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28-10-2020 | Original Article | Uitgave 3/2021

Cognitive Therapy and Research 3/2021

The Impact of Moral-Based Appraisals on Psychological Outcomes in Response to Analogue Trauma: An Experimental Paradigm of Moral Injury

Cognitive Therapy and Research > Uitgave 3/2021
Joel Hoffman, Angela Nickerson
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The online version of this article (https://​doi.​org/​10.​1007/​s10608-020-10172-7) contains supplementary material, which is available to authorized users.

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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.


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 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.


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.

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