Recontextualising moral injury among military veterans: An integrative theoretical review

Moral injury was originally conceived as a socially-inflicted wound of betrayal experienced by military veterans (Shay, 1994). However, moral injury has since been redefined by psychological researchers as an individualised, predominantly perpetration-driven, and psychopathological phenomenon (e.g., Currier et al., 2015; Jinkerson, 2016). However, social scientific researchers (e.g., Hodgson & Carey, 2017; Molendijk, 2019; Wiinikka-Lydon, 2017) have contested mainstream psychology's medicalisation and decontextualisation of moral injury. This theoretical review integrates insights from across these discourses, and brings them into dialogue with ideas from moral psychology, evolutionary science, and community psychology. The aim of this cross-disciplinary review is to promote a more holistic understanding of moral injury that does justice to its individual and social dimensions. Drawing on these different theoretical strands, this paper proposes that moral injury can be best understood as a psychological wound to basic human needs for social belonging and cohesion. The implications of this integrative understanding of moral injury for applied psychologists and other societal actors are explored. While the relevance of moral injury to civilian populations such as health and social care professionals is clear (e.g., Dombo et al., 2013; French et al., 2021), this paper focuses on military veterans, whose experiences originally prompted the coinage of the term. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.     

Counter‐intuitive moral judgement following traumatic brain injury

Several neurological patient populations, including traumatic brain injury (TBI), appear to produce an abnormally ‘utilitarian’ pattern of judgements to moral dilemmas; they tend to make judgements that maximize the welfare of the majority, rather than deontological judgements based on the following of moral rules (e.g., do not harm others). However, this patient research has always used extreme dilemmas with highly valued moral rules (e.g., do not kill). Data from healthy participants, however, suggest that when a wider range of dilemmas are employed, involving less valued moral rules (e.g., do not lie), moral judgements demonstrate sensitivity to the psychological intuitiveness of the judgements, rather than their deontological or utilitarian content (Kahane et al., Social Cognitive and Affective Neuroscience, 7, 2011, 393). We sought the moral judgements of 30 TBI participants and 30 controls on moral dilemmas where content (utilitarian/deontological) and intuition (intuitive/counter‐intuitive) were measured concurrently. Overall TBI participants made utilitarian judgements in equal proportions to controls; disproportionately favouring utilitarian judgements only when they were counter‐intuitive, and deontological judgements only when they were counter‐intuitive. These results speak against the view that TBI causes a specific utilitarian bias, suggesting instead that moral intuition is broadly disrupted following TBI.     

Moral reasoning,emotion understanding,and callous-unemotional traits in early-to-middle childhood

Relatively little is known about features of moral reasoning among young children with callous-unemotional (CU) traits (e.g., lack of guilt and empathy). This study tested associations between CU traits and emotion attributions (i.e., identification of others’ emotional states) and justifications (i.e., explanations for those emotional states), across social scenarios involving discreet versus salient distress cues. The participants were boys aged 6-to-10 years (N = 50; M_age = 7 years 7 months), who were interviewed about 12 hypothetical scenarios (eight with discreet and four with salient distress cues). Regression models indicated that CU traits, in interaction with high levels of antisocial behaviour, were associated with reduced emotion attributions of fear in discreet but not salient immoral scenarios. Higher CU traits were also associated with reduced justifications referencing others’ welfare in discreet scenarios, and increased references to action-orientated justifications in salient scenarios. These findings suggest that CU traits are associated with early moral reasoning impairments and that salience of distress may be important to these processes.     

How does culture shape our moral identity? Moral foundations in Saudi Arabia and Britain

North American measures of moral identity (MI) assume that caring and fairness are the most prototypical features of morality. Moral foundations theory describes such individualising foundations of morality as dominant in individualist cultures and binding foundations of morality as more particular to collectivist cultures. We weighed the criticism that moral identity scales are guilty of “liberal ethnocentrism” in two studies drawing on participants in the UK and Saudi Arabia. Only individualising traits were prototypical of concepts of moral people in Britain, while individualising and binding traits were both prototypical of such concepts in Saudi Arabia (Study 1, N = 160). In Study 2 (N = 539), participants completed the moral identity scale following typical instructions that referred to the prototypical traits of one of five moral foundations. Overall MI scores were lower in Britain than in Saudi Arabia, particularly when instructions described binding traits as characteristics of a moral person. Cross-cultural differences were mediated by the perceived cultural importance attributed to these traits, particularly binding traits. These results justify concerns that existing moral identity scales underestimate important cultural variation in conceptualising moral identity, but justice and caring concerns remain the best single candidates for a universal foundation of human morality.     

Moral Identity Predicts Adherence to COVID-19 Mitigation Procedures Depending on Political Ideology: A Comparison Between the USA and New Zealand

Reducing the spread of infectious viruses (e.g., COVID-19) can depend on societal compliance with effective mitigations. Identifying factors that influence adherence can inform public policy. In many cases, public health messaging has become highly moralized, focusing on the need to act for the greater good. In such contexts, a person's moral identity may influence behavior and serve to increase compliance through different mechanisms: if a person sees compliance as the right thing to do (internalization) and/or if a person perceives compliance as something others will notice as the right thing to do (symbolization). We argue that in societies that are more politically polarized, people's political ideology may interact with their moral identity to predict compliance. We hypothesized that where polarization is high (e.g., USA), moral identity should positively predict compliance for liberals to a greater extent than for conservatives. However, this effect would not occur where polarization is low (e.g., New Zealand). Moral identity, political ideology, and support for three different COVID-19 mitigation measures were assessed in both nations (N = 1,980). Results show that while moral identity can influence compliance, the political context of the nation must also be taken into account.     

Emotional Reactions and Moral Judgment: The Effects of Morally Challenging Interactions in Military Operations

This study explores the association between different types of morally challenging interactions during military deployment and response strategies (e.g., moral justification), as well as the mediating role of moral emotions. Interviews with Dutch servicemen who participated in military operations (e.g., in Afghanistan, Angola; N = 45) were content coded. We found a relationship between local-cultural and team-related interactions and moral justification; these effects were mediated by other-condemning emotions. Similarly, other-condemning emotions mediated the relationship between local-cultural interactions and relativism. This study points at the importance of other-condemning emotions in shaping military reactions to frequently occurring morally challenging interactions.     

Moral psychology of nursing robots: Exploring the role of robots in dilemmas of patient autonomy

Artificial intelligences (AIs) are widely used in tasks ranging from transportation to healthcare and military, but it is not yet known how people prefer them to act in ethically difficult situations. In five studies (an anthropological field study, n = 30, and four experiments, total n = 2150), we presented people with vignettes where a human or an advanced robot nurse is ordered by a doctor to forcefully medicate an unwilling patient. Participants were more accepting of a human nurse's than a robot nurse's forceful medication of the patient, and more accepting of (human or robot) nurses who respected patient autonomy rather than those that followed the orders to forcefully medicate (Study 2). The findings were robust against the perceived competence of the robot (Study 3), moral luck (whether the patient lived or died afterwards; Study 4), and command chain effects (Study 5; fully automated supervision or not). Thus, people prefer robots capable of disobeying orders in favour of abstract moral principles like valuing personal autonomy. Our studies fit in a new era in research, where moral psychological phenomena no longer reflect only interactions between people, but between people and autonomous AIs.     

“Put a Little Love in Your Heart”: Acceptance of Paternalistic and Ally Political Discourses Both Predict Pro-Roma Solidarity Intentions Through Moral Inclusion

The way politicians talk about minorities institutes the normative context of intergroup relations. We investigated how endorsement of different political discourses predicts donation and collective action intentions by majority members toward the Roma in five European countries. The survey was conducted online using samples demographically similar to the populations of Hungary, Slovakia, Romania, France, and Ireland (N = 5,054). First, results showed that accepting paternalistic discourse versus discourse promoting allyship were not distinguishable; both promoted higher moral inclusion which in turn predicted higher prosocial intentions. Second, donations (i.e., immediate relief) and collective action (i.e., social change action) were driven by identical factors. Third, acceptance of openly hostile political discourse neither predicted moral exclusion, nor lower prosocial intentions. In summary, our research provides important evidence that when it comes to Roma—non-Roma relations, the previously established distinction between solidarity intentions that aim to solidify status relations versus bring about social change is completely blurred, presumably because of the social context in which any positive message communicates moral inclusion challenging the hostile status quo.     

What predicts Australian university students' intentions to volunteer their time for community service?

University students represent one target population with great potential to serve as volunteers. The primary focus on describing the characteristics of students who choose to volunteer, however, has resulted in limited understanding of the psychosocial factors impacting on students' decisions to volunteer. To bridge this gap, we used an extension of a well‐known theoretical framework, the theory of planned behaviour (TPB), to predict students' intentions to volunteer for community service. Using content and thematic analysis, we explored also students' motivations and constraints for volunteering. Students (N = 235; M age = 22.09 years) self‐reported their attitude, normative influences, control perceptions, moral obligation, past behaviour, demographic characteristics, and intentions for volunteering via questionnaire. Regression analyses showed that the extended TPB explained 67% of the variance in students' volunteering intentions. In qualitative analyses, themes primarily represented the factors contributing to low efficacy for volunteering (e.g., time constraints). Control perceptions and perceived moral obligations related to volunteering represent important future targets to encourage student volunteering for organisations providing critical services for those most in need.     

Confronting Deep Moral Disagreement: The President's Council on Bioethics,Moral Status,and Human Embryos

The report of the President's Council on Bioethics, Human Cloning and Human Dignity, addresses the central ethical, political, and policy issue in human embryonic stem cell research: the moral status of extracorporeal human embryos. The Council members were in sharp disagreement on this issue and essentially failed to adequately engage and respectfully acknowledge each others' deepest moral concerns, despite their stated commitment to do so. This essay provides a detailed critique of the two extreme views on the Council (i.e., embryos have full moral status or they have none at all) and then gives theoretical grounding for our judgment about the intermediate moral status of embryos. It also supplies an account of how to address profound moral disagreements in the public arena, especially by way of constructing a middle ground that deliberately pays sincere respect to the views of those with whom it has deep disagreements.     

Permitting immoral behaviour: A generalized compensation belief hypothesis

When are we more likely to permit immoral behaviours? The current research examined a generalized compensation belief hypothesis that individuals, as observers, would morally tolerate and accept someone paying forward unfair treatment to an innocent person as a means to compensate for the perpetrator's previously experienced mistreatment. Across five experiments (N = 1107) based on economic games (Studies 1–4) and diverse real-life scenarios (Study 5), we showed that participants, as observing third parties, were more likely to morally permit and engage in the same negative act once they knew about previous maltreatment of the perpetrator. This belief occurred even when the content of received and paid-forward maltreatment was non-identical (Study 2), when the negative treatment was received from a non-human target (Study 3) and when the maltreatment was intangible (e.g. material loss) or relational (e.g. social exclusion; Study 5). Perceived required compensation mediated the effect of previous maltreatment on moral permission (Studies 4 and 5). The results consistently suggest that people's moral permission of immoral behaviours is influenced by perpetrator's previous mistreatment, contributing to a better understanding of the nature and nuances of our sense of fairness and contextualized moral judgement.     

Predicting moral attitudes and antisocial behavior in young team sport athletes: A self‐determination theory perspective

Identifying the factors associated with prosocial and antisocial behaviors in youth sport may provide evidence to inform interventions aimed at promoting prosocial behaviors and minimizing rule transgressions in young athletes. We investigated relations among social‐contextual factors (e.g., social support), personal motivational factors (e.g., psychological need satisfaction and motivation), young athletes’ attitudes toward prosocial (e.g., keeping winning in proportion) and antisocial (e.g., acceptance of cheating and gamesmanship) behaviors, and their actual rule violations during matches in two samples of athletes. Participants in Sample 1 were young team sport athletes (N = 355) and participants in Sample 2 were young male futsal players (N = 296). Athletes in Sample 1 completed validated self‐report measures of perceived autonomy support, basic need satisfaction, and autonomous and controlled motivation from self‐determination theory, moral attitudes, and past cheating behaviors. Athletes in Sample 2 completed identical measures and two additional behavioral measures: athletes’ self‐reported number of yellow cards received during competition in the last 6 months and the number of yellow cards athletes received from referees in the subsequent 2 months from competition records. We found significant relations between psychological need satisfaction and self‐determined motivation, and athletes’ moral attitudes in both samples. These effects held when statistically controlling for past behavior. Importantly, our prospective analysis of Sample 2 indicated that attitudes toward antisocial behaviors predicted athletes’ rule violations during subsequent tournament matches. Findings indicate that promoting autonomous motivation and need satisfaction through autonomy support may foster attitudes toward prosocial behaviors, and minimize rule transgressions, in young athletes.     

Social media reduce users' moral sensitivity: Online shaming as a possible consequence

In this study, we propose that social media reduce users' moral sensitivity through the mediation of the perceived moral intensity of hostile comments, which leads to behavioral consequences for online shaming. Three separate studies were conducted to explore this statement. Study 1 (N = 160) compared moral sensitivity between participants in simulated social media situations and a control group. Study 2 (N = 412) tested the mediating role of perceived moral intensity through self-rated questionnaires. Study 3 (N = 295) examined the behavioral consequences of reduced moral sensitivity on online shaming by manipulating social media and perceived moral intensity. Across these three studies with their different methodologies, we found consistent support for our prediction that social media reduce users' moral sensitivity. Also, our findings shed light on perceived moral intensity as a mediator. As expected, less perceived moral intensity and less moral sensitivity (as serial mediators) induced by social media led to a higher tendency to participate in online shaming. In addition, our research suggests that the harmful effects of social media could be restricted by improving users' perceived moral intensity in the form of reminders. These findings provide novel insights into the underlying mechanism of cyberviolence on social media and also contribute to the literature on the antecedents and consequences of moral sensitivity.     

Maturity is explicit: Self-importance of traits in humanitarian moral identity

Development of humanitarian moral identity may correspond with the growing self-importance of moral traits. This study considered the extent to which moral traits become explicit in novice and expert humanitarian moral identity narratives. Eighty humanitarian caregivers from L’Arche communities were given self-understanding interview prompts to assess temporal (i.e., past, present, and future) and relational expectations. Humanitarian responses were compared to four paragraphs comprised of moral traits (i.e., just, brave, caring, and religious) using a computational knowledge representation model known as latent semantic analysis (Landauer, T., McNamara, D., Dennis, S., & Kintsch, W. (Eds.). (2007). Handbook of latent semantic analysis (University of Colorado Institute of Cognitive Science). Mahwah, NJ: Erlbaum). Consistent with predictions, humanitarian experts displayed more explicitly self-important moral traits than novices on future and romantic partner expectations. Findings suggest that humanitarian development is associated with simulation related to future goal achievement and moral action modeled by close intimates.     

Solidarity across group lines: Secondary transfer effect of intergroup contact,perceived moral distance,and collective action

We tested, in three studies, whether the generalization of contact effects from primary to secondary outgroups—the secondary transfer effect (STE)—occurs for collective action. The results supported a serial mediation model: contact with immigrants by advantaged group members (Italians: Study 1, N = 146, 121 females, M_age = 28.31 years; Study 3, N = 406, 239 females, M_age = 36.35; British people, Study 2, N = 160, 113 females, M_age = 32.31) was associated with lower perceived moral distance toward primary outgroups, which in turn was associated with more positive attitudes and greater collective action intentions toward primary outgroups, and lower perceived moral distance toward secondary outgroups. Lower perceived moral distance toward secondary outgroups and stronger collective action intentions toward the primary outgroup were associated with higher collective action intentions toward secondary outgroups (results were inconsistent for attitudes). We discuss the findings with a focus on how a consideration of perceived moral distance extends current theorizing, and the relevance of generalized prejudice for the STE.     

Eliciting human intelligence: The effects of social exclusion and inclusion on information disclosure

Eliciting information from semicooperative sources presents a major challenge in investigative and intelligence settings. This research examines the role of the human need to belong in individuals' willingness to disclose critical information. We hypothesised that social exclusion would exert a threat to individuals' need to belong and self‐esteem, which would make them strive for social reconnection through sharing information with others. In two experiments (N = 150 and N = 135), social exclusion and inclusion were manipulated before participants were given the opportunity to disclose critical information in a semicooperative game setting (Study 1) or a mock intelligence interview (Study 2). Social exclusion did not influence information disclosure in any of the experiments. Instead, however, social inclusion unexpectedly increased information disclosure in the interview setting. We conclude that prior social experiences can influence the outcome of subsequent interviews, but the precise mechanisms underlying such influence are currently unknown.     

The influence of war on moral judgments about harm

How does war influence moral judgments about harm? While the general rule is “thou shalt not kill,” war appears to provide an exception to the moral prohibition on intentional harm. In three studies (n = 263, n = 557, n = 793), we quantify the difference in moral judgments across peace and war contexts, and explore two possible explanations for the difference. The findings demonstrate that third-party observers judge a trade-off of one life for five as more morally acceptable in war than in peace, especially if the one person is from an outgroup of the person making the trade-off. In addition, the robust difference in moral judgments across “switch” and “footbridge” trolley problems is attenuated in war compared to in peace. The present studies have implications for moral psychology researchers who use war-based scenarios to study broader cognitive or affective processes. If the war context changes judgments of moral scenarios by triggering group-based reasoning or altering the perceived structure of the moral event, using such scenarios to make decontextualized claims about moral judgment may not be warranted.     

I feel you feel what I feel: Perceived perspective‐taking promotes victims' conciliatory attitudes because of inferred emotions in the offender

In the context of bullying in a nursing workplace, we test the argument that an offender's perspective‐taking promotes victim conciliation, mediated by perceived perspective‐taking, that is, the extent to which the victim perceives the offender as taking their perspective. Perceived perspective‐taking facilitates the attribution of moral emotions (remorse, etc.) to the offender, thereby promoting conciliatory victim responses. However, perceived perspective‐taking would be qualified by the extent to which the severity of consequences expressed in the offender's perspective‐taking matches or surpasses the severity for the victim. In Studies 1 and 2 (Ns = 141 and 122, respectively), victims indicated greater trust and/or forgiveness when the offender had taken the victim's perspective. This was sequentially mediated by perceived perspective‐taking and victim's inference that the offender had felt moral emotions. As predicted, in Study 2 (but not Study 1), severity of consequences qualified victims' perceived perspective‐taking. Study 3 (N = 138) examined three potential mechanisms for the moderation by severity. Victims attributed greater perspective‐taking to the offender when the consequences were less severe than voiced by the offender, suggesting victims' appreciation of the offender's generous appraisal. Attributions of perspective‐taking and of moral emotions to the offender may play an important role in reconciliation processes. Key outcome: To the extent that victims perceive the offender as taking their perspective (perceived perspective‐taking), they infer that the offender feels more moral emotions, prompting victims to be more conciliatory. Perceived perspective‐taking benefits from the offender over‐stating the consequences to the victim.     

Exploring everyday experiences of cultural diversity: The construction,validation, and application of the normative multiculturalism scale

The 3-factor structure of the Normative Multiculturalism Scale (NMS)—Contact with Diversity (CD), Multicultural Ideology (MI), and Multicultural Policies and Practices (MPP)—was tested and confirmed with community samples from New Zealand (N = 381) and the United States (N = 311). Correlations with criterion measures (e.g., perceived minority disadvantage and attitudes to diversity) supported the criterion validity of the subscales. NMS factors were then examined as predictors of social connectedness in a British community sample (N = 347). Hierarchical multiple regression revealed that MI predicted general trust, and MI and MPP predicted national attachment. While MPP was associated with greater perceived threat, this relationship was dampened by the joint influences of MI and CD. The research presents a novel perspective on multiculturalism by adopting a normative approach and examining the main and interaction effects of contact with diversity, multicultural ideology, and multicultural policies on interpersonal and intergroup outcomes.     

The role of lay beliefs about group transgressions in acceptance of responsibility for ingroup harm-doing

Denial of responsibility by perpetrator groups is the most common response to group-based transgressions. Refusal to acknowledge responsibility has dire consequences for intergroup relations. In this research we assessed whether shifting lay beliefs about group-based transgressions in general influences acceptance of responsibility for a specific ingroup transgression. In two experimental studies we manipulated lay beliefs about group transgressions as reflecting either a group's stable character (i.e., a global defect construal) or a specific characteristic (i.e., a specific defect construal). Specific defect construals (compared to global defect construals) increased acceptance of ingroup responsibility by increasing group malleability beliefs, but reduced acceptance of ingroup responsibility by reducing the ingroup's perceived moral failure. These effects were moderated by ingroup superiority in Study 1, but not Study 2. We draw implications for our understanding of mechanisms of denial of responsibility, identity threat, and coping with this threat.