“Trapped in their Shame”: A Qualitative Investigation of Moral Injury in Forensic Psychiatry Patients

Individuals who engage in criminal behavior for which they are found not criminally responsible (NCR) may be at increased vulnerability to experience moral pain and, in extreme circumstances, moral injury after regaining insight into the consequences of their behavior. Yet, almost no research exists characterizing the nature, severity, or impact of moral pain in this population. Semi-structured interviews were conducted with nine forensic psychiatric patients and 21 of their care providers. Narratives were explored using thematic analysis. Findings demonstrate that NCR patients endorse symptoms consistent with moral injury, including feelings of guilt toward victims, shame for one’s behavior, and a loss of trust in one’s morality. Moral pain is a strong driver of behavior and must be understood as part of a constellation of factors influencing criminality, risk, and recovery. Future research must develop adequate tools to measure and characterize offense-related moral injury to understand its impact on this population

Leisure Activities and Motivational Profiles in Adaptation to Nursing Homes

International audienceBased on self-determination theory, this study examined the relationship between leisure activities, motivation, and adjustment to institutional living by older adults who live in nursing homes. We hypothesized that motivational profiles with higher levels of self-determined motivation represent the optimal profiles regarding participation in leisure activities, adaptation to nursing home living, and satisfaction with life. Participants completed questionnaires assessing motivation, leisure activity participation, life satisfaction, and adjustment to the nursing home. Results showed a relationship between the latter three factors. A latent profile analysis based on the different forms of motivation indicated four distinct profiles. Although no differences were found between the high self-determined profile (high self-determined motivation and low non-self-determined motivation) and the additive profile (high self-determined motivation and non- self-determined motivation), participants with a moderate profile and a low self-determined profile reported the lowest levels in leisure activity participation, adjustment to the nursing home, and satisfaction with life.Cette recherche étudie les liens entre motivation, participation aux activités de loisirs et adaptation de personnes âgées au centre d’hébergement dans lequel elles vivent. En accord avec la théorie de l’autodétermination, nous avons testé l’hypothèse que les profils les plus autodéterminés présenteront la meilleure adaptation, la plus grande participation aux activités de loisirs at la meilleure satisfaction de vie. Les participants ont rempli des questionnaires évaluant la motivation, la participation aux activités de loisirs ainsi que l’adaptation au centre d’hébergement. Une analyse des profils latents révèle que les profils hautement autodéterminés (score élevé de motivation autodéterminée et faible score de motivation non-autodéterminée) et les profils additifs (motivation autodéterminée et non autodéterminée élevées) ne diffèrent pas significativement alors que les participants aux profils modérés et aux profils faiblement autodéterminés présentent les scores les plus bas d’adaptation au centre d’hébergement, de participation aux activités de loisirs et de satisfaction de vie