Why some people struggle more than others with moral violations in the long-term: A belief updating model of moral injury

Exposure to potentially morally injurious events (PMIE) poses a threat to one’s moral beliefs that can lead to prolonged and impairing mental health outcomes (e.g., PTSD, depression, suicidality) related to moral injury (MI). Despite recent advances in MI research, little is known about how the experience of PMIE actually influences mental health outcomes and why some people are more affected by MI than others. Addressing these issues, the present article connects research from clinical science on MI with the basic science literature on belief updating through a cognitive neuroscience lens. In doing so, we propose a novel theoretical model of MI that allows empirically testable hypotheses about when and how PMIE is likely leading to worse long-term MI-related mental health outcomes. In particular, we argue that the integration of PMIE and its effect on an individual’s moral belief system depends on two factors: the perception of the PMIE as a moral violation, and the weight an individual assigns to their prior moral beliefs relative to the weight of the PMIE. We point then to some implications for the understanding, prevention and treatment of MI-related psychopathology. Before we outline some directions for future research on the underpinnings of this model, we develop a new comprehensive experimental research paradigm that allows to empirically study the psychopathology of MI from lab to real-life: the Moral Injury Paradigm (MIP) aimed at stimulating further MI research.