Network analysis of emotion regulation and moral injury symptoms among medical staff.

Current research indicates that medical staff frequently experience potentially morally injurious events, leading to moral injury (MI), which is associated with adverse physical and mental health as well as occupational burnout. Using the conceptual model of MI, this study investigated the symptom-level connections between distinct emotion regulation (ER) strategies—cognitive reappraisal (CR) and expressive suppression (ES)—and MI symptoms among medical staff. Using network analysis, we assessed ER capacities and MI symptoms in a sample of 1,001 medical staff. An ER-MI network was constructed to depict the interplay between these variables, with additional analysis examining gender and professional differences in the ER-MI network characteristics. Results revealed that cognitive reappraisal was negatively correlated with various MI symptoms, while expressive suppression was positively correlated. Several critical connections were identified, such as connections between cognitive reappraisal and Loss of faith, cognitive reappraisal and Loss of trust, and ES and Feeling betrayed. Bridge centrality metrics indicated that cognitive reappraisal had a negative bridge expected influence (BEI) value, whereas expressive suppression had a positive BEI value. Network comparison tests revealed significant gender differences on two specific between-community connections: between cognitive reappraisal and Feeling betrayed and between cognitive reappraisal and Self-condemnation. There was no significant professional difference in ER-MI network characteristics in the current study. These findings may provide novel perspectives for understanding MI through the lens of ER and highlight potential targets for prevention and intervention strategies aimed at medical staff.