“Trapped in their Shame”: A Qualitative Investigation of Moral Injury in Forensic Psychiatry Patients

Individuals who engage in criminal behavior for which they are found not criminally responsible (NCR) may be at increased vulnerability to experience moral pain and, extreme circumstances, injury after regaining insight into the consequences of their behavior. Yet, almost no research exists characterizing nature, severity, or impact this population. Semi-structured interviews were conducted with nine forensic psychiatric patients and 21 care providers. Narratives explored using thematic analysis. Findings demonstrate that NCR endorse symptoms consistent injury, including feelings guilt toward victims, shame one’s behavior, a loss trust morality. Moral is strong driver must understood as part constellation factors influencing criminality, risk, recovery. Future develop adequate tools measure characterize offense-related understand its on