Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA; Neuroscience PhD Program, Emory University, USA.
Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, USA; Molecular and Systems Pharmacology PhD Program, Emory University, USA.
J Psychiatr Res. 2024 May;173:326-332. doi: 10.1016/j.jpsychires.2024.03.016. Epub 2024 Mar 16.
Race-related stress (RRS) is an unrecognized source of moral injury (MI)-or the emotional and/or spiritual suffering that may emerge after exposure to events that violate deeply held beliefs. Additionally, MI has not been explored as a mechanism of risk for post-traumatic stress disorder (PTSD) in trauma-exposed civilians. We examined relations among exposure to potentially morally injurious events (moral injury exposure, MIE), related distress (moral injury distress, MID), and RRS in Black Americans. Potential indirect associations between RRS and PTSD symptoms via MID were also examined.
Black Americans (n = 228; 90.4% female; M = 31.6 years. SD = 12.8 years) recruited from an ongoing study of trauma completed measures assessing civilian MIE and MID, RRS, and PTSD. Bivariate correlations were conducted with MIE and MID, and mediation analysis with MID, to examine the role of MI in the relationship between RRS and PTSD symptom severity.
MIE was significantly correlated with cultural (r = 0.27), individual (r = 0.29), and institutional (r = 0.25) RRS; MID also correlated with cultural (r = 0.31), individual (r = 0.31), and institutional (r = 0.26) RRS (ps < 0.001). We found an indirect effect of RRS on PTSD symptoms via MID (β = 0.10, p < 0.005).
All types of RRS were associated with facets of MI, which mediated the relationship between RRS and current PTSD symptoms. MI may be a potential mechanism through which RRS increases the risk for PTSD in Black individuals.
与种族相关的压力（RRS）是一种未被认识到的道德伤害（MI）来源——或者在经历违反深刻信仰的事件后可能出现的情绪和/或精神痛苦。此外，MI 尚未作为创伤暴露的平民创伤后应激障碍（PTSD）的风险机制进行探讨。我们研究了黑人中可能与道德伤害事件（道德伤害暴露，MIE）、相关痛苦（道德伤害痛苦，MID）和 RRS 相关的关系。还研究了 RRS 通过 MID 与 PTSD 症状之间的潜在间接关联。
从一项正在进行的创伤研究中招募的黑人美国人（n=228；90.4%为女性；M=31.6 岁，SD=12.8 岁）完成了评估平民 MIE 和 MID、RRS 和 PTSD 的措施。进行了 MIE 和 MID 的双变量相关，以及 MID 的中介分析，以检验 MI 在 RRS 与 PTSD 症状严重程度之间关系中的作用。
MIE 与文化（r=0.27）、个体（r=0.29）和机构（r=0.25）RRS 显著相关；MID 也与文化（r=0.31）、个体（r=0.31）和机构（r=0.26）RRS 相关（ps<0.001）。我们发现 RRS 通过 MID 对 PTSD 症状有间接影响（β=0.10，p<0.005）。
所有类型的 RRS 都与 MI 的各个方面相关，这中介了 RRS 与当前 PTSD 症状之间的关系。MI 可能是 RRS 增加黑人个体 PTSD 风险的潜在机制。
