What does the term 'moral injury' mean and what are the causes and consequences of it for investigators of online child exploitation?

Law enforcement professionals who investigate online child exploitation can be continually exposed to traumatising visual images in their jobs for significant periods – this puts them at risk of moral injury, PTSD, anxiety, depression and secondary trauma. While the latter terms are familiar to policymakers and professionals who work in this area, moral injury is a term that is less well known. This guide explains what is currently understood by the term moral injury and the causes and consequences of it for police investigators who work in this area. It is likely to be of interest to practitioners who investigate online child exploitation, as well as other professionals who support them. It also has relevance to those who may encounter traumatising imagery in other contexts.

What is moral injury?

The term emerged from clinical work with US military veterans and is defined by Nash and colleagues (2010) as “changes in biological, psychological, social, or spiritual functioning resulting from witnessing or perpetrating acts or failures to act that transgress deeply held, communally shared moral beliefs and expectations”.

Examples from the military include the accidental killing, or the witnessing of deliberate killing, of civilians or friendly forces through poor communication, intelligence, or decision-making.

Moral injury can result in significant psychological distress. Symptoms of moral injury include guilt, frustration, depression, self-harm, shame, loss of spirituality/religiosity, or a sense of rejection.

Moral injury can result in significant psychological distress.

Experiencing a trauma itself does not inevitably result in moral injury. Of importance is how individuals interpret the event and whether it generates significant dissonance with their moral framework, their worldview, and their actions.

Diagram to show how moral injury may develop in ICAT investigators

If dissonance exists, this can negatively affect how they feel about themselves leading to self-condemnation and in some cases, a complete loss of agency.

In police child exploitation investigations, officers are primarily assigned to watch footage of children who have been victimised, which challenges the foundations of their moral framework.

Literature suggests that common symptoms of moral injury in this population include intrusive thoughts, intense negative appraisal, and emotional distress (guilt, shame, disgust) such that individuals avoid cues that serve as reminders of the traumatic experience; a coping strategy known as cognitive avoidance.

common symptoms of moral injury include intrusive thoughts, intense negative appraisal, and emotional distress

Intrusions in the form of nightmares can happen, triggering renewed suffering and further avoidance of memories relating to the original trauma. Further damage can occur when feelings of safety, control, trust, and self-esteem become distorted.

How is it different from PTSD?

Moral injury shares similar elements with PTSD. In both, individuals use cognitive and behavioural avoidance strategies to achieve emotional suppression as a way of coping.

Moral injury is not predicated on a fear stimulus, but on thoughts and feelings such as guilt and shame. While PTSD begins with an event that is often life-threatening or harmful to self or others, moral injury results as a cognitive response to such stimuli, depending on how they are processed in line with moral values.

Additionally, moral injuries differ from PTSD traumas as they are more strongly associated with emotions that develop after the event rather than the emotions that are experienced during it.

A venn diagram showing how Moral Injury is different from PTSD


The research suggests that in some cases the personal and professional identity of child exploitation investigators can be destabilised because of their role, leaving them unable to reconcile their experiences with their existing belief systems, which can trigger substantial distress and symptoms of moral injury.

Equal attention should be paid to recognising the possibility of developing moral injury alongside other better-understood traumatic responses, such as PTSD.