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Network analysis of emotion regulation and moral injury symptoms among medical staff
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  • Published: 24 January 2026

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

  • Yu Zhou1,2,
  • Wenke Zhu1,2,
  • Jun Wang1,2,
  • Kuiliang Li3,
  • Rui Zhi1,2,
  • Lu Zhao1,2,
  • Lijun Hao4,
  • Yusen Han1,2,
  • Jie Wang1,2,
  • Qianyu Wang1,2,
  • Xinyi Wang1,2,
  • Yue Cui1,2,
  • Weiguo Wang4,
  • Jing Chen5 &
  • …
  • Lei Ren1,2 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Health care
  • Psychology

Abstract

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.

Data availability

The data from this study can be obtained by requesting it from the corresponding author. Due to privacy or ethical restrictions, the data is not publicly available.

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Acknowledgements

We would like to thank all the individuals who participated in the study.

Funding

This study was funded by Dr. Lei Ren’s Start-up Fund (a special research initiation grant for new faculty) at Logistics University of PAP (HQXY-2025-BS-001).

Author information

Authors and Affiliations

  1. Military Psychology Section, Logistics University of PAP, Tianjin, 300309, China

    Yu Zhou, Wenke Zhu, Jun Wang, Rui Zhi, Lu Zhao, Yusen Han, Jie Wang, Qianyu Wang, Xinyi Wang, Yue Cui & Lei Ren

  2. Military Mental Health Services & Research Center, Tianjin, 300309, China

    Yu Zhou, Wenke Zhu, Jun Wang, Rui Zhi, Lu Zhao, Yusen Han, Jie Wang, Qianyu Wang, Xinyi Wang, Yue Cui & Lei Ren

  3. School of Psychology, Shaanxi Normal University, Xi’an, 710062, China

    Kuiliang Li

  4. Department of Basic Courses, Logistics University of PAP, Tianjin, 300309, China

    Lijun Hao & Weiguo Wang

  5. Department of Nursing, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, 350025, China

    Jing Chen

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Contributions

Yu Zhou, Wenke Zhu and Lei Ren conceptualized the study and drafted the manuscript. Yu Zhou, Jun Wang, Kuiliang Li, Weiguo Wang, Jing Chen and Lei Ren completed the data collection work. Wenke Zhu, Kuiliang Li and Lei Ren undertook the statistical analysis. Kuiliang Li, Rui Zhi, Lu Zhao, Lijun Hao, Yusen Han, Jie Wang, Qianyu Wang, Xinyi Wang, Yue Cui, Weiguo Wang, Jing Chen revised the manuscript. Each author has thoroughly reviewed the draft and given their approval for the final version of the manuscript. All authors accepted responsibility for the entirety of the research presented.

Corresponding authors

Correspondence to Weiguo Wang, Jing Chen or Lei Ren.

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Cite this article

Zhou, Y., Zhu, W., Wang, J. et al. Network analysis of emotion regulation and moral injury symptoms among medical staff. Sci Rep (2026). https://doi.org/10.1038/s41598-026-35438-0

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  • Received: 11 August 2025

  • Accepted: 06 January 2026

  • Published: 24 January 2026

  • DOI: https://doi.org/10.1038/s41598-026-35438-0

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Keywords

  • Medical staff
  • Emotion regulation
  • Moral injury
  • Gender differences
  • Network analysis
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