel, 2013. The Canadian Journal of Psychiatry, 61(1_suppl), 64S–76S.
   PubMedGoogle Scholar
• Brémeault-Phillips, S., Pike, A., Scarcella, F., & & Cherwick, T. (2019). Spirituality and moral injury among military personnel: A mini-review. Frontiers in Psychiatry, 10, 276–276.
   PubMed Web of Science ®Google Scholar
• Brock, R. N., & Lettini, G. (2012). Soul repair: Recovering from moral injury after war (p. 43). Boston: Beacon Press.
   Google Scholar
• Brocklehurst, H. (2007). Children and War. In A. Collins (Ed.), Contemporary security studies (pp. 379–392). Oxford: Oxford University Press.
   Google Scholar
• Brocklehurst, H. (2016). Who's afraid of children?: Children, conflict and international relations (Ser. Ethics and Global Politics) (pp. 1–24). London: Routledge.
   Google Scholar
• Burkman, K., Maguen, S., & Purcell, N. (2021). Impact of killing: A treatment program for military veterans with moral injury. In J. M. Currier, K. D. Drescher, & J. A. Nieuwsma (Eds.), Addressing moral injury in clinical practice (pp. 203–221). Washington: American Psychological Association. http://public.eblib.com/choice/PublicFullRecord.aspx?p=6320967.
   Google Scholar
• Burman, E. (1994). Innocents abroad: Western fantasies of childhood and the iconography of emergencies. Disasters, 18(3), 238–253.
   PubMed Web of Science ®Google Scholar
• Carey, L. B., Hodgson, T. J., Krikheli, L., Soh, R. Y., Armour, A. R., Singh, T. K., & Impiombato, C. G. (2016). Moral injury, spiritual care and the role of chaplains: An exploratory scoping review of literature and resources. Journal of Religion and Health, 55(4), 1218–1245.
   PubMed Web of Science ®Google Scholar
• Coombs, L. (2018). Operationalizing strong, secure, engaged: The child soldier dimension. Calgary: Canadian Global Affairs Institute.
   Google Scholar
• Currier, J. M., Drescher, K. D., & Nieuwsma, J. A. (2020). Addressing moral injury in clinical practice. Washington: American Psychological Association. http://public.eblib.com/choice/PublicFullRecord.aspx?p=6320967.
   Google Scholar
• Dallaire Initiative. (2012). Child Soldiers: A handbook for security sector actors (p. 42). The Roméo Dallaire Child Soldiers Initiative Dalhousie University Halifax. https://dallaireinstitute.org/publications/
   Google Scholar
• Dallaire, R. (2011). They fight Like soldiers, they die like children (pp. 1–2). Toronto: Random House.
   Google Scholar
• Denov, M. S. (2010). Child soldiers: Sierra Leone's revolutionary united front. Cambridge: Cambridge University Press.
   Google Scholar
• Drescher, K. D., Foy, D. W., Kelly, C., Leshner, A., Schutz, K., & Litz, B. (2011). An exploration of the viability and usefulness of the construct of moral injury in war veterans. Traumatology, 17(1), 8–13.
   Google Scholar
• Easterbrook, B., Plouffe, R. A., Houle, S. A., Liu, A., McKinnon, M. C., Ashbaugh, A. R., … Nazarov, A. (2022). Risk factors for moral injury among Canadian armed forces personnel. Frontiers in Psychiatry, 13, 892320–892320. doi:10.3389/fpsyt.2022.892320
   PubMed Web of Science ®Google Scholar
• Exline, J. J., Grubbs, J. B., Pargament, K. I., & Yali, A. M. (2014). The religious and spiritual struggles scale: Development and initial validation. Psychology of Religion and Spirituality, 6(3), 208–222.
   Web of Science ®Google Scholar
• Farnsworth, J. K., Drescher, K. D., Evans, W., & Walser, R. D. (2017). A functional approach to understanding and treating military-related moral injury. Journal of Contextual Behavioral Science, 6(4), 391–397.
   Web of Science ®Google Scholar
• Farnsworth, J. K., Drescher, K. D., Nieuwsma, J. A., Walser, R. B., & Currier, J. M. (2014). The role of moral emotions in military trauma: Implications for the study and treatment of moral injury. Review of General Psychology, 18(4), 249–262.
   Web of Science ®Google Scholar
• Fleming, W. H. (2021). Moral injury and the absurd: The suffering of moral paradox. Journal of Religion and Health, 60(5), 3012–3033.
   PubMed Web of Science ®Google Scholar
• Fleming, W. H. (2022). Complex moral injury: Shattered moral assumptions. Journal of Religion and Health, 61(2), 1022–1050.
   PubMed Web of Science ®Google Scholar
• Goldberg, J., Magruder, K. M., Forsberg, C. W., Friedman, M. J., Litz, B. T., Vaccarino, V., … Smith, N. L. (2016). Prevalence of post-traumatic stress disorder in aging Vietnam-era veterans: Veterans administration cooperative study 569: Course and consequences of post-traumatic stress disorder in Vietnam-era veteran twins. The American Journal of Geriatric Psychiatry, 24(3), 181–191.
   PubMed Web of Science ®Google Scholar
• Gray, M. J., Schorr, Y., Nash, W., Lebowitz, L., Amidon, A., Lansing, A., … Litz, B. T. (2012). Adaptive disclosure: An open trial of a novel exposure-based intervention for service members with combat-related psychological stress injuries. Behavior Therapy, 43(2), 407–415. doi:10.1016/j.beth.2011.09.001
   PubMed Web of Science ®Google Scholar
• Griffin, B. J., Purcell, N., Burkman, K., Litz, B. T., Bryan, C. J., Schmitz, M., … Maguen, S. (2019). Moral injury: An integrative review. Journal of Traumatic Stress, 32(3), 350–362. doi:10.1002/jts.22362
   PubMed Web of Science ®Google Scholar
• Haight, W., Sugrue, E., Calhoun, M., & Black, J. (2016). A scoping study of moral injury: Identifying directions for social work research. Children and Youth Services Review, 70, 190–200.
   Web of Science ®Google Scholar
• Held, P., Klassen, B. J., Zalta, A. K., & Pollack, M. H. (2017). Understanding the impact and treatment of moral injury among military service members. Focus, 15(4), 399–405. doi:10.1176/appi.focus.20170023
   PubMedGoogle Scholar
• Hughes, J. (2006). Child soldiers: Are US military members prepared to deal with the threat? Arlington: Air War Coll Maxwell AFB AL.
   Google Scholar
• Hunter, C. (2008). Eight lives down. London: Corgi Books.
   Google Scholar
• Jamieson, N., Usher, K., Maple, M., & Ratnarajah, D. (2020). Invisible wounds and suicide: Moral injury and veteran mental health. International Journal of Mental Health Nursing, 29, 105–109.
   PubMed Web of Science ®Google Scholar
• Jinkerson, J. D. (2016). Defining and assessing moral injury: A syndrome perspective. Traumatology, 22(2), 122.
   Google Scholar
• Jones, K. A., Freijah, I., Carey, L., Carleton, R. N., Devenish-Meares, P., Dell, L., … Phelps, A. J. (2022). Moral injury, chaplaincy and mental health provider approaches to treatment: A scoping review. Journal of Religion and Health, 61(2), 1–44.
   PubMed Web of Science ®Google Scholar
• Jones, M. (2016). Encountering children in conflict zones: The British experience [Unpublished PhD Dissertation]. Department of International Politics, Aberystwyth University.
   Google Scholar
• Jones, N., Sharp, M. L., Phillips, A., & Stevelink, S. A. (2019). Suicidal ideation, suicidal attempts, and self-harm in the UK armed forces. Suicide and Life-Threatening Behavior, 49(6), 1762–1779.
   PubMed Web of Science ®Google Scholar
• Jordan, A. H., Eisen, E., Bolton, E., Nash, W. P., & Litz, B. T. (2017). Distinguishing war-related PTSD resulting from perpetration- and betrayal-based morally injurious events. Psychological Trauma: Theory, Research, Practice and Policy, 9(6), 627–634.
   PubMed Web of Science ®Google Scholar
• Koenig, H. G., & Al Zaben, F. (2021). Moral injury: An increasingly recognized and widespread syndrome. Journal of Religion and Health, 60(5), 2989–3011.
   PubMed Web of Science ®Google Scholar
• Koenig, H. G., Ames, D., Youssef, N. A., Oliver, J. P., Volk, F., Teng, E. J., … Pearce, M. (2018). Screening for moral injury: The moral injury symptom scale - military version short form. Military Medicine, 183(11-12), 665.
   Web of Science ®Google Scholar
• Koenig, H. G., Boucher, N. A., Oliver, R. J. P., Youssef, N., Mooney, S. R., Currier, J. M., & Pearce, M. (2017). Rationale for spiritually oriented cognitive processing therapy for moral injury in active duty military and veterans with posttraumatic stress disorder. The Journal of Nervous and Mental Disease, 205(2), 147–153.
   PubMed Web of Science ®Google Scholar
• Kopacz, M. S., Connery, A. L., Bishop, T. M., Bryan, C. J., Drescher, K. D., Currier, J. M., & Pigeon, W. R. (2016). Moral injury: A new challenge for complementary and alternative medicine. Complementary Therapies in Medicine, 24, 29–33. doi:10.1016/j.ctim.2015.11.003
   PubMed Web of Science ®Google Scholar
• Laifer, A. L., Amidon, A. D., Lang, A. J., & Litz, B. T. (2015). Treating war-related moral injury and loss with adaptive disclosure: A case study. In E. C. Ritchie (Ed.), Posttraumatic stress disorder and related diseases in combat veterans (pp. 331–349). Cham: Springer.
   Google Scholar
• Litz, B. T., & Kerig, P. K. (2019). Introduction to the special issue on moral injury: Conceptual challenges, methodological issues, and clinical applications. Journal of Traumatic Stress, 32(3), 341–349. doi:10.1002/jts.22405
   PubMed Web of Science ®Google Scholar
• Litz, B. T., Rusowicz-Orazem, L., Doros, G., Grunthal, B., Gray, M., Nash, W., & Lang, A. J. (2021). Adaptive disclosure, a combat-specific PTSD treatment, versus cognitive-processing therapy, in deployed marines and sailors: A randomized controlled non-inferiority trial. Psychiatry Research, 297, 113761.
   PubMed Web of Science ®Google Scholar
• Litz, B. T., Stein, N., Delaney, E., Lebowitz, 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(8), 695–706.
   PubMed Web of Science ®Google Scholar
• Maguen, S., Burkman, K., Madden, E., Dinh, J., Bosch, J., Keyser, J., … Neylan, T. C. (2017). Impact of killing in war: A randomized, controlled pilot trial. Journal of Clinical Psychology, 73(9), 997–1012.
   PubMed Web of Science ®Google Scholar
• Meijer, M. (2011). Transactional analysis of child warriors as the opposing force. NATO/RTO, Child Soldiers as the Opposing Force, Final Report of the HFM-159/RTO Task Group. https://apps.dtic.mil/sti/pdfs/ADA539989.pdf.
   Google Scholar
• Mircica, A. D., Hickmott, C. J., Kilbey, S., Hughes, J. H., & McManus, F. (2011). The psychological well-being of professional armed forces personnel facing child soldiers: A literature review. NATO/RTO, Child Soldiers as the Opposing Force, Final Report of the HFM-159/RTO Task Group, 5-1. https://apps.dtic.mil/sti/pdfs/ADA539989.pdf.
   Google Scholar
• Molendijk, T. (2018). Moral injury in relation to public debates: The role of societal misrecognition in moral conflict-colored trauma among soldiers. Social Science & Medicine, 211, 314–320.
   PubMed Web of Science ®Google Scholar
• Molendijk, T. (2019). The role of political practices in moral injury: A study of Afghanistan veterans. Political Psychology, 40(2), 261–275.
   Web of Science ®Google Scholar
• Nash, W. P., & Litz, B. T. (2013). Moral injury: A mechanism for war-related psychological trauma in military family members. Clinical Child and Family Psychology Review, 16(4), 365–375.
   PubMed Web of Science ®Google Scholar
• NATO. (2016). Mental health training. https://www.sto.nato.int/.
   Google Scholar
• NATO. (2021, 22 April). Operation and Missions: Past and present. https://www.nato.int/cps/en/natohq/topics_52060.htm.
   Google Scholar
• Nichter, B., Norman, S. B., Maguen, S., & Pietrzak, R. H. (2021, March 5). Moral injury and suicidal behavior among US combat veterans: Results from the 2019-2020 national health and resilience in veterans study. Depression and Anxiety. doi:10.1002/da.23145
   PubMed Web of Science ®Google Scholar
• Nichter, B., Norman, S., Haller, M., & Pietrzak, R. H. (2019). Psychological burden of PTSD, depression, and their comorbidity in the US veteran population: Suicidality, functioning, and service utilization. Journal of Affective Disorders, 256, 633–640.
   PubMed Web of Science ®Google Scholar
• Nieuwsma, J. A., Brancu, M., Wortmann, J., Smigelsky, M. A., King, H. A., VISN 6 MIRECC Workgroup, & Meador, K. G. (2021). Screening for moral injury and comparatively evaluating moral injury measures in relation to mental illness symptomatology and diagnosis. Clinical Psychology & Psychotherapy, 28(1), 239–250.
   PubMed Web of Science ®Google Scholar
• Nieuwsma, J., Walser, R. D., K Farnsworth, J., D Drescher, K., G Meador, K., & Nash, W. (2015). Possibilities within acceptance and commitment therapy for approaching moral injury. Current Psychiatry Reviews, 11(3), 193–206.
   Web of Science ®Google Scholar
• Nordstrand, A. E., Bøe, H. J., Holen, A., Reichelt, J. G., Gjerstad, C. L., & Hjemdal, O. (2019). Danger-and non-danger-based stressors and their relations to posttraumatic deprecation or growth in Norwegian veterans deployed to Afghanistan. European Journal of Psychotraumatology, 10(1), 1601989.
   PubMed Web of Science ®Google Scholar
• Pearce, M., Haynes, K., Rivera, N. R., & Koenig, H. G. (2018). Spiritually integrated cognitive processing therapy: A new treatment for post-traumatic stress disorder that targets moral injury. Global Advances in Health and Medicine, 7, doi:10.1177/2164956118759939
   PubMedGoogle Scholar
• Purcell, N., Maguen, S., Koenig, C. J., & Bosch, J. (2016). Veterans’ perspectives on the psychosocial impact of killing in war. Counseling Psychologist, 44(7), 1062–1099.
   Web of Science ®Google Scholar
• Ramage, A. E., Litz, B. T., Resick, P. A., Woolsey, M. D., Dondanville, K. A., Young-McCaughan, S., … STRONG STAR Consortium. (2016). Regional cerebral glucose metabolism differentiates danger-and non-danger-based traumas in post-traumatic stress disorder. Social Cognitive and Affective Neuroscience, 11(2), 234–242.
   PubMed Web of Science ®Google Scholar
• Rhead, R., MacManus, D., Jones, M., Greenberg, N., Fear, N. T., & Goodwin, L. (2020). Mental health disorders and alcohol misuse among UK military veterans and the general population: A comparison study. Psychological Medicine, 52(2), 292–302.
   PubMed Web of Science ®Google Scholar
• Richardson, N. M., Lamson, A. L., Smith, M., Eagan, S. M., Zvonkovic, A. M., & Jensen, J. (2020). Defining moral injury among military populations: A systematic review. Journal of Traumatic Stress, 33(4), 575–586.
   PubMed Web of Science ®Google Scholar
• Rusu, C., Zamorski, M. A., Boulos, D., & Garber, B. G. (2016). Prevalence comparison of past-year mental disorders and suicidal behaviours in the Canadian armed forces and the Canadian general population. Canadian Journal of Psychiatry, 61(Suppl. 1), 46S–55S.
   PubMedGoogle Scholar
• Schuster Wachen, J., Evans, W., Jacoby, V., & Blankenship, A. (2020). Cognitive processing therapy. In J. M. Currier, K. D. Drescher, & J. A. Nieuwsma (Eds.), Addressing moral injury in clinical practice (pp. 143–161). Washington: American Psychological Association. http://public.eblib.com/choice/PublicFullRecord.aspx?p=6320967.
   Google Scholar
• Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31(2), 182–119.
   Web of Science ®Google Scholar
• Shay, J. (1992). Achilles in Vietnam: Combat trauma and the undoing of character. New York, NY: Scribner.
   Google Scholar
• Shea, M. T., Presseau, C., Finley, S. L., Reddy, M. K., & Spofford, C. (2017). Different types of combat experiences and associated symptoms in OEF and OIF national guard and reserve veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 9(S1), 19.
   PubMedGoogle Scholar
• Steenkamp, M. M., Litz, B. T., Gray, M. J., Lebowitz, L., Nash, W., Conoscenti, L., … Lang, A. (2011). A brief exposure-based intervention for service members with PTSD. Cognitive and Behavioral Practice, 18(1), 98–107.
   Web of Science ®Google Scholar
• Thompson, M. M. (2015). Moral injury in military operations: A review of the literature and key considerations for the Canadian armed forces. Ottawa: Department of National Defence, Government of Canada.
   Google Scholar
• Trivedi, R. B., Post, E. P., Sun, H., Pomerantz, A., Saxon, A. J., Piette, J. D., … Nelson, K. (2015). Prevalence, comorbidity, and prognosis of mental health among US veterans. American Journal of Public Health, 105(12), 2564–2569.
   PubMed Web of Science ®Google Scholar
• UN Children’s Fund (UNICEF). (2007, February). The Paris Principles. Principles and guidelines on children associated with armed forces or armed groups. Retrieved April 22, 2021, from https://www.refworld.org/docid/465198442.html.
   Google Scholar
• United Nations (UN). (2018). Children in armed conflict. Retrieved from https://resourcecentre.savethechildren.net/library/annual-report-secretary-general-children-and-armed-conflict-caac-2018.
   Google Scholar
• Vermetten, E., & Jetly, R. (2018). A critical outlook on combat-related PTSD: Review and case reports of guilt and shame as drivers for moral injury. Military Behavioral Health, 6(2), 156–164.
   Google Scholar
• United States Marine Corps. (2002). Child soldiers: Implications for U.S. forces. Quantico: US Marine Corps.
   Google Scholar
• Veterans Affairs. (2020). Veterans Fact Sheet 2020. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/874821/6.6409_CO_Armed-Forces_Veterans-Factsheet_v9_web.pdf.
   Google Scholar
• Walser, R., & Wharton, E. (2020). Acceptance and commitment therapy: Using mindfulness and values in the treatment of moral injury. In J. M. Currier, K. D. Drescher, & J. A. Nieuwsma (Eds.), Addressing moral injury in clinical practice (pp. 163–181). Washington: American Psychological Association. http://public.eblib.com/choice/PublicFullRecord.aspx?p=6320967.
   Google Scholar
• Wessells, M. G. (2006). Child Soldiers: From violence to protection. Harvard, MA: Harvard University Press.
   Google Scholar
• Wisco, B. E., Marx, B. P., May, C. L., Martini, B., Krystal, J. H., Southwick, S. M., & Pietrzak, R. H. (2017). Moral injury in US combat veterans: Results from the national health and resilience in veterans study. Depression and Anxiety, 34(4), 340–347.
   Web of Science ®Google Scholar
• Zefferman, M. R., & Mathew, S. (2020). An evolutionary theory of moral injury with insight from Turkana warriors. Evolution and Human Behavior, 41(5), 341–353.
   Web of Science ®Google Scholar