# Measuring Moral Injury Events in Veterans and Soldiers

> **NIH VA IK1** · OLIN TEAGUE VETERANS CENTER · 2020 · —

## Abstract

Service Members often describe their worst military-based traumas as the confrontation with
unresolvable moral dilemmas that rattle their fundamental sense of self. Moral Injury is the debilitating
syndrome that indexes the psychiatric and functional impairment associated with these military-based
traumas. The objective of this study is to improve the measurement of the moral injury construct by
evaluating two moral injury event questionnaires (i.e., Moral Injury Events Scale [MIES]1 and Moral Injury
Questionnaire-Military Version [MIQM]2) and refining these instruments by creating new measures of
moral injury events and mechanisms using items from the MIES and MIQM. This study will conduct
secondary analysis on data from two longitudinal parent studies: a Department of Veterans Affairs (VA)
Veterans Integrated Service Network 17 Center of Excellence (CoE) study of Iraq and Afghanistan War
Veterans (N = ~500) and a Department of Defense (DoD) Walter Army Institute of Research (WRAIR)
study of active duty Soldiers (N = ~800). Data on the MIES and MIQM, along with a set of theoretically
relevant predictors and outcomes, are being collected at two time points approximately eight months
apart in the Veteran and Soldier samples, and will be ready to analyze by spring 2017 and spring 2018
for the Soldier and Veteran samples, respectively. This objective will be accomplished by pursuing three
specific aims: 1) the occurrence of moral injury events and mechanisms will be assessed using item-
level analysis of the MIES and MIQM; 2) the dimensionality of the MIES, MIQM, and new refined
measures that disaggregate moral injury event and mechanism items on both measures will be tested
using expert review, exploratory factor analysis, confirmatory factor analysis, and graded response (item
response theory) analysis. The reliability and construct validity of the MIES, MIQM, and new measures
of moral injury events and mechanisms will be evaluated using correlational coefficients, multiple
regressions, and structural equation models. 3) Empirically driven recommendations for assessing moral
injury events and mechanisms will be developed and disseminated throughout the VA and DoD.
 This Career Development Award -1 (CDA-1) will provide Dr. Frankfurt with the support needed to
move her towards her career goal of being an independent VA clinical research scientist with a focus in
military trauma-related sequelae including moral injury and aim to improve post-deployment
reintegration. To achieve this goal, Dr. Frankfurt’s training plan includes VA psychology leadership
training and professional development training. Specific training goals for the proposed CDA-1 include:
(1) Mentorship in psychometrics, assessment, and measurement construction; (2) Mentorship in
advanced interdisciplinary clinical and theoretical domains relevant to moral injury; and (3) Mentorship in
project administration, grantsmanship, and research in the VA and DoD, and how to conduct research in...

## Key facts

- **NIH application ID:** 9879631
- **Project number:** 5IK1RX002427-03
- **Recipient organization:** OLIN TEAGUE VETERANS CENTER
- **Principal Investigator:** Sheila Frankfurt O'Brien
- **Activity code:** IK1 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-04-01 → 2021-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9879631

## Citation

> US National Institutes of Health, RePORTER application 9879631, Measuring Moral Injury Events in Veterans and Soldiers (5IK1RX002427-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9879631. Licensed CC0.

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