Abstract
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 = .019, Δf 2 = 0.25), negative view of others (β = -0.34, SE = 0.16, p = .044, Δf 2 = 0.20), and a large effect for changes in negative view of self (β = -0.31, SE = 0.13, p = .019, Δf 2 = 0.54). These findings suggest elevation may be well-suited to target trauma-related symptoms and future research should further examine its clinical utility.
Highlights
For United States veterans, post-traumatic stress disorder (PTSD) is a common consequence following exposure to a traumatic event that is associated with distress, impaired functioning and increased healthcare utilization [1–3]
Higher elevation following the two elevationinducing videos and reflection exercise was a significant predictor of residual change or decrease in state shame (β = −0.40, SE = 0.19, p = 0.038) from before the elevation videos, above and beyond the effects of positive affect experienced in response to the videos
The addition of state elevation resulted in a medium-sized contribution to the guilt model ( f 2 = 0.18), but the 95% confidence intervals (CI) included zero (−0.03, 0.52)
Summary
For United States veterans, post-traumatic stress disorder (PTSD) is a common consequence following exposure to a traumatic event that is associated with distress, impaired functioning and increased healthcare utilization [1–3]. Symptoms of PTSD can involve distressing memories, strong negative beliefs, avoidance behaviors, higher physiological reactivity, and feelings of anger, guilt, or shame [4]. Veterans often experience severe symptomology and poor prognoses [6], highlighting the need to study and identify new avenues to enhance treatment. The purpose of this experimental study is to examine the role of moral elevation, a positive psychology construct, in the context of experiencing trauma-related cognitions and emotions among a sample of veterans with PTSD symptoms.
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