The Impact of Moral-Injury Cognitions on Psychological Outcomes in Refugees: An Experimental Investigation

Abstract

Moral-injury cognitions (beliefs regarding moral violations) represent a potential mechanism that may underlie the association between potentially morally injurious events (PMIEs) and psychological symptoms in refugees. We implemented a novel experimental paradigm (i.e., the simulation of a PMIE using mental imagery) to investigate the impact of moral-injury cognitions on psychological outcomes in 71 Arabic-speaking refugees. A latent class analysis of preexisting moral-injury beliefs yielded three classes characterized by (a) high moral-injury beliefs about violations by others (49.3%), (b) high moral-injury beliefs about violations by others and by oneself (25.5%), and (c) low moral-injury beliefs (25.5%). Investigation of group differences revealed that the moral-injury classes reported greater negative emotional responses following the simulated PMIE. Furthermore, the association between moral-injury classes and psychological outcomes was moderated by situation-specific blame appraisals of the simulated PMIE. These findings have important implications for psychological interventions for refugees.