Development of a Moral Injury Scale

This research project aimed to develop a scale to identify and assess moral injury in veterans.

About the project

Moral injury is defined as the psychological, biological, spiritual, behavioural and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations. Experiencing an event that goes against moral or ethical beliefs can lead to trauma symptoms, which is distinct from the reaction that typically occurs in PTSD.

This project aimed to develop an outcome scale to identify and assess moral injury in veterans. The project included qualitative interviews with service members, veterans, mental health clinicians and chaplains, followed by cross-nation reliability and validity testing. The project lead to the development of a validated 14-item Moral Injury Outcome Scale (MIOS).

• Moral Injury Outcome Scale (MIOS) Study Summary Report (PDF 2.15 MB)

Open Arms is now exploring embedding the MIOS into their existing suite of outcome measures, to screen and assess clients who have experienced a morally injurious event and inform their treatment and care.

International Collaboration

The project was conducted by Phoenix Australia – Centre for Posttraumatic Mental Health in collaboration with an international consortium. The international consortium consisted of study sites across Australia, the United States, the United Kingdom, Israel, and Canada to ensure cross-country validity.