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This study aimed to identify associations between moral injury on mental and behavioural health. Literature searches of psychological and medical databases were conducted through April 2020. Eligible studies measured moral injury or PMIEs, and health outcomes (e.g., depression, substance use and suicidality). Fifty\u2010seven publications representing 49 separate samples were included. Studies examined the impact of moral injury on post\u2010traumatic stress disorder (PTSD) (<jats:italic>n<\/jats:italic>\u2009=\u200943); depression (<jats:italic>n<\/jats:italic>\u2009=\u200932); anxiety (<jats:italic>n<\/jats:italic>\u2009=\u200915); suicide (<jats:italic>n<\/jats:italic>\u2009=\u200915); substance use (<jats:italic>n<\/jats:italic>\u2009=\u200914); and \u2018other\u2019 health outcomes, including pain, burnout, sleep disturbance and treatment\u2010seeking behaviours (<jats:italic>n<\/jats:italic>\u2009=\u200911). The majority of studies found significant positive associations between moral injury\u2010related constructs, mental health and behavioural health outcomes; however, the majority were also cross\u2010sectional and focused on military samples. Proposed mediators included lack of social support, negative cognitions and meaning\u2010making. Moderators included self\u2010compassion, pre\u2010deployment mental health education and mindfulness. Moral injury is associated with a variety of negative health outcomes. Research is needed to determine the mechanisms by which moral injury may influence these outcomes over time.<\/jats:p>","DOI":"10.1002\/cpp.2607","type":"journal-article","created":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T05:47:31Z","timestamp":1619848051000},"page":"92-110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":154,"title":["Moral injury, mental health and behavioural health outcomes: A systematic review of the literature"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7606-4666","authenticated-orcid":false,"given":"Nicole A.","family":"Hall","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Missouri  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam T.","family":"Everson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Missouri  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison R.","family":"Billingsley","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Missouri  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Beth","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Missouri  Columbia Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usy148"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(18)30622-6"},{"key":"e_1_2_9_5_1","unstructured":"2001 World Health Organization Geneva Switzerland T. 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