Identity in turmoil: Investigating the morally injurious dimensions of minority stress
Background: Sexual and gender minorities (SGMs) are at an increased risk for developing mental health disorders due to their socially stigmatized identities. Minority stress (i.e. discrimination, identity nondisclosure, internalized stigma) has been shown to impact mental health outcomes among SGMs....
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | European Journal of Psychotraumatology |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/20008066.2025.2479396 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850114019044622336 |
|---|---|
| author | Andrew A. Nicholson Sandhya Narikuzhy Jakub Wolf Mina Pichtikova Magdalena Siegel James Mirabelli Taylor Hatchard Niki Hosseini-Kamkar Ella Bawagan Sophia L. Roth Christina Mutschler Ruth A. Lanius Fardous Hosseiny Kristen Eckstrand Brigitte Lueger-Schuster |
| author_facet | Andrew A. Nicholson Sandhya Narikuzhy Jakub Wolf Mina Pichtikova Magdalena Siegel James Mirabelli Taylor Hatchard Niki Hosseini-Kamkar Ella Bawagan Sophia L. Roth Christina Mutschler Ruth A. Lanius Fardous Hosseiny Kristen Eckstrand Brigitte Lueger-Schuster |
| author_sort | Andrew A. Nicholson |
| collection | DOAJ |
| description | Background: Sexual and gender minorities (SGMs) are at an increased risk for developing mental health disorders due to their socially stigmatized identities. Minority stress (i.e. discrimination, identity nondisclosure, internalized stigma) has been shown to impact mental health outcomes among SGMs. Both distal and proximal minority stressors may serve as potentially morally injurious events (PMIEs), which may lead to moral injury and trauma/stressor-related symptoms. Critically, minority stress-related moral injury among SGMs has never before been explored using a mixed-methods approach.Methods: Thirty-seven SGM participants with diverse minority identities participated in the study. Using a convergent parallel mixed-methods design, we conducted semi-structured qualitative interviews, performed clinical assessments, and administered a comprehensive battery of quantitative measures. Here, we modified the Moral Injury Event Scale (MIES) for use with SGMs. Qualitative themes were extracted and then converged with MIES scores to investigate differential thematic presentations based on the quantitative intensity of SGM-related PMIEs.Results: Data analysis indicated four core themes related to moral injury among SGMs: shame (internalizing stigma), guilt, betrayal/loss of trust, and attachment injuries (rejection, altered sense-of-self, and social cognition). The qualitative presentation of these themes differed depending on MIES severity. Attachment injuries emerged as a unique core feature of moral injury among SGMs, whereby the remaining core themes align with previous moral injury research. Furthermore, quantitative analyses revealed that the level of exposure to and intensity of minority stress-related PMIEs was positively associated with hazardous alcohol use and trauma-related symptoms.Conclusions: This is the first mixed-methods study to investigate minority stressors as PMIEs, highlighting how these experiences may contribute to symptoms of moral injury among SGMs. Moral injury may serve as a valuable framework for better understanding trauma-related symptoms and mental health disparities among SGMs. These findings have the potential to inform novel treatment interventions aimed at addressing mental health burdens among SGMs. |
| format | Article |
| id | doaj-art-8dda2f7d066d461e913a3494a2faa1bc |
| institution | OA Journals |
| issn | 2000-8066 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj-art-8dda2f7d066d461e913a3494a2faa1bc2025-08-20T02:36:59ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662025-12-0116110.1080/20008066.2025.2479396Identity in turmoil: Investigating the morally injurious dimensions of minority stressAndrew A. Nicholson0Sandhya Narikuzhy1Jakub Wolf2Mina Pichtikova3Magdalena Siegel4James Mirabelli5Taylor Hatchard6Niki Hosseini-Kamkar7Ella Bawagan8Sophia L. Roth9Christina Mutschler10Ruth A. Lanius11Fardous Hosseiny12Kristen Eckstrand13Brigitte Lueger-Schuster14School of Psychology, University of Ottawa, Ottawa, ON, CanadaAtlas Institute for Veterans and Families, Ottawa, ON, CanadaDepartment of Clinical and Health Psychology, University of Vienna, Vienna, AustriaDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, CanadaDepartment of Clinical and Health Psychology, University of Vienna, Vienna, AustriaDepartment of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, CanadaDepartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, CanadaAtlas Institute for Veterans and Families, Ottawa, ON, CanadaAtlas Institute for Veterans and Families, Ottawa, ON, CanadaHealth and Wellness, University of Toronto, Toronto, ON, CanadaSchool of Psychology, University of Ottawa, Ottawa, ON, CanadaDepartment of Psychiatry, Western University, London, ON, CanadaAtlas Institute for Veterans and Families, Ottawa, ON, CanadaDepartment of Psychiatry, University of Pittsburgh, Pittsburgh, PN, USADepartment of Clinical and Health Psychology, University of Vienna, Vienna, AustriaBackground: Sexual and gender minorities (SGMs) are at an increased risk for developing mental health disorders due to their socially stigmatized identities. Minority stress (i.e. discrimination, identity nondisclosure, internalized stigma) has been shown to impact mental health outcomes among SGMs. Both distal and proximal minority stressors may serve as potentially morally injurious events (PMIEs), which may lead to moral injury and trauma/stressor-related symptoms. Critically, minority stress-related moral injury among SGMs has never before been explored using a mixed-methods approach.Methods: Thirty-seven SGM participants with diverse minority identities participated in the study. Using a convergent parallel mixed-methods design, we conducted semi-structured qualitative interviews, performed clinical assessments, and administered a comprehensive battery of quantitative measures. Here, we modified the Moral Injury Event Scale (MIES) for use with SGMs. Qualitative themes were extracted and then converged with MIES scores to investigate differential thematic presentations based on the quantitative intensity of SGM-related PMIEs.Results: Data analysis indicated four core themes related to moral injury among SGMs: shame (internalizing stigma), guilt, betrayal/loss of trust, and attachment injuries (rejection, altered sense-of-self, and social cognition). The qualitative presentation of these themes differed depending on MIES severity. Attachment injuries emerged as a unique core feature of moral injury among SGMs, whereby the remaining core themes align with previous moral injury research. Furthermore, quantitative analyses revealed that the level of exposure to and intensity of minority stress-related PMIEs was positively associated with hazardous alcohol use and trauma-related symptoms.Conclusions: This is the first mixed-methods study to investigate minority stressors as PMIEs, highlighting how these experiences may contribute to symptoms of moral injury among SGMs. Moral injury may serve as a valuable framework for better understanding trauma-related symptoms and mental health disparities among SGMs. These findings have the potential to inform novel treatment interventions aimed at addressing mental health burdens among SGMs.https://www.tandfonline.com/doi/10.1080/20008066.2025.2479396Minority stressmoral injurysexual minoritiesgender minoritiesguiltshame |
| spellingShingle | Andrew A. Nicholson Sandhya Narikuzhy Jakub Wolf Mina Pichtikova Magdalena Siegel James Mirabelli Taylor Hatchard Niki Hosseini-Kamkar Ella Bawagan Sophia L. Roth Christina Mutschler Ruth A. Lanius Fardous Hosseiny Kristen Eckstrand Brigitte Lueger-Schuster Identity in turmoil: Investigating the morally injurious dimensions of minority stress European Journal of Psychotraumatology Minority stress moral injury sexual minorities gender minorities guilt shame |
| title | Identity in turmoil: Investigating the morally injurious dimensions of minority stress |
| title_full | Identity in turmoil: Investigating the morally injurious dimensions of minority stress |
| title_fullStr | Identity in turmoil: Investigating the morally injurious dimensions of minority stress |
| title_full_unstemmed | Identity in turmoil: Investigating the morally injurious dimensions of minority stress |
| title_short | Identity in turmoil: Investigating the morally injurious dimensions of minority stress |
| title_sort | identity in turmoil investigating the morally injurious dimensions of minority stress |
| topic | Minority stress moral injury sexual minorities gender minorities guilt shame |
| url | https://www.tandfonline.com/doi/10.1080/20008066.2025.2479396 |
| work_keys_str_mv | AT andrewanicholson identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT sandhyanarikuzhy identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT jakubwolf identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT minapichtikova identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT magdalenasiegel identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT jamesmirabelli identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT taylorhatchard identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT nikihosseinikamkar identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT ellabawagan identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT sophialroth identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT christinamutschler identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT ruthalanius identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT fardoushosseiny identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT kristeneckstrand identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress AT brigitteluegerschuster identityinturmoilinvestigatingthemorallyinjuriousdimensionsofminoritystress |