Executive Division, National Center for PTSD.
Center for Mental Healthcare & Outcomes Research, Health Services Research and Development Service.
Psychol Trauma. 2024 Feb;16(2):280-291. doi: 10.1037/tra0001533. Epub 2023 Jun 22.
The concept of moral injury resonates with impacted populations, but research has been limited by existing measures, which have primarily focused on war veterans and asked about exposure to potentially morally injurious events (PMIEs) rather than PMIE exposure outcomes. Our goal was to develop and examine the psychometric properties of the Moral Injury and Distress Scale (MIDS), a new measure of the possible emotional, cognitive, behavioral, social, and/or spiritual sequelae of PMIE exposure.
The MIDS was validated by surveying three groups: military veterans, healthcare workers, and first responders ( = 1,232).
Most respondents (75.0%; = 924) reported PMIE exposure. Analyses yielded 18 items that contributed to a single latent factor representing moral distress with fully or partially invariant configurations, loadings, and intercepts across occupational groups. The MIDS full-scale score demonstrated excellent internal consistency (α = .95) and moderate 2-week stability ( = .68, < .001, = 155). For convergent validity, associations between the MIDS and PMIE exposure measures, as well as putative indicators of moral injury (e.g., guilt, shame), were positive and large ( = .59-.69, < .001), as were correlations with posttraumatic stress, depressive, and insomnia symptoms ( = .51-.67, < .001). The MIDS was a stronger predictor of functioning than PMIE exposure measures, explaining seven times greater unique variance (9% vs. 1%-1.3%).
The MIDS is the first scale to assess moral injury symptoms indexed to a specific PMIE that is validated across several high-risk populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
道德伤害的概念引起了受影响人群的共鸣，但研究受到现有测量方法的限制，这些方法主要集中在退伍军人身上，并询问他们是否接触过潜在的道德伤害事件（PMIE），而不是 PMIE 暴露的结果。我们的目标是开发和检验道德伤害和痛苦量表（MIDS）的心理测量特性，这是一种衡量 PMIE 暴露后可能出现的情绪、认知、行为、社会和/或精神后果的新方法。
通过对三组人群进行调查，对 MIDS 进行了验证：退伍军人、医护人员和急救人员（n=1232）。
大多数受访者（75.0%，n=924）报告了 PMIE 暴露。分析得出 18 个项目，这些项目共同构成了一个单一的潜在因素，代表道德痛苦，在职业群体中具有完全或部分不变的结构、负荷和截距。MIDS 总分表现出极好的内部一致性（α=0.95）和适度的 2 周稳定性（r=0.68，p<0.001，n=155）。在收敛效度方面，MIDS 与 PMIE 暴露测量以及道德伤害的假定指标（例如，内疚、羞耻）之间的关联是积极的且较大的（r=0.59-0.69，p<0.001），与创伤后应激、抑郁和失眠症状的相关性也是如此（r=0.51-0.67，p<0.001）。与 PMIE 暴露测量相比，MIDS 是功能的更好预测指标，解释了七倍的独特方差（9%比 1%-1.3%）。
MIDS 是第一个评估特定 PMIE 索引的道德伤害症状的量表，该量表在几个高风险人群中得到验证。（PsycInfo 数据库记录（c）2024 APA，保留所有权利）。
