Date of Award

Spring 2023

Degree Type


Director of Thesis

Dr. George Khushf

First Reader

Dr. Yi Sun

Second Reader

Dr. Yi Sun


Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to feelings of shame and guilt that prevent a veteran from seeking proper healthcare services and social support. As such, novel therapies are being developed to address aspects of self-forgiveness that are vital for moral repair. Moreover, algorithmic development with respect to moral injury is a double-edged sword, as generalization of data using proxies for symptoms of PTSD from the EHR can omit important aspects of moral injury, but at the same time algorithms can reveal new correlations between data that can help to better understand moral injury and its relationship to PTSD. Addressing the use of proxies in algorithm development by creating an Algorithmic Review Board (ARB) and better understanding moral injury from a societal and community point of view by analyzing moral injury in the civilian population and post-deployment could lead to a new model for moral injury and PTSD that will inform care and improve treatment outcomes.

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© 2023, Amanda Julia Manea