Defining and Measuring Moral Injury: Rationale, Design, and Preliminary Findings From the Moral Injury Outcome Scale Consortium

In the current paper, we first describe the rationale for and methodology employed by an international research consortium, the Moral Injury Outcome Scale (MIOS) Consortium, the aim of which is to develop and validate a content‐valid measure of moral injury as a multidimensional outcome. The MIOS Consortium comprises researchers and clinicians who work with active duty military service members and veterans in the United States, the United Kingdom, the Netherlands, Australia, and Canada. We describe the multiphase psychometric development process being conducted by the Consortium, which will gather phenomenological data from service members, veterans, and clinicians to operationalize subdomains of impact and to generate content for a new measure of moral injury. Second, to illustrate the methodology being employed by the Consortium in the first phase of measure development, we present a small subset of preliminary results from semistructured interviews and questionnaires conducted with care providers (N = 26) at three of the 10 study sites. The themes derived from these initial preliminary clinician interviews suggest that exposure to potentially morally injurious events is associated with broad psychological/behavioral, social, and spiritual/existential impacts. The early findings also suggest that the outcomes associated with acts of commission or omission and events involving others’ transgressions may overlap. These results will be combined with data derived from other clinicians, service members, and veterans to generate the MIOS. Resumen Spanish s by Asociación Chilena de Estrés Traumático (ACET) Definiendo y midiendo el daño moral: fundamentos, diseño y resultados preliminares de la escala consorcio de consecuencias del daño moral DEFINIENDO Y MIDIENDO EL DAÑO MORAL En el documento actual, describimos en primer lugar los fundamentos y la metodología empleados por un consorcio internacional de investigación, la Escala Consorcio de consecuencias del daño moral (MIOS en sus siglas en inglés), cuyo objetivo es desarrollar y validar una medida de daño moral con contenido válido y como consecuencias multidimensionales. El Consorcio MIOS está compuesto por investigadores y clínicos que trabajan con miembros del servicio militar activos y veteranos en los Estados Unidos, el Reino Unido, los Países Bajos, Australia y Canadá. Describimos el proceso de desarrollo psicométrico multifase que está llevando a cabo el Consorcio, que recopilará datos fenomenológicos