Measuring symptoms of moral injury in veterans and active duty military with PTSD


Journal Article (Review)

© 2018 by the author. Licensee MDPI, Basel, Switzerland. The Moral Injury Symptom Scale-Military Version (MISS-M) is a 45-item measure of moral injury (MI) symptoms designed to use in Veterans and Active Duty Military with PTSD. This paper reviews the psychometric properties of the MISS-M identified in a previous report, discusses the rationale for the development of the scale, and explores its possible clinical and research applications. The MISS-M consists of 10 theoretically grounded subscales that assess the psychological and spiritual/religious symptoms of MI: guilt, shame, betrayal, moral concerns, loss of meaning/purpose, difficulty forgiving, loss of trust, self-condemnation, spiritual/religious struggles, and loss of religious faith/hope. The scale has high internal reliability, high test-retest reliability, and a factor structure that can be replicated. The MISS-M correlates strongly with PTSD severity, depressive symptoms, and anxiety symptoms, indicating convergent validity, and is relatively weakly correlated with social, spiritual, and physical health constructs, suggesting discriminant validity. The MISS-M is the first multidimensional scale that measures both the psychological and spiritual/religious symptoms of MI and is a reliable and valid measure for assessing symptom severity in clinical practice and in conducting research that examines the efficacy of treatments for MI in Veterans and Active Duty Military personnel.

Full Text

Duke Authors

Cited Authors

  • Koenig, HG

Published Date

  • March 17, 2018

Published In

Volume / Issue

  • 9 / 3

Electronic International Standard Serial Number (EISSN)

  • 2077-1444

Digital Object Identifier (DOI)

  • 10.3390/rel9030086

Citation Source

  • Scopus