Abstract
This study assessed the Moral Injury Symptoms Scale – Military Version – Short Form’s (MISS-M-SF) factor structure and construct validity. Participants included 3650 combat-deployed U.S. veterans who answered all 10 MISS-M-SF items from the sixth wave of The Veterans Metric Initiative (TVMI). EFA results suggested a two-factor solution, based on item wording, fit best. CFA results indicated a bifactor model (one general factor and two method factors, based on item wording) fit best. Further investigation revealed that a one-factor model could be used despite the data’s multidimensionality. Item-level analyses revealed four items represented the general factor exceptionally well, potentially simplifying assessment in research and clinical applications. Construct validity was also demonstrated through moderate to high correlations with conceptually related measures.
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Data Availability
All data have been made publicly available at the Inter-University Consortium for Political and Social Research and can be accessed at https://www.icpsr.umich.edu/web/ICPSR/studies/38051/summary. This study was not preregistered.
Notes
All analyses were also performed using unweighted and weighted data. Similar results leading to the same statistical conclusions were found in both; thus, only results using the weighted data are presented.
RMSEA tends to over-reject models with small degrees of freedom (Kenny et al., 2015).
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Funding
The Veterans Metrics Initiative (TVMI) research was managed by the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), and it was collaboratively sponsored by the Bob Woodruff Foundation, Health Net Federal Services, HJF, Lockheed Martin Corporation, Marge and Philip Odeen, May and Stanley Smith Charitable Trust, National Endowment for the Humanities, Northrop Grumman, Prudential, Robert R. McCormick Foundation, Rumsfeld Foundation, Schultz Family Foundation, The Heinz Endowments, U.S. Department of Veterans Affairs Health Services Research and Development Service, Walmart Foundation, and Wounded Warrior Project, Inc. The Clearinghouse for Military Family Readiness at Penn State is the result of a partnership funded by the Department of Defense between the Office of the Deputy Assistant Secretary of Defense for Military Community and Family Policy and the USDA’s National Institute of Food and Agriculture through a cooperative agreement with the Pennsylvania State University. This work leverages funds by the USDA’s National Institute of Food and Agriculture and Hatch Appropriations.
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RPC contributed to conceptualization, formal analysis, methodology, software, visualization, writing, and review and editing. CBR contributed to conceptualization, methodology, project administration, visualization, writing, and review and editing. NRM contributed to data curation, funding acquisition, investigation, methodology, project administration, resources, validation, and review and editing. JAB contributed to investigation, project administration, and review and editing. KJM contributed to review and editing. DFP contributed to funding acquisition, project administration, resources, supervision, and review and editing.
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This study was performed in line with the principles of the Declaration of Helsinki. Ethical approval was obtained from ICF International, Inc. (Date: 03/19/2019/No.: 151636.0.000.00.000).
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Chesnut, R.P., Richardson, C.B., Morgan, N.R. et al. The Moral Injury Symptoms Scale–Military Version–Short Form: Further Scale Validation in a U.S. Veteran Sample. J Relig Health 61, 3384–3401 (2022). https://doi.org/10.1007/s10943-022-01606-5
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DOI: https://doi.org/10.1007/s10943-022-01606-5