Citation

Szabó D, Békés V, Lévay EE, Salgó E, Unoka ZS. Eur. J. Psychotraumatol. 2023; 14(2): e2247227.

Copyright

(Copyright © 2023, The Author(s), Publisher Co-action Publishing)

DOI

10.1080/20008066.2023.2247227

PMID

37650250

Abstract

BACKGROUND: Moral injury emerges when someone perpetrates, fails to prevent, or witnesses acts that violate their own moral or ethical code. Nash et al. [(2013). Psychometric evaluation of the moral injury events scale. Military Medicine, 178(6), 646-652] developed a short measure, the Moral Injury Events Scale (MIES) to facilitate the empirical study of moral injury in the military. Our study aimed to develop a civilian version of the measure (MIES-CV) and examine its psychometric properties in a sample of psychiatric inpatients .

METHODS: In this cross-sectional study, the sample comprised 240 adult patients (71.7% female) with a mean age of 31.57 (SD = 11.69). The most common diagnoses in the sample were anxiety disorders (58.3%), depressive disorders (53.8%), and borderline personality disorder (39.6%). Participants were diagnosed using structured clinical interviews and filled out psychological questionnaires.

RESULTS: Exploratory factor analysis suggested that Nash et al.'s model (Perceived Transgressions, Perceived Betrayals) represents the data well. This two-factor solution showed an excellent fit in the confirmatory factor analysis, as well. Meaningful associations were observed between moral injury and psychopathology dimensions, shame, reflective functioning, well-being, and resilience. The Perceived Betrayals factor was a significant predictor of bipolar disorders, PTSD, paranoid personality disorder, borderline personality disorder, and avoidant personality disorder.

CONCLUSIONS: Our study demonstrated that this broad version of the MIES is a valid measure of moral injury that can be applied to psychiatric patients.

Language: en

Keywords

Adult; Humans; Female; Male; Cross-Sectional Studies; reliability; validity; Personality; moral injury; Personality Disorders; Psychometrics; *Non-alcoholic Fatty Liver Disease; *Stress Disorders, Post-Traumatic/diagnosis; Daño moral; Escala de Eventos de Daño Moral–Versión Civil MIES-CV; Fiabilidad; MIES-CV; Moral Injury Events Scale–Civilian Version MIES-CV; Pacientes psiquiátricos hospitalizados; personality disorders; psychiatric inpatients; Trastornos de personalidad; Validez; 人格障碍; 可靠性; 有效性; 精神病住院患者; 道德伤害