Examining Moral Injury in Legal-Involved Veterans: Psychometric Properties of the Moral Injury Events Scale.

Background: Veterans comprise about 8% of the incarcerated US population. Legal system involvement may result in exposure to events that violate moral expectations (ie, moral injury). Currently, there are no validated measures for assessing legal-related moral injury.

Methods: The goal of this study was to conduct a psychometric evaluation of an adapted version of the Moral Injury Events Scale (MIES) to assess moral injury among legal-involved individuals. This study collected demographic and clinical data via a semistructured survey. Veterans then completed the original and adapted versions of the MIES, the PTSD Checklist for DSM-5, and Personal Health Questionnaire-9.

Results: One hundred veterans with a history of incarceration completed the MIES and an adapted version for legal-involved persons (MIES-LIP). More than 90% of participants reported potentially morally injurious experiences in the legal context. While confirmatory factor analysis did not support the proposed factor structure of the MIES-LIP, an exploratory factor analysis supported a 2-factor solution characterized by self- and other-directed moral injury.

Conclusions: The MIES-LIP demonstrated strong psychometric properties, including good reliability and convergent validity, suggesting that legal-related moral injury is a salient and distinct phenomenon affecting legal-involved veterans. Future studies should consider the MIES-LIP as a tailored tool for legal-involved veterans.