Validation of the Expressions of Moral Injury Scale-Military version-Short Form

Clin Psychol Psychother. 2020 Jan;27(1):61-68. doi: 10.1002/cpp.2407. Epub 2019 Nov 22.

Abstract

Military personnel may encounter morally injurious events that lead to emotional, social, and spiritual suffering that transcend and/or overlap with mental health diagnoses (e.g., post-traumatic stress disorder [PTSD]). Advancement of scientific research and potential clinical innovation for moral injury (MI) requires a diversity of measurement approaches. Drawing on results from the bifactor model in Currier et al.'s (2017) psychometric evaluation of the Expressions of Moral Injury Scale-Military version (EMIS-M), this study validated a four-item short form of the instrument with two samples of veterans with a history of war-zone service. Namely, despite the reduced number of items, the EMIS-M-Short Form (SF) yielded favourable internal consistency and comparable levels of convergent validity with theoretically related constructs (e.g., PTSD and struggles with morality and ultimate meaning) as the full-length version. Notwithstanding the possible utility of distinguishing between self- and other-directed forms of MI, factor analytic results further revealed that the EMIS-M-SF was best conceptualized with a unidimensional factorial model that might allow for a general assessment of MI-related outcomes. Overall, these initial results suggest that the EMIS-M-SF may hold promise as a short, reliable, and valid assessment of overall outcomes related to a possible MI.

Keywords: PTSD; assessment; military trauma; moral injury; service member; veteran.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Military Personnel / psychology*
  • Military Personnel / statistics & numerical data
  • Morals*
  • Psychometrics
  • Reproducibility of Results
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires / standards*
  • United States
  • Veterans / psychology*
  • Veterans / statistics & numerical data
  • Young Adult