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.

参与犯罪行为而被认定不负刑事责任 (NCR) 的个人在重新了解其行为的后果后，可能更容易遭受道德痛苦，在极端情况下，还会遭受道德伤害。然而，几乎没有研究描述这一人群中道德痛苦的性质、严重程度或影响。对 9 名法医精神病患者和 21 名护理人员进行了半结构化访谈。使用主题分析来探索叙事。研究结果表明，NCR 患者认可与道德伤害一致的症状，包括对受害者的内疚感、对自己的行为感到羞耻以及对自己的道德失去信任。精神痛苦是行为的强大驱动力，必须将其理解为影响犯罪、风险和康复的一系列因素的一部分。未来的研究必须开发足够的工具来衡量和描述与犯罪相关的道德伤害，以了解其对这一人群的影响。