Inducing moral elevation in veterans with PTSD: An experimental investigation using a mixed methods approach

McGuire, Adam P.; Mignogna, Joseph

doi:10.1177/2043808720982415

Cited by 16 publications

(22 citation statements)

References 31 publications

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“…This decision was based on two considerations. First, results from quantitative and qualitative analyses of data from Study 1 indicated the elevation videos elicited a distinct response from positive affect or general amusement that was consistent with the theory of elevation (22); thus, establishing that the same videos used in this study elicit the desired state elevation response within this population. Second, there are significant resource constraints to collecting data for an in-person, experimental study that requires a veteran sample with elevated PTSD symptom severity; thus, a within-person design without a control condition increased feasibility of completing data collection and increased power for the present set of analyses.…”

Section: Participants and Proceduressupporting

confidence: 59%

“…In this pilot study, weekly measures of elevation in response to the acts of fellow group members was associated with greater weekly engagement in the group treatment and lower avoidance symptoms at post-treatment. Notably, results from the initial version of the current experimental study (Study 1) demonstrated that veterans who reported elevated levels of PTSD symptoms can indeed experience elevation in response to portrayals of virtuous behavior (22). In Study 1, veterans reported higher elevation after they watched videos intended to induce elevation compared to a control group that was presented with videos intended to induce general positive affect and amusement.…”

Section: Elevation and Ptsdmentioning

confidence: 74%

“…The purpose of this study is to investigate the specific effects of eliciting elevation in veterans with significant PTSD symptoms on trauma-related cognitions and emotions following a trauma reminder-expanding on preliminary findings from the initial experiment (Study 1) that demonstrated veterans with PTSD symptoms have the capacity to experience elevation (22). Based on existing research, it was hypothesized that negative emotions (shame and guilt) and negative cognitions about the self, others, and self-blame would reduce over time following a trauma reminder task.…”

Section: Current Studymentioning

confidence: 99%

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Changes in Trauma-Related Cognitions and Emotions After Eliciting Moral Elevation: Examining the Effects of Viewing Others' Virtuous Behavior on Veterans With PTSD

et al. 2022

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Moral elevation is described as feeling inspired after witnessing someone perform a virtuous act. Past work suggests the features of moral elevation may be contrary to PTSD, yet few studies have directly tested its impact on relevant symptoms. This experimental study assessed changes in trauma-related cognitions and emotions from after a trauma reminder task to after an elevation induction exercise. We hypothesized that higher elevation after the induction exercise would be associated with greater reductions in cognitions and emotions. Veterans with probable PTSD (N = 38) completed measures of trauma-related cognitions and emotions, once after a written trauma narrative exercise (T1) and again after watching two videos designed to elicit elevation (T2). Veterans also completed measures of state elevation after each video. Results suggest veterans experienced small, significant decreases in self-blame (d = 0.36) and negative beliefs about others (d = 0.46), and medium, significant decreases in guilt (d = 0.68), shame (d = 0.60), and negative beliefs about self (d = 0.69) between T1 and T2. As hypothesized, higher elevation was associated with significantly greater reductions in multiple outcomes above and beyond the effects of general positive affect. Specifically, there were medium effects for changes in shame (β = −0.42, SE = 0.17, p = 0.019, Δf2 = 0.25), negative view of others (β = −0.34, SE = 0.16, p = 0.044, Δf2 = 0.20), and a large effect for changes in negative view of self (β = −0.31, SE = 0.13, p = 0.019, Δf2 = 0.54). These findings suggest elevation may be well-suited to target trauma-related symptoms and future research should further examine its clinical utility.

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Section: Participants and Proceduressupporting

confidence: 59%

Section: Elevation and Ptsdmentioning

confidence: 74%

Section: Current Studymentioning

confidence: 99%

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Changes in Trauma-Related Cognitions and Emotions After Eliciting Moral Elevation: Examining the Effects of Viewing Others' Virtuous Behavior on Veterans With PTSD

et al. 2022

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“…This study is part of a larger study on the role of positive psychology constructs in the development and maintenance of PTSD; detailed information about the parent study is reported elsewhere (McGuire & Mignogna, 2021). Briefly, the parent study recruited veterans between the ages of 18–90 with subclinical or clinical PTSD symptoms (defined as a positive screen on a symptom checklist, as described below).…”

Section: Methodsmentioning

confidence: 99%

Resilience predicts posttraumatic cognitions after a trauma reminder task and subsequent positive emotion induction among veterans with PTSD.

Szabo¹,

Frankfurt²,

Kurz³

et al. 2022

Psychological Trauma: Theory, Research, Practice, and

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Objective: Posttraumatic stress disorder (PTSD) is a common problem for veterans. Resilience, the tendency to bounce back from difficult circumstances, is negatively associated with posttraumatic cognitions (PTCs) among individuals with a history of trauma, and it may be important to understand responses to trauma reminders. Method: Using a quasi-experimental design, we examined the association between trait resilience and state PTCs in veterans with PTSD (n = 47, M age = 48.60, 91.8% male) at two points: following a written trauma narrative exposure (Time 1 [T1]), and following a subsequent positive distraction task (i.e., brief, positive video; Time 2 [T2]). Results: After controlling for PTSD symptom severity and combat exposure, resilience was negatively associated with PTCs at T1 (DR 2 = .19) and T2 (DR 2 = .13). However, resilience was a poor predictor of change in PTCs from T1 to T2. We also examined the relationship between resilience and subtypes of PTCs: resilience was associated with negative views of the self (T1, DR 2 = .24) but not negative views of the world or self-blame (T1, DR 2 s # .07); these results were consistent at T2. Conclusions: Thus, resilience may attenuate negative trauma-related cognitions after trauma recall; however, this study was not designed to test causal pathways. Future research could examine whether resilience-building exercises reduce negative PTCs after trauma reminders among veterans. Additional research is needed to generalize to other trauma-exposed populations. Clinical Impact StatementPosttraumatic stress disorder (PTSD) is a highly prevalent and debilitating disorder for war veterans. This study uses a quasi-experimental design to help further understanding about how resilience is related to one proposed mechanism of PTSD-posttraumatic cognitions-in response to reminders of the trauma. Our findings suggest that resilience may buffer against negative trauma-related cognitions after trauma recall, though future research is needed to understand the long-term clinical utility.

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“…However, additional research is needed to further examine the experiences linked with inducing moral elevation in a controlled setting, which may lead to a better understanding of its potential therapeutic effects. This paper aims to extend findings from an experimental study where participants were presented with a trauma reminder and measured for momentary recovery of trauma-related symptoms (McGuire & Mignogna, 2021) by exploring the potential links between induced moral elevation and relevant outcomes among a series of case examples.…”

Section: Introductionmentioning

confidence: 99%

Biopsychosocial correlates and individual differences for eliciting moral elevation in veterans with PTSD: An experimental case series

McGuire¹,

Nguyen²,

Burns³

et al. 2022

Preprint

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Background and Objectives: A promising approach to incorporate positive psychology principles into trauma-focused treatment is moral elevation—feeling inspired by witnessing a virtuous act. This study aimed to explore potential links between inducing moral elevation and relevant outcomes in a series of case examples.Methods: Veterans with probable PTSD completed experimental tasks including a written trauma narrative exercise and watching videos designed to elicit elevation. Participants also completed baseline assessments, repeated measures of trauma-related cognitions, emotions, state elevation, and saliva sample collection. Four individual cases were identified and reviewed: two positive responders (high elevation scores after videos) and two nonresponders (restricted elevation response).Results: Positive responder cases shared a trajectory of decreased cognitions, emotions, and moral injury distress from after the trauma narrative exercise to after elevation exercises, whereas nonresponders reported minimal to no changes. Positive responders also demonstrated decreases in cortisol that continued to decline in a delay period, whereas nonresponders demonstrated increases in cortisol. Additional differences were identified regarding history of experiences and dispositional traits.Limitations: This case series analysis is limited to four participants and does not include a control condition, which limits causal claims. These findings also represent experiences in a controlled laboratory setting; thus, it is unclear if they generalize to daily life for veterans with PTSD.Conclusions: Future work is needed to expand our understanding of whether higher levels of state elevation contribute to changes in biopsychosocial outcomes, and to determine individual factors that indicate who might benefit from elevation-based interventions.

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Inducing moral elevation in veterans with PTSD: An experimental investigation using a mixed methods approach

Cited by 16 publications

References 31 publications

Changes in Trauma-Related Cognitions and Emotions After Eliciting Moral Elevation: Examining the Effects of Viewing Others' Virtuous Behavior on Veterans With PTSD

Changes in Trauma-Related Cognitions and Emotions After Eliciting Moral Elevation: Examining the Effects of Viewing Others' Virtuous Behavior on Veterans With PTSD

Resilience predicts posttraumatic cognitions after a trauma reminder task and subsequent positive emotion induction among veterans with PTSD.

Biopsychosocial correlates and individual differences for eliciting moral elevation in veterans with PTSD: An experimental case series

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