TY  - JOUR
PY  - 2018//
TI  - Screening for moral injury: the Moral Injury Symptom Scale - Military Version Short Form
JO  - Military medicine
A1  - Koenig, Harold G.
A1  - Ames, Donna
A1  - Youssef, Nagy A.
A1  - Oliver, John P.
A1  - Volk, Fred
A1  - Teng, Ellen J.
A1  - Haynes, Kerry
A1  - Erickson, Zachary D.
A1  - Arnold, Irina
A1  - O'Garo, Keisha
A1  - Pearce, Michelle
SP  - e659
EP  - e665
VL  - 183
IS  - 11-12
N2  - INTRODUCTION: To develop a short form (SF) of the 45-item multidimensional Moral Injury Symptom Scale - Military Version (MISS-M) to use when screening for moral injury and monitoring treatment response in veterans and active duty military with PTSD. <br><br>METHODS: A total of 427 veterans and active duty military with PTSD symptoms were recruited from VA Medical Centers in Augusta, GA; Los Angeles, CA; Durham, NC; Houston, TX; and San Antonio, TX; and from Liberty University, Lynchburg, Virginia. The sample was randomly split in two. In the first half (n = 214), exploratory factor analysis identified the highest loading item on each of the 10 MISS scales (guilt, shame, moral concerns, loss of meaning, difficulty forgiving, loss of trust, self-condemnation, religious struggle, and loss of religious faith) to form the 10-item MISS-M-SF; confirmatory factor analysis was then performed to replicate results in the second half of the sample (n = 213). Internal reliability, test-retest reliability, and convergent, discriminant, and concurrent validity were examined in the overall sample. The study was approved by the institutional review boards and the Research & Development (R&D) Committees at Veterans Administration medical centers in Durham, Los Angeles, Augusta, Houston, and San Antonio, and the Liberty University and Duke University Medical Center institutional review boards. <br><br>FINDINGS: The 10-item MISS-M-SF had a median of 50 and a range of 12-91 (possible range 10-100). Over 70% scored a 9 or 10 (highest possible) on at least one item. Cronbach's alpha was 0.73 (95% CI 0.69-0.76), and test-retest reliability was 0.87 (95% CI 0.79-0.92). Convergent validity with the 45-item MISS-M was r = 0.92. Discriminant validity was demonstrated by relatively weak correlations with social, religious, and physical health constructs (r = 0.21-0.35), and concurrent validity was indicated by strong correlations with PTSD, depression, and anxiety symptoms (r = 0.54-0.58). <br><br>DISCUSSION: The MISS-M-SF is a reliable and valid measure of MI symptoms that can be used to screen for MI and monitor response to treatment in veterans and active duty military with PTSD.<p />  <p>Language: en</p>
LA  - en
SN  - 0026-4075
UR  - http://dx.doi.org/10.1093/milmed/usy017
ID  - ref1
ER  -