A new study has shed light on the impact of potentially morally injurious events (PMIE) on the mental health of aid workers. The study, published in the journal Traumatology, found that PMIE were a significant risk factor for PTSD, depression, and posttraumatic growth among aid workers. Furthermore, the study identified negative cognitions and self-care as important mechanisms in the relationship between PMIE and mental health outcomes. The findings were published in Frontiers in Psychology.
PMIE are events that violate one’s deeply held moral values or beliefs, and can cause significant inner conflict and psychological distress. Although PMIE have been recognised as an important psychological risk factor in many high-risk occupational groups, this study is the first to investigate their impact on the mental health of aid workers.
The study recruited 243 aid workers who had completed at least one aid assignment. Participants completed an online questionnaire about their PMIE, trauma history, and mental health. A structural equation model was constructed to examine the roles of negative cognitions and subsequent self-care behaviours in the relationship between PMIE and PTSD symptoms, depression symptoms, and posttraumatic growth, above and beyond the contribution of potentially traumatic events.
The study found that 81.1% of aid workers had been exposed to PMIE, with other-related PMIE being much more prevalent (75.3%) than betrayal-related PMIE (27.4%) and self-related PMIE (22.8%). All participants had experienced at least one potentially traumatic event, with the mean number of events being 16.39. The study also found that 19.3% of participants reported clinical PTSD, and 24.2% reported clinical depression.
The results of the study suggest that negative cognitions play a significant role in the relationship between PMIE and PTSD and depression symptoms. The study found that the indirect effect through negative cognitions fully accounted for the associations between PMIE and symptoms of PTSD and depression. For the association between PMIE and posttraumatic growth, two indirect effects emerged: the first through negative cognitions and subsequent self-care, and the second through self-care alone.
The study’s authors suggest that psychoeducation could be helpful in preparing aid workers for PMIE and in providing them with coping skills. They also suggest that aid organisations could provide guidance on practising self-care and training for leadership roles about PMIE and signs of moral injury to look out for in colleagues. Mental health professionals who assist aid workers should also consider PMIE in their initial assessments and open the discussion about PMIE, as disclosure of PMIE may be challenging for many.
The study highlights the importance of addressing PMIE as a risk factor for mental health among aid workers. The findings suggest that negative cognitions and self-care are important mechanisms in the relationship between PMIE and mental health outcomes, and that interventions aimed at addressing these mechanisms could be helpful in preventing PMIE from leading to enduring distress. Further research is needed to explore the impact of PMIE on aid workers’ mental health and to identify effective interventions to support aid workers in coping with PMIE.