The Impact of Moral-Based Appraisals on Psychological Outcomes in Response to Analogue Trauma: An Experimental Paradigm
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ORIGINAL ARTICLE
The Impact of Moral‑Based Appraisals on Psychological Outcomes in Response to Analogue Trauma: An Experimental Paradigm of Moral Injury Joel Hoffman1 · Angela Nickerson1 Accepted: 20 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background There is evidence that negative appraisals about events violating moral expectations (i.e., moral injury) may contribute to psychological outcomes (i.e., non-fear reactions, intrusive memories, physiological responses). However, the causal impact of these appraisals is not well understood due to limited attempts to examine these relationships experimentally. Method Participants in this study were 123 undergraduate students from the University of New South Wales. Participants engaged in a mental imagery task by listening to an audio scenario of a motor vehicle accident, and then viewed negative emotional images related to the scenario. Participants were primed to focus on aspects of the scenario relating to: (1) moral violations enacted by the self (MI-Self), (2) moral violations enacted by others (MI-Others), or (3) non-moral factors contributing to the accident (No-MI). Results Results indicated that both moral-based appraisal groups had significantly lower physiological arousal, compared to the No-MI group. Additionally, participants with lower anxiety in the MI-Self group experienced more guilt, sadness and intrusions compared to the No-MI group. Those with high anxiety in the MI-Self group had fewer intrusions compared to the No-MI group. Conclusions Findings provide preliminary evidence for the role of moral appraisals in responses associated with moral injury, which may aide the development of current conceptualizations regarding moral injury-related responses. Cognitive models of posttraumatic stress disorder (PTSD) propose that the development and maintenance of psychological symptoms following a traumatic event are dependent on how the event is appraised (Ehlers and Clark 2000; Foa et al. 1989). This is supported by research showing associations between negative appraisals and PTSD symptoms (Beck et al. 2004; Bryant et al. 2007; Bryant and Guthrie 2005). Analogue trauma studies, using experimental methods such as the trauma film paradigm (i.e. viewing the aftermath of a motor vehicle accident), have been useful Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10608-020-10172-7) contains supplementary material, which is available to authorized users. * Joel Hoffman [email protected] Angela Nickerson [email protected] 1
School of Psychology, UNSW Australia, Sydney, NSW 2052, Australia
in elucidating the causal relationship between negative appraisals of stressful events and relevant post-traumatic outcomes such as emotions, physiological responses and intrusive memories (Hagenaars and Arntz 2012; Holmes and Bourne 2008; James et al. 2016). While these methods have been instrumental in increasing our understanding of fear-based responses to
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