Study examining moral injury in health care workers is focusing on functional brain changes

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Researchers using MRI scans to pinpoint moral injury effects

By Celine Zadorsky

For many health care workers, the past year and a half of the COVID-19 pandemic has taken a toll on their mental health. Recognizing this is a growing concern, a London research team from Lawson Health Research Institute and Western University’s Schulich School of Medicine & Dentistry is examining moral injury amongst health care workers by imaging the effects on the brain.

“We are trying to look closely at what happens in the brain when a person recalls a moral injury event,” says Dr. Ruth Lanius, Associate Scientist at Lawson and Professor at Western’s Schulich School of Medicine & Dentistry. “By understanding the changes happening in the brain, we may be better able to treat individuals suffering from moral injury.”

Moral injury refers to an injury to an individual’s moral conscious which can produce profound emotional guilt and shame. During this ongoing pandemic, some health care workers have experienced emotionally difficult situations that resulted in moral injury.

“Those suffering from moral injury have a cognitive or thinking component which may include repeated thoughts that they didn’t provide the best care for example, or that they let their family down do to their intense work schedule or need to self-isolated,” explains Dr. Lanius, who is also a psychiatrist at London Health Sciences Centre (LHSC). ‘These thoughts are coupled with intense visceral distress, a gnawing sensation in the stomach or the feeling like one is being eaten up inside. I think once we help resolve the visceral distress, we will also see the negative thinking patterns settle down.”

The new study will involve around 60 health care workers. These research participants will undergo a functional MRI scan at the beginning of the study and have the option to receive eight weeks of treatment. Then, another MRI scan will be done to see if and how the moral injury changes and possibly resolves within the brain. “This can be very validating for the health care workers since brain scans can make the invisible wound of moral injury visible,” adds Dr. Lanius.

The research team’s goal is to better understand what networks of the brain are activated with moral injury. Dr. Lanius hopes this would help establish more neuroscientifically guided treatments. “We have to help our health care workers heal from the tremendous hardships they often endure.”

Health care workers are still being recruited for this study. Interested participants can contact Research Coordinator Suzy Southwell 519-685-8500 ext. 35186 or suzy.southwell@lhsc.on.ca.

Celine Zadorsky works in Communications & External Relations, Lawson Health Research Institute.