Gratitude as a Moderator of PTSD Symptoms and Health-Related Quality of Life Associated with Potentially Morally Injurious Events in First Responders

First responders may experience potentially morally injurious events (PMIEs) due to the nature of their occupation. Furthermore, gratitude has been shown to buffer the effect of traumatic events on PTSD symptoms. The current study seeks to address gaps in the literature by 1) establishing that PMIEs exist in a first responder population, 2) examining the association of PMIEs with PTSD symptoms and health related quality of life (HRQoL) in a first responder population, and 3) investigating gratitude as a moderator of PMIEs’ association with PTSD symptoms and HRQoL. 294 participants were recruited from multiple first responder agencies/departments within southeastern Texas (in-person) and nationwide (online). Participants completed the Moral Injury Events Scale (MIES), the Posttraumatic Stress Checklist for Civilians (PCL-C), the Gratitude, Resentment, and Appreciation Short Form (GRAT-S), and a modified version of the SF-12 v.2. Average rates of PMIEs in first responders were higher than military samples with an overall average of 40.65% for the sample. Regression analyses indicate PMIEs are significantly associated with PTSD symptoms in first responders (β = .39, p < .001), but gratitude was not a significant moderator of PMIEs’ association with PTSD symptoms or HRQoL. We discuss potential treatment approaches for first responders who have experienced PMIEs as well as potential outreach strategies to increase access to mental healthcare.