Examining the Overlap Between Moral Injury and PTSD in US Veterans and Active Duty Military.

Journal Article (Journal Article)

Moral injury (MI) is a syndrome thought to be separate from posttraumatic stress disorder (PTSD), yet having some overlap. To determine the overlap, we examined the relationship between MI and the four DSM-5 PTSD symptom clusters (B, C, D, E) in US veterans and active duty military (ADM). The 45-item Moral Injury Symptom Scale (MISS-M) was administered to 591 veterans and ADM who had served in a combat theater and had PTSD symptoms. PTSD symptoms were measured with the PTSD Symptom Checklist-5, which assesses the four PTSD symptom clusters. Total MISS-M scores were more strongly associated with PTSD symptom cluster D (negative cognitions and emotions) in both bivariate and multivariate analyses. Findings for a 10-item version of the MISS-M (MISS-M-SF) closely followed those of the MISS-M. Although the overlap between MI and PTSD occurs to some extent across all PTSD symptoms clusters, the largest overlap tends to be with the negative cognitions and emotions cluster.

Full Text

Duke Authors

Cited Authors

  • Koenig, HG; Youssef, NA; Ames, D; Teng, EJ; Hill, TD

Published Date

  • January 2020

Published In

Volume / Issue

  • 208 / 1

Start / End Page

  • 7 - 12

PubMed ID

  • 31738222

Electronic International Standard Serial Number (EISSN)

  • 1539-736X

Digital Object Identifier (DOI)

  • 10.1097/NMD.0000000000001077


  • eng

Conference Location

  • United States