Moral Injury in Human Rights Advocates

Objective: Human rights advocates investigate, document, and combat abuses of individuals and groups around the world and are routinely exposed to events that can be seen as potentially morally injurious. However, few studies have examined the unique risk factors for poor mental health outcomes among this population, and none has explored the impact of moral injury, which is particularly germane given the relevance of this concept arising from the occupational exposure to morally injurious events inherent to human rights work. Method: To address this deficit, we first conducted an exploratory factor analysis on a set of questions about moral injury that had previously been administered to a sample of human rights advocates. Based on this analysis, we modified and reduced these items and identified two constituent subscales. Next, we collected data on a new sample to replicate the factor structure of the reduced scale and to validate the subscales. Finally, we examined the relationship between the two subscales of the reduced moral injury scale and related concepts including posttraumatic stress disorder (PTSD), self-efficacy, and perfectionism in the original sample of human rights advocates. Results: As predicted, moral injury was associated with PTSD symptom severity and, independently, with self-efficacy and perfectionism. Conclusions: The findings add to a growing body of research demonstrating the application of moral injury to civilian populations, particularly those systematically exposed to PMIEs who engage in work to address injustice and violence.