Screening for Moral Injury: The Moral Injury Symptom Scale - Military Version Short Form.

Autor: Koenig HG; Departments of Medicine and Psychiatry, Duke University Medical Center, 201 Trent Drive, Durham, NC.; Department of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia.; Department of Pastoral Care, Durham Veterans Affairs Medical Center, 508 Fulton St, Durham, NC., Ames D; Mental Health Service, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA.; David Geffen School of Medicine, University of California, 760 Westwood Plaza, Los Angeles, CA., Youssef NA; Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Charlie Norwood VA Medical Center, 1 Freedom Way, Augusta, GA., Oliver JP; Department of Pastoral Care, Durham Veterans Affairs Medical Center, 508 Fulton St, Durham, NC., Volk F; Department of Counselor Education and Family Studies, School of Behavioral Sciences, Liberty University, 1971 University Blvd, Lynchburg, VA., Teng EJ; Baylor College of Medicine and Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX., Haynes K; South Texas Veterans Healthcare System, 4318 Woodcock Dr #120, San Antonio, TX., Erickson ZD; Research Service, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA., Arnold I; Research Service, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA., O'Garo K; Department of Psychiatry, Duke University Medical Center, 201 Trent Drive, Durham, NC., Pearce M; Department of Family and Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD.
Jazyk: angličtina
Zdroj: Military medicine [Mil Med] 2018 Nov 01; Vol. 183 (11-12), pp. e659-e665.
DOI: 10.1093/milmed/usy017
Abstrakt: 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.
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.
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).
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.
Databáze: MEDLINE
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