Veterans Elevation Response Study (VERS)

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VERS: Veterans Elevation Response Study

Purpose: The purpose of this study is to investigate how veterans suffering from PTSD symptoms and possible moral injury respond to elevation stimuli in a controlled laboratory setting. Specifically, this study aims to identify the unique effects of experiencing moral elevation in this population across various domains including emotional (e.g., shame, guilt), cognitive (e.g., trauma-related beliefs), biological (e.g., cortisol), and physiological (e.g., HRV) responses.

Background: Moral elevation can be considered antithetical to PTSD and moral injury. Elevation is triggered after witnessing a virtuous act (e.g., courage, generosity, etc.) and leads one to feel inspired and uplifted, whereas moral injury is triggered by witnessing an immoral act and along with PTSD, results in strong negative beliefs about the world (e.g., “no one can be trusted”) or about oneself (e.g., feelings of self-disgust). Additionally, moral elevation is linked with social affiliation urges and a desire to become a better person, whereas PTSD symptoms and moral injury are associated with avoiding people or places that are reminders of a traumatic event and increased isolation.

Past work has demonstrated that viewing moral elevation videos elicits higher daily moral elevation, which was associated with desirable outcomes related to mental health such as greater positive affect, social affiliation, and compassionate goals. Other experimental studies found participants demonstrated more prosocial behavior and increased HRV after viewing similar moral elevation videos. However, these studies are limited because they are based on non-clinical samples. One study examined a clinical population and found moral elevation predicted lower daily symptoms of anxiety, dysphoria, and hostility in anxious and depressed patients. The potential role of moral elevation in those suffering from PTSD symptoms and moral injury distress is largely unknown, despite theoretical links. To date, only one pilot study has found preliminary results that indicate moral elevation is negatively correlated with PTSD symptoms and moral injury. However, that study relied upon observational data and self-report measures with no controlled manipulation to test whether this clinical population experiences moral elevation in response to known triggers. Therefore, to better understand the role of moral elevation in the context of trauma-related distress, and subsequently identify potential treatment implications, further research is needed.

This pilot study will be the first known experimental study to test whether moral elevation can be elicited in Veterans with PTSD and moral injury. By comparing responses to moral elevation versus amusement, this study will demonstrate whether this clinical population reports the unique physiological, emotional, and cognitive benefits uniquely associated with moral elevation (versus responses associated with general positive affect, as elicited by amusement videos).

Furthermore, this study will measure responses to moral elevation that are directly related to the conceptualization of PTSD and moral injury, such as changes to maladaptive trauma-related beliefs. Overall, results could highlight specific mechanisms through which moral elevation impacts PTSD and moral injury, and expand our understanding of how it can be best utilized in conjunction with existing treatments to alleviate trauma-related distress.

Adam P. McGuire
Adam P. McGuire
Assistant Professor of Psychology