Sentenced to Shame: Moral Injury Exposure in Former Lifers

Objective: A significant increase in the release of individuals who served life sentences (i.e., lifers) in California has created the opportunity to study aspects of their psychological wellness for the first time. Moral injury may be a particularly relevant factor to consider in this population but has not been previously studied. This study is the first to explore the concept of moral injury within a currently or formerly incarcerated population. Method: Former lifers currently in reentry in California (N = 41) completed a survey that measured their moral injury exposure (MIE), MIE-related guilt, MIE-related shame, MIE-related rumination, religiosity, attempts at making amends, and flourishing. Results: As expected, a high rate of lifetime MIEs was endorsed (97.6%). Events linked to life sentence crimes (75.6%) and time in prison (56.1%) were very common. Lower levels of MIE-related shame (r = −.58, p < .01) and higher levels of religiosity (r = .35, p < .05) were significantly associated with greater flourishing. By contrast, degree of MIE exposure, MIE-related guilt, and MIE-related rumination, and making amends were all weakly associated with flourishing. Conclusion: Our results highlight that MIE is pervasive in this population and extends beyond life sentence crimes. Moreover, our findings suggest that it is lifers' self-concept following MIEs that appears to affect well-being upon release, rather than the extent and nature of moral injury exposure. Further research exploring moral injury in incarcerated and formerly incarcerated populations is needed to improve their well-being and chances of successful reentry. Clinical Impact Statement This study is the first to explore the concept of moral injury within a currently or formerly incarcerated population. The study suggests that the incarcerated experience high levels of moral injury exposure and that shame related to moral injury exposure may affect a person's ability to succeed postrelease. The high likelihood of moral injury exposure should be considered in treatment plans and goals for patients who have experienced long-term incarceration.