Potentially morally injurious events as a mediator of the association of gratitude and mindfulness with distress.

Abstract

Objective: Potentially morally injurious events (PMIEs) are events that contradict one’s own personal ethics and may promote a deep sense of violation, leading to psychological distress. Individuals with greater trait gratitude and mindfulness may be less likely to perceive events as being morally injurious and may, in turn, be less likely to experience subsequent distress. The current study seeks to examine (a) PMIE rates in a multioccupational first responder sample and (b) the indirect effect of trait gratitude and mindfulness on psychological distress via fewer perceived PMIEs. Method: 293 first responders from agencies/departments within southeastern Texas (in-person) and nationwide (online) completed a survey assessing PMIEs, PTSD symptoms (PCL-C), anxiety (GAD-7), depression (PHQ-8), gratitude (GRAT-S), and mindfulness (MAAS). Results: PMIEs were common (61% witnessed a transgression; 21% committed a transgression; 40% felt betrayed by others). Gratitude was indirectly associated with fewer PTSD [−.09, 95% CI (−.13, −.05)], anxiety [−.03, 95% CI (−.04, −.01)], and depression [−.03, 95% CI (−.05, −.01)] symptoms via lower PMIEs. Similarly, mindfulness was indirectly associated with fewer PTSD [−.92, 95% CI (−1.55, −.38)], anxiety [−.20, 95% CI (−.42, .02)], and depression [−.26, 95% CI (−.48, −.06)] symptoms via lower PMIEs. Conclusions: PMIEs were common in this first responder sample and associated with increased distress. Trait gratitude and mindfulness may protect first responders from perceiving events as morally injurious, which may lead to improved mental health.

Longitudinal associations between moral injury perceptions and mental health among healthcare workers during the pandemic.

“…This was reflected by both frequency and mean scores for the other-MIP and betrayal-MIP subscales versus the self-MIP subscale. Notably, our sample reported relatively comparable or higher other-MIPs and betrayal-MIPS compared to those reported by veteran and first responder samples (e.g., Senger et al, 2022;Wisco et al, 2017). This is perhaps unsurprising, given the highly tumultuous time period with ever-changing policies and equipment shortages.…”

The Internal Consistency of the Moral Injury Event Scale

“…Chaplo et al. (2019) (α = .70) differed from the average for Transgression-Self, as did Senger et al (2024) (α = .63) and Ogle et al (2018) (α = .66) for Transgression-Other. Haight et al (2017) reported wider confidence intervals for Betrayal (α = .69; 95% CI [.88–.93]), indicating higher intra-sample variability, perhaps reflecting a smaller sample size ( n = 32).…”

Associations of resilience and hope with mental and physical health among firefighters

“…The PTGI response options do not allow the rater to specify the nature of the change that has occurred for them as well as other important details such as how much change has occurred. Finally, future work should examine if these relationships still hold after accounting for known personality traits/risk factors such as neuroticism as well as investigating more prevalent mental health outcomes such as anxiety and depression (Meyer et al, 2019; Senger et al, 2022).…”

“…Furthermore, PTSD symptoms have a positive and bidirectional association with chronic pain (Brennstuhl et al, 2015). Despite these challenges, the majority of firefighters are resilient (Lee et al, 2014; Senger et al, 2022), and little research has focused on firefighter behavioral health, resilience, and well‐being. This work has great potential to inform resilience training and wellness programming in the fire service.…”