Development and evaluation of the Expressions of Moral Injury ScaleMilitary Version
Development and evaluation of the Expressions of Moral Injury ScaleMilitary Version
复制标题
DOI：
10.1002/cpp.2170
复制
发表时间：
2018-05-01
影响因子：
3.6
通讯作者：
Albright, David L.
中科院分区：
文献类型：
--
作者：
Currier, Joseph M.;Farnsworth, Jacob K.;Albright, David L.
人们一致认为，军事人员可能会遇到比研究人员和临床医生历史上所认识到的更加多样化的挑战。道德伤害（MI）代表了一种新兴的结构，以捕捉行为，社会和精神痛苦，可能超越和重叠的精神健康诊断（例如，创伤后应激障碍和重度抑郁症）。精神伤害表达量表军事版（EMIS-M）的开发是为了提供一个可靠和有效的手段，评估军事人口的MI的警告信号。利用独立样本的退伍军人谁曾在战区环境中服役，因素分析结果显示2个不同的因素与MI表达针对自我（9项）和他人（8项）。这些分量表产生了良好的内部一致性和时间稳定性超过6个月。当与创伤后应激障碍、重度抑郁症和其他理论上相关的结构（例如，宽恕，社会支持，道德情感和战斗暴露），EMIS-M分数表现出强大的收敛，发散和增量效度。此外，尽管结构方程模型的研究结果支持了研究2中可能存在的一般MI因素，但自我和他人导向表达的关联模式提供了证据，证明不同形式的宽恕和战斗暴露的有效性存在差异。因此，EMIS-M提供了一个面部有效的，心理测量学验证的工具，用于评估研究和临床环境中明显的MI亚型的表达。展望未来，EMIS-M将有望推进对MI的科学理解，同时支持临床医生的创新，以定制循证治疗和/或开发新的方法来解决MI。
There is consensus that military personnel can encounter a far more diverse set of challenges than researchers and clinicians have historically appreciated. Moral injury (MI) represents an emerging construct to capture behavioural, social, and spiritual suffering that may transcend and overlap with mental health diagnoses (e.g., post-traumatic stress disorder and major depressive disorder). The Expressions of Moral Injury ScaleMilitary Version (EMIS-M) was developed to provide a reliable and valid means for assessing the warning signs of a MI in military populations. Drawing on independent samples of veterans who had served in a war-zone environment, factor analytic results revealed 2 distinct factors related to MI expressions directed at both self (9 items) and others (8 items). These subscales generated excellent internal consistency and temporal stability over a 6-month period. When compared to measures of post-traumatic stress disorder, major depressive disorder, and other theoretically relevant constructs (e.g., forgiveness, social support, moral emotions, and combat exposure), EMIS-M scores demonstrated strong convergent, divergent, and incremental validity. In addition, although structural equation modelling findings supported a possible general MI factor in Study 2, the patterns of associations for self- and other-directed expressions yielded evidence for differential validity with varying forms of forgiveness and combat exposure. As such, the EMIS-M provides a face valid, psychometrically validated tool for assessing expressions of apparent MI subtypes in research and clinical settings. Looking ahead, the EMIS-M will hopefully advance the scientific understanding of MI while supporting innovation for clinicians to tailor evidence-based treatments and/or develop novel approaches for addressing MI in their work.