Measuring Civilian Moral Injury: A Comparison of the Psychometric Properties of Three Measures of Moral Injury among the General Population
Moral injury research has been expanded to populations beyond the military in recent years. A key barrier to further research into moral injury in civilian populations is the lack of valid, reliable measures of the construct appropriate for general civilian use. This paper addresses this barrier by exploring the psychometrics of three measures of moral injury in a general civilian sample: the Moral Injury Scale for Youth, and adapted versions of the Moral Injury Events Scale and Expressions of Moral Injury Scale-Military. A sample of civilian women (n = 192) and men (n = 88) completed a battery of questionnaires comprising the above measures, and additional scales designed to capture theoretically-supported correlates of moral pain, psychopathology, and wellbeing. Confirmatory factor analysis found that the factor structure of the three moral injury measures was replicated within our civilian sample. No scale showed significant association with age or gender, indicating discriminant validity. All measures correlated as predicted with measures of psychopathology and wellbeing at the total score level. Correlations of individual subscales with each of these measures were more varied, suggesting conceptual differences in how moral injury is experienced in civilian populations. Despite psychometric support, all three scales required error covariances for certain items to obtain satisfactory model fit and displayed problems in item wording which may inflate internal consistency and warrant further scale construction efforts for this population. Findings indicate that civilian populations also experience moral injury, but that existing measures may have certain problems capturing this effectively.