APA recognises moral injury
Moral injury has officially been recognised by the American Psychiatric Association (APA). Moral injury is a form of biopsychosocial-spiritual harm incurred from committing, witnessing, or being subject to actions that violate one’s moral code.
This recognition comes after years of global research and advocacy to acknowledge the condition – particularly by La Trobe University’s Associate Professor Lindsay Carey, CSM.
The APA included “moral problem” in the newest 2025 text revision update of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) as part of its Supplementary Codes defining moral problems: “to include experiences that disrupt one’s understanding of right and wrong, or sense of goodness of oneself, others or institutions”. The DSM handbook is used to classify and diagnose mental health conditions used by US and other mental health care providers around the world. The DSM-5-TR update notes a spectrum of moral problems consisting of ‘moral dilemma’, ‘moral distress’ and the more enduring effect of ‘moral injury’.
Carey was one of the lead researchers and authors along with academics from Harvard University and Duke University who worked in collaboration with the APA DSM clinical committee to ensure that moral injury was incorporated into the DSM.
He has a career history of quietly collaborating and developing resources and training towards suicide prevention among veterans and seeking acknowledgment that many veterans are not just affected by PTSD but also impacted by moral injury.
In 2019 he was awarded the Weary Dunlop Award by the Australasian Military Medicine Association (AMMA) for his collaborative research into moral injury. In 2024 he received the Conspicuous Service Medal in the Military Division for devotion to duty in moral injury research and the development of resources and training to support Australian Defence Force personnel.
Published October 2025