Abstract
The Moral Injury Symptom Scale-Military Version (MISS-M) is a 45-item measure of moral injury (MI) symptoms designed to use in Veterans and Active Duty Military with PTSD. This paper reviews the psychometric properties of the MISS-M identified in a previous report, discusses the rationale for the development of the scale, and explores its possible clinical and research applications. The MISS-M consists of 10 theoretically grounded subscales that assess the psychological and spiritual/religious symptoms of MI: guilt, shame, betrayal, moral concerns, loss of meaning/purpose, difficulty forgiving, loss of trust, self-condemnation, spiritual/religious struggles, and loss of religious faith/hope. The scale has high internal reliability, high test-retest reliability, and a factor structure that can be replicated. The MISS-M correlates strongly with PTSD severity, depressive symptoms, and anxiety symptoms, indicating convergent validity, and is relatively weakly correlated with social, spiritual, and physical health constructs, suggesting discriminant validity. The MISS-M is the first multidimensional scale that measures both the psychological and spiritual/religious symptoms of MI and is a reliable and valid measure for assessing symptom severity in clinical practice and in conducting research that examines the efficacy of treatments for MI in Veterans and Active Duty Military personnel.
Highlights
Veterans and individuals currently serving in the military often have traumatic experiences while participating in combat operations that place them at risk for post-traumatic stress disorder (PTSD)
This is evident from research showing that PTSD is one of the most common mental disorders suffered by Veterans seen in the U.S Veterans Administration Health System (Hoge and Warner 2014; Fulton et al 2015), and this is true for Active Duty Military personnel (Lane et al 2012)
Be aware that there are interventions out there that may help to relieve Moral injury (MI) whether that occurs in Veterans, Active Duty Military personnel, or even those not in the military who are disabled with PTSD
Summary
Are feelings that combat Veterans often have due to combat experiences. Circle a single number between 1 and 10 for each statement (“a great deal” or “very true” to “not at all” or “very untrue”): Spiritual/Religious Struggles. I wonder whether God had abandoned me. I felt punished by God for my lack of devotion. I wondered what I did for God to punish me. I questioned the power of God. 43. I wondered whether my church had abandoned me. Compared to when you first went into the military has your religious faith since . (“weakened a lot,” “weakened a little,” “strengthened a little,” “strengthened a lot”). Scoring: First, reverse score items 13–16, 17, 21–28, 30–31, 34, 37, and 44–45, and sum all items together (or those of individual subscales if subscale scores are desired).
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