Biopsychosocial correlates and individual differences for inducing moral elevation in veterans with PTSD: An experimental case series


Background and Objectives: A promising approach to incorporate positive psychology principles into trauma-focused treatment is moral elevation—feeling inspired by witnessing a virtuous act. This study aimed to explore potential links between inducing moral elevation and relevant outcomes in a series of case examples. Methods: Veterans with probable PTSD completed experimental tasks including a written trauma narrative exercise and watching videos designed to elicit elevation. Participants also completed baseline assessments, repeated measures of trauma-related cognitions, emotions, state elevation, and saliva sample collection. Four individual cases were identified and reviewed: two positive responders (high elevation scores after videos) and two nonresponders (restricted elevation response). Results: Positive responder cases shared a trajectory of decreased cognitions, emotions, and moral injury distress from after the trauma narrative exercise to after elevation exercises, whereas nonresponders reported minimal to no changes. Positive responders also demonstrated decreases in cortisol that continued to decline in a delay period, whereas nonresponders demonstrated increases in cortisol. Additional differences were identified regarding history of experiences and dispositional traits. Limitations: This case series analysis is limited to four participants and does not include a control condition, which limits causal claims. These findings also represent experiences in a controlled laboratory setting; thus, it is unclear if they generalize to daily life for veterans with PTSD. Conclusions: Future work is needed to expand our understanding of whether higher levels of state elevation contribute to changes in biopsychosocial outcomes, and to determine individual factors that indicate who might benefit from elevation-based interventions.

PsyArXiv [preprint]
Adam P. McGuire
Adam P. McGuire
Assistant Professor of Psychology