Bringing Light into the Dark: Moral Injury and Exploring the Impact of Eliciting Moral Elevation on the Daily Experiences of U.S. Veterans.

Abstract

Moral elevation is described as feeling inspired after witnessing someone engage in virtuous behavior, whereas moral injury is the result of internal conflict that stems from exposure to morally injurious experiences. Building on previous work that used moral elevation to benefit veterans, this study explored the relationship between eliciting elevation, daily motives, and affective experiences for veterans with moral injury-related distress. Using an ABA experimental design, veterans (final n = 22) first completed 4 daily surveys that only included brief daily measures (A), followed by 4 days of measures combined with a daily elevation-eliciting exercise (B), then 4 daily surveys with measures only again (A). On days 5-8, elevation was elicited by presenting short video clips featuring moral exemplars performing virtuous acts, consistent with previous work. Using linear mixed effects models, we assessed the concurrent effects of state elevation on daily experiences during days with elevation elicitation. We also fit linear mixed effects models to compare pre-post changes in daily experiences before and after days 5-8 of watching elevation videos. Results indicated state elevation after videos was linked with higher daily positive affect, self-improvement motives, and compassionate motives. Veterans also reported a significant decrease in daily negative affect, fear, hostility, guilt, and sadness, along with significant decreases in suicidal ideation in the four days after watching elevation videos compared to baseline. These findings provide preliminary support for the potential benefits of eliciting elevation in veterans with moral injury distress and suggest elevation elicitation could be associated with desirable outcomes in daily life.