TY - JOUR
T1 - The longitudinal association between moral injury appraisals and psychological outcomes in refugees
AU - Nickerson, Angela
AU - Byrow, Yulisha
AU - Hoffman, Joel
AU - O'Donnell, Meaghan
AU - Bryant, Richard A.
AU - Mastrogiovanni, Natalie
AU - McMahon, Tadgh
AU - Benson, Greg
AU - Mau, Vicki
AU - Liddell, Belinda J.
PY - 2022/9
Y1 - 2022/9
N2 - Background: Refugees report a diverse array of psychological responses following persecution and displacement. Little is known, however, regarding the mechanisms that underlie differential psychological reactions in refugees. This study investigated the longitudinal impact of negative moral appraisals about one's own actions [i.e. moral injury-self (MI-self) appraisals] and others' actions [i.e. moral injury-other (MI-others) appraisals] on a variety of psychological symptoms over a period of 6 months. Methods: Participants were 1085 Arabic, Farsi, Tamil, or English-speaking refugees who completed a survey at baseline and 6 months later either on-line or via pen-and-paper. The survey indexed demographic factors, exposure to potentially traumatic events (PTEs), exposure to ongoing stressors, MI-other appraisals, MI-self appraisals, re-experiencing and arousal symptoms, and feelings of sadness, anger and shame. Results: Findings indicated that, after controlling for demographics, PTE exposure and ongoing stressors, MI-other appraisals predicted increased re-experiencing and hyperarousal symptoms, and feelings of sadness and shame. MI-self appraisals predicted decreased feelings of shame, and decreased re-experiencing symptoms. In contrast, psychological symptoms at baseline did not as strongly influence MI appraisals 6 months later. Conclusions: These findings highlight the important role that cognitive appraisals of adverse events play in the longitudinal course of psychological symptoms. These results thus have important implications for the development of tailored psychological interventions to alleviate the mental health burden held by refugees.
AB - Background: Refugees report a diverse array of psychological responses following persecution and displacement. Little is known, however, regarding the mechanisms that underlie differential psychological reactions in refugees. This study investigated the longitudinal impact of negative moral appraisals about one's own actions [i.e. moral injury-self (MI-self) appraisals] and others' actions [i.e. moral injury-other (MI-others) appraisals] on a variety of psychological symptoms over a period of 6 months. Methods: Participants were 1085 Arabic, Farsi, Tamil, or English-speaking refugees who completed a survey at baseline and 6 months later either on-line or via pen-and-paper. The survey indexed demographic factors, exposure to potentially traumatic events (PTEs), exposure to ongoing stressors, MI-other appraisals, MI-self appraisals, re-experiencing and arousal symptoms, and feelings of sadness, anger and shame. Results: Findings indicated that, after controlling for demographics, PTE exposure and ongoing stressors, MI-other appraisals predicted increased re-experiencing and hyperarousal symptoms, and feelings of sadness and shame. MI-self appraisals predicted decreased feelings of shame, and decreased re-experiencing symptoms. In contrast, psychological symptoms at baseline did not as strongly influence MI appraisals 6 months later. Conclusions: These findings highlight the important role that cognitive appraisals of adverse events play in the longitudinal course of psychological symptoms. These results thus have important implications for the development of tailored psychological interventions to alleviate the mental health burden held by refugees.
KW - anger
KW - depression
KW - moral injury
KW - posttraumatic stress
KW - refugees
UR - http://www.scopus.com/inward/record.url?scp=85097191379&partnerID=8YFLogxK
U2 - 10.1017/S0033291720004262
DO - 10.1017/S0033291720004262
M3 - Article
C2 - 33261693
AN - SCOPUS:85097191379
SN - 0033-2917
VL - 52
SP - 2352
EP - 2364
JO - Psychological Medicine
JF - Psychological Medicine
IS - 12
ER -