Nash William P, Marino Carper Teresa L, Mills Mary Alice, Au Teresa, Goldsmith Abigail, Litz Brett T
Boston VA Research Institute, 150 South Huntington Avenue, Boston, MA 02130, USA.
Mil Med. 2013 Jun;178(6):646-52. doi: 10.7205/MILMED-D-13-00017.
Literature describing the phenomenology of the stress of combat suggests that war-zone experiences may lead to adverse psychological outcomes such as post-traumatic stress disorder not only because they expose persons to life threat and loss but also because they may contradict deeply held moral and ethical beliefs and expectations. We sought to develop and validate a measure of potentially morally injurious events as a necessary step toward studying moral injury as a possible adverse consequence of combat. We administered an 11-item, self-report Moral Injury Events Scale to active duty Marines 1 week and 3 months following war-zone deployment. Two items were eliminated because of low item-total correlations. The remaining 9 items were subjected to an exploratory factor analysis, which revealed two latent factors that we labeled perceived transgressions and perceived betrayals; these were confirmed via confirmatory factor analysis on an independent sample. The overall Moral Injury Events Scale and its two subscales had favorable internal validity, and comparisons between the 1-week and 3-month data suggested good temporal stability. Initial discriminant and concurrent validity were also established. Future research directions were discussed.
描述战斗压力现象学的文献表明，战区经历可能导致诸如创伤后应激障碍等不良心理后果，这不仅是因为这些经历使人面临生命威胁和损失，还因为它们可能与根深蒂固的道德和伦理信念及期望相矛盾。我们试图开发并验证一种衡量潜在道德伤害事件的方法，作为将道德伤害作为战斗可能产生的不良后果进行研究的必要步骤。我们在战区部署后的1周和3个月，对现役海军陆战队队员施测了一个由11个项目组成的自我报告道德伤害事件量表。由于项目与总分的相关性较低，剔除了两个项目。其余9个项目进行了探索性因素分析，结果揭示了两个潜在因素，我们将其标记为感知到的违规行为和感知到的背叛行为；在一个独立样本上通过验证性因素分析对这些因素进行了确认。道德伤害事件总量表及其两个分量表具有良好的内部效度，1周和3个月数据的比较表明具有良好的时间稳定性。还建立了初步的区分效度和同时效度。讨论了未来的研究方向。
