A Systematic Review and Meta-Analysis of Moral Injury Outcome Measures

被引：0

作者：

Brandon J. Griffin ^{[1
]}

Larry R. Price ^{[2
]}

Zakery Jenkins ^{[3
]}

Alexis Childs ^{[1
]}

Lauren Tong ^{[1
]}

Rebecca A. Raciborski ^{[2
]}

Marcela C. Weber ^{[1
]}

Jeffrey M. Pyne ^{[2
]}

Shira Maguen ^{[1
]}

Sonya B. Norman ^{[2
]}

Dawne Vogt ^{[1
]}

机构：

[1] Central Arkansas Veterans Healthcare System, Mental Health Service, 2200 Fort Roots Dr, North Little Rock, 72114, AR

[2] University of Arkansas for Medical Sciences, Little Rock, AR

[3] Texas State University, San Marcos, TX

[4] San Francisco VA Health Care System, San Francisco, CA

[5] University of CA – San Francisco, San Francisco, CA

[6] Executive Division at National Center for PTSD, VA White River Junction Healthcare System, White River Junction, VT

[7] University of CA – San Diego, San Diego, CA

[8] Women’s Health Sciences Division at National Center for PTSD, VA Boston Healthcare System, Boston, MA

[9] Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA

来源：

Current Treatment Options in Psychiatry | / 12卷 / 1期

关键词：

Depression; Meta-analysis; Moral injury; Post-traumatic stress disorder; Scale development;

D O I：

10.1007/s40501-024-00342-9

中图分类号：

学科分类号：

摘要：

Purpose of Review: As evidence accumulates for the pernicious effects of exposure to potentially morally injurious events (PMIEs) on mental health, the need for improved measurement of moral injury has grown. This article summarizes the psychometric properties of scales that assess cognitive, emotional, social, and spiritual concerns linked to PMIE exposure and uses meta-analysis to describe associations between these scales and measures of posttraumatic stress and depression. Findings: We reviewed 104 articles reporting results from 110 samples, in which 13 different scales were administered to assess the impacts of PMIE exposure (i.e., moral injury). Overall, the scales exhibited good to excellent internal consistency and moderate to large bivariate associations with posttraumatic stress (r =.63, 95% Confidence Interval [CI] [.55,.71]) and depression (r =.59, 95% CI [.51,.66]). Measures varied as to whether they indexed problems to a specific event, had a unidimensional or multidimensional factor structure, used a unipolar or bipolar response format to record item responses, used a cut score to distinguish moral injury from normative distress, were assessed for sensitivity to change over time, and were validated for use with multiple at-risk populations. Summary: Assessment of moral injury has progressed tremendously. Recent scales extend prior work that focused on whether respondents endorsed PMIE exposure by measuring the potential impacts of an exposure. Mental health clinicians and researchers can use this article to choose a scale that best fits their moral injury measurement needs. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2025.

引用

共 75 条

[1] Litz B.T., Stein N., Delaney E., Lebowitz L., Nash W.P., Silva C., Et al., Moral injury and moral repair in war veterans: a preliminary model and intervention strategy, Clin Psychol Rev, 29, 8, pp. 695-706, (2009)
[2] Maguen S., Griffin B.J., Pietrzak R.H., McLean C.P., Hamblen J.L., Norman S.B., Prevalence of moral injury in nationally representative samples of combat veterans, healthcare workers, and first responders
[3] Maguen S., Griffin B.J., Copeland L.A., Perkins D.F., Finley E.P., Vogt D., Gender differences in prevalence and outcomes of exposure to potentially morally injurious events among post-9/11 veterans, J Psychiatr Res, 130, pp. 97-103, (2020)
[4] Maguen S., Griffin B.J., Vogt D., Hoffmire C.A., Blosnich J.R., Bernhard P.A., Et al., Moral injury and peri- and post-military suicide attempts among post-9/11 veterans, Psychol Med, 53, 7, pp. 3200-3209, (2023)
[5] Maguen S., Nichter B., Norman S.B., Pietrzak R.H., Moral injury and substance use disorders among US combat veterans: results from the 2019–2020 National Health and Resilience in Veterans Study, Psychol Med, 53, 4, pp. 1364-1370, (2023)
[6] Norman S.B., Feingold J.H., Kaye-Kauderer H., Kaplan C.A., Hurtado A., Kachadourian L., Et al., Moral distress in frontline healthcare workers in the initial epicenter of the COVID-19 pandemic in the United States: relationship to PTSD symptoms, burnout, and psychosocial functioning, Depress Anxiety, 38, 10, pp. 1007-1017, (2021)
[7] Norman S.B., Nichter B., Maguen S., Na P.J., Schnurr P.P., Pietrzak R.H., Moral injury among U.S. combat veterans with and without PTSD and depression, J Psych Res, 154, pp. 190-197, (2022)
[8] Currier J.M., Holland J.M., Drescher K., Foy D., Initial Psychometric Evaluation of the Moral Injury Questionnaire-Military Version: Moral Injury Questionnaire, Clin Psychol Psychother, 22, 1, pp. 54-63, (2015)
[9] Nash W.P., Marino Carper T.L., Mills M.A., Au T., Goldsmith A., Litz B.T., Psychometric evaluation of the Moral Injury Events Scale, Mil Med, 178, 6, pp. 646-652, (2013)
[10] Levi-Belz Y., Greene T., Zerach G., Associations between moral injury, PTSD clusters, and depression among Israeli veterans: a network approach, Eur J Psychotraumatol, 11, 1, (2020)

← 1 2 3 4 5 6 7 8 →