Examining the Overlap between Moral Injury and PTSD in US Veterans and Active Duty Military

Harold G. Koenig, Nagy A. Youssef, Donna Ames, Ellen J. Teng, Terrence D. Hill

Research output: Contribution to journalArticle

Abstract

Moral injury (MI) is a syndrome thought to be separate from posttraumatic stress disorder (PTSD), yet having some overlap. To determine the overlap, we examined the relationship between MI and the four DSM-5 PTSD symptom clusters (B, C, D, E) in US veterans and active duty military (ADM). The 45-item Moral Injury Symptom Scale (MISS-M) was administered to 591 veterans and ADM who had served in a combat theater and had PTSD symptoms. PTSD symptoms were measured with the PTSD Symptom Checklist-5, which assesses the four PTSD symptom clusters. Total MISS-M scores were more strongly associated with PTSD symptom cluster D (negative cognitions and emotions) in both bivariate and multivariate analyses. Findings for a 10-item version of the MISS-M (MISS-M-SF) closely followed those of the MISS-M. Although the overlap between MI and PTSD occurs to some extent across all PTSD symptoms clusters, the largest overlap tends to be with the negative cognitions and emotions cluster.

Original languageEnglish (US)
Pages (from-to)7-12
Number of pages6
JournalJournal of Nervous and Mental Disease
Volume208
Issue number1
DOIs
StatePublished - Jan 1 2020

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Veterans
Post-Traumatic Stress Disorders
Wounds and Injuries
Cognition
Emotions
Checklist
Multivariate Analysis

Keywords

  • active duty military
  • Moral injury
  • overlap
  • posttraumatic stress disorder
  • symptom clusters
  • veterans

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Examining the Overlap between Moral Injury and PTSD in US Veterans and Active Duty Military. / Koenig, Harold G.; Youssef, Nagy A.; Ames, Donna; Teng, Ellen J.; Hill, Terrence D.

In: Journal of Nervous and Mental Disease, Vol. 208, No. 1, 01.01.2020, p. 7-12.

Research output: Contribution to journalArticle

Koenig, Harold G. ; Youssef, Nagy A. ; Ames, Donna ; Teng, Ellen J. ; Hill, Terrence D. / Examining the Overlap between Moral Injury and PTSD in US Veterans and Active Duty Military. In: Journal of Nervous and Mental Disease. 2020 ; Vol. 208, No. 1. pp. 7-12.
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