Currier Joseph M, Holland Jason M, Drescher Kent, Foy David
Psychology Department, University of South Alabama, Mobile, AL, USA; Fuller Theological Seminary, Graduate School of Psychology, Pasadena, CA, USA.
Clin Psychol Psychother. 2015 Jan-Feb;22(1):54-63. doi: 10.1002/cpp.1866. Epub 2013 Sep 10.
Moral injury is an emerging construct related to negative consequences associated with war-zone stressors that transgress military veterans' deeply held values/beliefs. Given the newness of the construct, there is a need for instrumentation that might assess morally injurious experiences (MIEs) in this population. Drawing on a community sample of 131 Iraq and/or Afghanistan Veterans and clinical sample of 82 returning Veterans, we conducted an initial psychometric evaluation of the newly developed Moral Injury Questionnaire-Military version (MIQ-M)-a 20-item self-report measure for assessing MIEs. Possibly due to low rates of reporting, an item assessing sexual trauma did not yield favourable psychometric properties and was excluded from analyses. Veterans in the clinical sample endorsed significantly higher scores across MIQ-M items. Factor analytic results for the final 19 items supported a unidimensional structure, and convergent validity analyses revealed that higher scores (indicative of more MIEs) were correlated with greater general combat exposure, impairments in work/social functioning, posttraumatic stress and depression in the community sample. In addition, when controlling for demographics, deployment-related factors and exposure to life threat stressors associated with combat, tests of incremental validity indicated that MIQ-M scores were also uniquely linked with suicide risk and other mental health outcomes. These findings provide preliminary evidence for the validity of the MIQ-M and support the applicability of this measure for further research and clinical work with Veterans.
Military service can confront service members with experiences that undermine their core sense of humanity and violate global values and beliefs. These types of experiences increase the risk for posttraumatic maladjustment in this population, even when accounting for rates of exposure to life threat traumas. Moral injury is an emerging construct to more fully capture the many possible psychological, ethical, and spiritual/existential challenges among persons who served in modern wars and other trauma-exposed professional groups. There is currently a need for psychometrically sound instrumentation for assessing morally injurious experiences (MIEs). The Moral Injury Questionnaire - Military Version (MIQ-M) was developed to provide a tool for assessing possible MIEs among military populations. This study provides preliminary evidence of the validity - including factorial, concurrent, and incremental - and clinical utility of the MIQ-M for further applications in clinical and research contexts.
道德损伤是一种新出现的概念，与战区应激源相关的负面后果有关，这些应激源违背了退伍军人根深蒂固的价值观/信念。鉴于这一概念尚新，需要有能够评估这一人群道德损伤经历（MIEs）的工具。我们以131名伊拉克和/或阿富汗退伍军人的社区样本以及82名返乡退伍军人的临床样本为基础，对新开发的《道德损伤问卷 - 军事版》（MIQ - M）进行了初步心理测量评估，这是一种用于评估MIEs的20项自我报告量表。可能由于报告率较低，一项评估性创伤的条目未产生良好的心理测量特性，因此被排除在分析之外。临床样本中的退伍军人在MIQ - M各条目上的得分显著更高。对最终19个条目的因素分析结果支持单维结构，收敛效度分析表明，更高的分数（表明更多的MIEs）与社区样本中更多的一般战斗暴露、工作/社会功能受损、创伤后应激障碍和抑郁相关。此外，在控制人口统计学、与部署相关的因素以及与战斗相关的生命威胁应激源暴露情况后，增量效度检验表明，MIQ - M得分也与自杀风险和其他心理健康结果有独特关联。这些发现为MIQ - M的效度提供了初步证据，并支持该量表在退伍军人进一步研究和临床工作中的适用性。
军事服役可能使军人面临破坏其核心人性观念并违背全球价值观和信念的经历。即使考虑到生命威胁创伤的暴露率，这类经历也会增加这一人群创伤后适应不良的风险。道德损伤是一个新出现的概念，旨在更全面地捕捉现代战争及其他遭受创伤的专业群体中人员可能面临的诸多心理、伦理和精神/生存挑战。目前需要心理测量健全的工具来评估道德损伤经历（MIEs）。《道德损伤问卷 - 军事版》（MIQ - M）的开发旨在为评估军人中可能存在的MIEs提供一种工具。本研究为MIQ - M在临床和研究背景下进一步应用提供了效度（包括因素效度、同时效度和增量效度）及临床效用的初步证据。
