Courageous action as a potential protection from moral injury — ASN Events
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  3. Courageous action as a potential protection from moral injury

Courageous action as a potential protection from moral injury (#854)

Cindy LS Pury 1 , Rylee Bryant 1 , Jessica N Carroll 1 , Elizabeth A Crain 1 , Avery R Degennaro 1 , Aishah Khan 1 , Elsah E Napier 1 , Chloe C O'Brien 1 , Abigail L Rowell 1 , CJ Swartzwelter 1 , Mary I Thompson 1
  1. Clemson University, Clemson, SC, United States

Background

Does acting courageously protect us from moral injury? Negative psychological effects stemming from exposure to a violation of what’s right (Shay, 1995) have been linked in a variety of occupations to a variety of negative outcomes, including PTSD, depression, anxiety, and suicidality (Amsalem et al., 2021; Hall et al., 2022; Shay, 1995; Sugrue, 2020). Potentially morally injurious experiences (PMIEs; Drescher et al., 2011) lead to moral injury when there is dissonance between one’s actions during the event compared to the belief that one is a moral person (Litz et al., 2009). Courageous actions involve taking a worthwhile risk (Pury & Saylors, 2017), with the worth often representing a morally good goal (e.g., Lopez et al., 2003; Lord, 1918). 

Aims

We predict that participants describing a PMIE who tried to stop the event would rate those actions in a manner consistent with courage. Additionally, compared to participants who did not try to stop the event, those taking action would think about the PMIE it in a less negative and more positive way.

Method

We have preliminary results from 172 participants from a paid online sample. All participants were asked if they had ever experienced an event in an organization that violated their sense of right and wrong (a PMIE): 149 (87%) answered yes and were asked additional questions about the PMIE and any attempts they made to stop it. Responses to open-ended questions were analyzed using Linguistic Inquiry and Word Count (Boyd et al., 2022)

Results

Eighty two (55%) did something to try to stop the action or reduce the harm; 67 (45%) did not. Descriptions of actions taken to stop a PMIE are broadly consistent with the hallmarks of courageous action, and rating of courageousness correlates significantly with a more positive emotional tone when describing the PMIE.

Conclusion

Data collection is ongoing, but if our hypotheses are supported, we suggest that courageous resistance can mitigate the harm from PMIEs.

  1. Amsalem, D., Lazarov, A., Markowitz, J. C., Naiman, A., Smith, T. E., Dixon, L. B., & Neria, Y. (2021). Psychiatric symptoms and moral injury among us healthcare workers in the COVID-19 era. BMC Psychiatry, 21. https://doi.org/10.1186/s12888-021-03565-9
  2. Boyd, R., Ashokkumar, A., Seraj, S., & Pennebaker, J. (2022). The Development and Psychometric Properties of LIWC-22. https://doi.org/10.13140/RG.2.2.23890.43205
  3. Drescher, K. D., Foy, D. W., Kelly, C., Leshner, A., Schutz, K., & Litz, B. (2011). An exploration of the viability and usefulness of the construct of moral injury in war veterans. Traumatology, 17(1), 8-13. https://doi.org/10.1177/1534765610395615
  4. Hall, N. A., Everson, A. T., Billingsley, M. R., & Miller, M. B. (2022). Moral injury, mental health and behavioural health outcomes: A systematic review of the literature. Clinical Psychology & Psychotherapy, 29(1), 92-110. https://doi.org/https://doi.org/10.1002/cpp.2607
  5. Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009, Dec). Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev, 29(8), 695-706. https://doi.org/10.1016/j.cpr.2009.07.003
  6. Lopez, S. J., O'Byrne, K. K., & Petersen, S. (2003). Profiling courage. In S. J. Lopez & C. R. Snyder (Eds.), Positive psychological assessment: A handbook of models and measures. (pp. 185-197). American Psychological Association. https://doi.org/10.1037/10612-012
  7. Lord, H. G. (1918). The psychology of courage. John W. Luce.
  8. Pury, C. L. S., & Saylors, S. (2017). Courage, courageous acts, and positive psychology. In D. S. Dunn (Ed.), Positive Psychology: Established and Emerging Issues (pp. 153-168). Routledge.
  9. Shay, J. (1995). Achilles in Vietnam: Combat Trauma and the Undoing of Character. Simon & Schuster.
  10. Sugrue, E. P. (2020). Moral Injury Among Professionals in K–12 Education. American Educational Research Journal, 57(1), 43-68. https://doi.org/10.3102/0002831219848690
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