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Measuring Civilian Moral Injury – Development, validation and applied use of the Occupational Moral Injury Scale (OMIS) 

Abstract:  Moral Injury (MI) describes profound suffering that stems from repeated or intense involvement in moral violations. It is defined as symptoms that result from involvement in either perpetrating or witnessing actions that violate one’s core beliefs in high stakes situations (Griffin et al., 2019; Litz et al., 2009) or betrayal by a leader or trusted authority (Shay, 2014). MI often appears as pronounced guilt, shame, anger, existential conflict, and loss of trust (Jinkerson, 2016; Yeterian et al., 2019), with secondary symptoms often including depression, anxiety, self-harm, suicidal ideation, substance use, and social problems (Currier et al., 2019; Frankfurt & Frazier, 2016; Griffin et al., 2019; Jinkerson, 2016). While MI frequently overlaps with mental health diagnoses, in particular posttraumatic stress disorder (PTSD), it is considered as distinct from PTSD in both presentation and etiology (Barnes et al., 2019; Bryan et al., 2018; Currier et al., 2019).   

Present day understanding of MI originally arose from research into military trauma and the experiences of soldiers after war, but it is increasingly expanding to broader range of non-military occupational settings in recent years. However, a key barrier to further research into MI in civilian populations has been the lack of valid, reliable measures of the construct appropriate for general civilian or non-military occupational use. My PhD addresses this gap through a series of four studies, developing, refining and then applying the Occupational Moral Injury Scale (OMIS) – a novel measure designed to capture both morally injurious events (MIEs) and primary markers of moral injury (guilt, shame, anger, loss of trust, existential conflict) in any occupational setting, without the need for modification. The OMIS provides a psychometrically validated tool for assessing moral injury risk in any occupational setting. It is currently in use within government Organisations within Canberra, and will help facilitate further research and understanding of how moral injury presents in high-risk occupational settings beyond the military and allow for direct comparison between these groups for the first time. 

Biography: Victoria Thomas is a registered psychologist, clinical registrar and final year clinical PhD student at the Australian National University. Her research explores the construct of moral injury outside the military context, with a focus on scale construction efforts to capture moral injury experiences in occupational settings. In clinical practice she has a key interest in trauma work and is currently practicing in this area.